Which of the following best describes 'severe features' of pre-eclampsia according to ACOG criteria that would mandate delivery regardless of gestational age?
- A Proteinuria >300 mg/24 hours
- B New-onset headache unresponsive to medication and not accounted for by alternative diagnoses ✓
- C Blood pressure 140/90 mmHg on two occasions six hours apart
- D Mild pedal edema with normal liver enzymes
Correct answer: B. New-onset headache unresponsive to medication and not accounted for by alternative diagnoses
Explanation
Severe features of pre-eclampsia include systolic BP ≥160 or diastolic BP ≥110 mmHg, thrombocytopenia <100,000/µL, impaired liver function (LFTs twice normal), progressive renal insufficiency (creatinine >1.1 mg/dL), pulmonary edema, and new-onset headache unresponsive to medication. Basic proteinuria >300 mg/24 hours without other severe features is diagnostic of pre-eclampsia but not a severe feature per se. Severe features mandate delivery at ≥34 weeks and immediate delivery consideration <34 weeks.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.