A 26-year-old primigravida at 34 weeks of gestation presents with blood pressure of 156/104 mmHg on two readings 4 hours apart, and 2+ proteinuria on dipstick. She complains of epigastric pain and visual disturbances. Which of the following is the MOST appropriate next step in her management?

• A Start oral antihypertensive and observe in outpatient
• B Admit and initiate corticosteroids only, plan delivery at 37 weeks
• C Perform immediate cesarean section without magnesium sulfate
• D Administer magnesium sulfate and plan delivery ✓

Explanation

This patient meets criteria for severe features of pre-eclampsia (BP ≥160/110 or proteinuria with severe symptoms such as epigastric pain and visual disturbances). At 34 weeks, the standard management is magnesium sulfate for seizure prophylaxis combined with expedited delivery after maternal stabilization. Corticosteroids are indicated only if delivery is anticipated within 34 0/7 weeks, but the presence of severe features at 34 weeks mandates delivery rather than expectant management.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.