A 32-year-old woman with chronic hypertension conceives. At 22 weeks gestation, she develops proteinuria >300 mg/24 hours, which was absent at booking. Her blood pressure has risen from a baseline of 138/90 to 162/108 mmHg. What is the MOST appropriate diagnosis?

• A Chronic hypertension
• B Gestational hypertension
• C Superimposed pre-eclampsia ✓
• D De novo pre-eclampsia

Explanation

Superimposed pre-eclampsia is diagnosed in a woman with pre-existing chronic hypertension who develops new-onset proteinuria after 20 weeks, or a sudden significant rise in BP in a woman whose hypertension was previously well-controlled. This patient had controlled chronic hypertension and now demonstrates a worsening BP along with new proteinuria, satisfying the criteria. The onset before 34 weeks also portends a more severe course.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.