A 30-year-old primigravida at 34 weeks presents with BP 158/106 mmHg, proteinuria 2+ on dipstick, and severe headache. Her platelet count is 88,000/µL, AST is 110 IU/L, and serum creatinine is 1.4 mg/dL. Which single criterion defines this as severe pre-eclampsia independent of her blood pressure level?
- A Proteinuria ≥ 2+ on dipstick
- B Severe headache unresponsive to analgesics
- C Platelet count < 100,000/µL ✓
- D Gestational age < 34 weeks
Correct answer: C. Platelet count < 100,000/µL
Explanation
Per ACOG 2019 guidelines (Williams Obstetrics 26th edition), thrombocytopenia (platelet count < 100,000/µL) is a stand-alone severe feature of pre-eclampsia regardless of blood pressure level. Headache is a severe symptom but must be 'new onset and not responded to medication' plus be contextually significant. Dipstick proteinuria of 2+ is insufficient alone — quantitative thresholds (≥ 300 mg/24h or protein:creatinine ≥ 0.3) are diagnostic, not severity markers. Gestational age does not determine severity classification.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.