A primigravida at 32 weeks presents with BP 158/105 mmHg, 2+ proteinuria, and serum sFlt-1/PlGF ratio of 85. According to current evidence and WHO guidelines, which intervention has the strongest evidence for improving maternal-fetal outcome in this scenario?
- A Corticosteroid administration followed by expectant management until 34 weeks if stable ✓
- B Immediate delivery by cesarean section
- C Administration of IV magnesium sulfate for neuroprotection of the fetus
- D Low-dose aspirin 150 mg initiated immediately
Correct answer: A. Corticosteroid administration followed by expectant management until 34 weeks if stable
Explanation
At 32 weeks with severe features of pre-eclampsia, current guidelines recommend corticosteroids (betamethasone) for fetal lung maturation followed by expectant management in a tertiary centre until 34 weeks if the maternal and fetal condition remains stable. Immediate delivery at 32 weeks carries significant neonatal morbidity. Magnesium sulfate is indicated for seizure prophylaxis, not neonatal neuroprotection at this gestation. Aspirin is preventive and not therapeutic. sFlt-1/PlGF >85 confirms severe placental dysfunction.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.