A pregnant woman at 28 weeks develops pre-eclampsia with severe features. Current ACOG guidance recommends initiating antihypertensive therapy when BP reaches which threshold?
- A ≥140/90 mmHg on two readings 4 hours apart
- B ≥150/100 mmHg persistently
- C ≥160/110 mmHg on two readings within 15–30 minutes ✓
- D ≥170/110 mmHg regardless of symptoms
Correct answer: C. ≥160/110 mmHg on two readings within 15–30 minutes
Explanation
ACOG and current guidelines define the threshold for acute antihypertensive therapy as persistent severe-range BP ≥160/110 mmHg confirmed on two readings within 15–30 minutes, at which point treatment with IV labetalol, IV hydralazine, or oral nifedipine should begin within 30–60 minutes to prevent maternal stroke. The threshold for diagnosing hypertension is ≥140/90, but immediate drug therapy is reserved for the severe range. The CHIPS trial additionally supports tight control even at lower thresholds for long-term maternal outcomes.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.