A 32-year-old primigravida at 32 weeks develops BP 158/106 mmHg, headache, and 24-hour urinary protein of 450 mg. Serum creatinine is 1.3 mg/dL and platelet count is 88,000/µL. Serum AST is 145 IU/L. Which single feature places this case in the 'severe features' category that is NOT merely elevated BP?

• A Proteinuria > 300 mg/24 hours
• B BP ≥ 140/90 mmHg on two occasions
• C Gestational age < 34 weeks
• D Platelet count < 100,000/µL ✓

Explanation

Per ACOG criteria, severe features of pre-eclampsia include platelet count < 100,000/µL, doubling of serum creatinine (> 1.1 mg/dL), severe persistent right upper quadrant pain, pulmonary oedema, new-onset headache unresponsive to medication, and visual disturbances. Proteinuria > 300 mg/24 hours is merely diagnostic of pre-eclampsia, not a severe feature. Gestational age is a prognostic factor, not a severity criterion.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.