A 32-year-old primigravida at 34 weeks presents with headache, visual disturbances, BP 160/110 mmHg, proteinuria 4+ on dipstick, and serum creatinine 1.3 mg/dL. She has no prior seizures. Which feature BEST qualifies this as severe preeclampsia warranting immediate delivery consideration?
- A Proteinuria 4+ on dipstick
- B Gestational age of 34 weeks
- C Serum creatinine 1.3 mg/dL (doubling from baseline) ✓
- D Primigravid status
Correct answer: C. Serum creatinine 1.3 mg/dL (doubling from baseline)
Explanation
According to ACOG 2019/Williams Obstetrics criteria, severe features of preeclampsia include serum creatinine >1.1 mg/dL OR doubling from baseline in the absence of other renal disease — a marker of renal involvement. Proteinuria quantity (3+ or 4+) is no longer used to classify severity; only its presence is required for classical preeclampsia diagnosis. Gestational age and parity are risk factors, not severity classifiers.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.