A 28-year-old primigravida at 32 weeks develops BP 158/104 mmHg, proteinuria 2+ on dipstick, and serum creatinine 1.3 mg/dL. Which additional laboratory finding would most specifically indicate haematological involvement warranting immediate delivery consideration?
- A Platelet count 85,000/µL with elevated LDH and raised AST ✓
- B Serum uric acid 7.2 mg/dL
- C Haemoglobin 9.8 g/dL with microcytic indices
- D Serum albumin 2.6 g/dL
Correct answer: A. Platelet count 85,000/µL with elevated LDH and raised AST
Explanation
Thrombocytopenia (platelets <100,000/µL), elevated LDH, and elevated liver enzymes together fulfil the haematological criteria for HELLP syndrome, a severe variant of pre-eclampsia. HELLP syndrome is itself an indication for delivery regardless of gestational age. Elevated uric acid and low albumin are common non-specific findings in pre-eclampsia but do not alone mandate immediate delivery; anaemia here suggests iron deficiency rather than haemolysis.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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