A 30-year-old primigravida at 32 weeks presents with BP 158/106 mmHg, proteinuria 3+ on dipstick, and serum creatinine 1.4 mg/dL. She has no symptoms. Which feature BEST classifies this as severe pre-eclampsia rather than non-severe?

• A Proteinuria 3+ on dipstick
• B Gestational age of 32 weeks
• C Absence of symptoms
• D Serum creatinine 1.4 mg/dL (doubling of baseline) ✓

Explanation

According to ACOG criteria, severe features of pre-eclampsia include serum creatinine ≥1.1 mg/dL or doubling of baseline creatinine in the absence of other renal disease. A creatinine of 1.4 mg/dL represents impaired renal function, a recognized severe feature. Proteinuria degree alone (even heavy) does not define severity; absence of symptoms does not exclude severe disease; gestational age determines timing of delivery but not severity classification.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.