A 28-year-old primigravida at 34 weeks has BP 158/106 mmHg on two readings 4 hours apart, with 2+ proteinuria. She has no symptoms. The HYPITAT trial evidence supports which initial management strategy?

• A Expectant management until 37 weeks with antihypertensives and close surveillance
• B Corticosteroids followed by delivery within 24 hours regardless of gestational age
• C Immediate delivery is associated with better maternal outcome compared to expectant management at ≥37 weeks ✓
• D Delivery at 34 weeks results in better neonatal outcomes than delivery at 37 weeks

Explanation

The HYPITAT trial showed that in women with gestational hypertension or mild pre-eclampsia at term (≥37 weeks), induction of labour is associated with a better composite maternal outcome compared to expectant management. The trial specifically addressed term pregnancies; at 34 weeks, expectant management with steroids is appropriate. This question tests the correct application of trial evidence to term gestation.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.