A 32-year-old primigravida at 34 weeks develops severe hypertension (BP 170/115 mmHg), proteinuria 3+, and serum creatinine 1.4 mg/dL. LFTs are normal and platelet count is 98,000/µL. Which feature MOST clearly upgrades this to severe pre-eclampsia according to ACOG 2019 criteria?
- A Proteinuria of 3+
- B Gestational age of 34 weeks
- C Platelet count < 100,000/µL ✓
- D Bilateral leg oedema
Correct answer: C. Platelet count < 100,000/µL
Explanation
ACOG 2019 lists severe features of pre-eclampsia as: systolic BP ≥160 or diastolic ≥110 on two occasions, thrombocytopaenia (platelets < 100,000/µL), renal insufficiency (creatinine > 1.1 mg/dL or doubling of baseline), impaired liver function (transaminases ≥ 2× normal), pulmonary oedema, or new-onset headache unresponsive to medications. Proteinuria quantity alone and oedema are not severe criteria; gestational age does not define severity.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.