A primigravida at 35 weeks has gestational hypertension with blood pressures around 148/96 mmHg. She has no proteinuria, normal laboratory values, and no severe features. The fetus has normal growth and reassuring biophysical findings. What is the recommended plan regarding timing of delivery?
- A Immediate delivery by induction of labour now
- B Expectant management with surveillance until 37 completed weeks, then delivery ✓
- C Expectant management until 39 weeks regardless of evolution
- D Delivery at 32 weeks if blood pressure crosses 150 systolic
Correct answer: B. Expectant management with surveillance until 37 completed weeks, then delivery
Explanation
Pre-eclampsia without severe features and uncomplicated gestational hypertension are managed expectantly with regular maternal and fetal surveillance until 37 completed weeks of gestation, after which delivery is recommended because expectant care beyond this offers little benefit and increases risk of disease progression and abruptio placentae. Immediate delivery at 35 weeks exposes the neonate to preventable prematurity. Waiting until 39 weeks contradicts the accepted threshold, and 150 systolic is not itself an indication for delivery.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.