Which of the following women has the greatest risk of developing pre-eclampsia in her current pregnancy?
- A A 24-year-old secundigravida whose first pregnancy was normotensive
- B A 22-year-old primigravida with a body mass index of 23 kg/m2
- C A 28-year-old multigravida who had pre-eclampsia requiring delivery at 32 weeks in her last pregnancy ✓
- D A 35-year-old multigravida with well-controlled hypothyroidism
Correct answer: C. A 28-year-old multigravida who had pre-eclampsia requiring delivery at 32 weeks in her last pregnancy
Explanation
A personal history of pre-eclampsia, especially early-onset disease requiring preterm delivery, is the strongest individual risk factor, with recurrence rates of approximately 15 to 25 percent and much higher for early-onset index disease. Primigravidity and obesity are genuine risk factors, but their magnitude is far smaller than prior affected pregnancy. Well-controlled hypothyroidism carries little additional risk. This hierarchy guides aspirin prophylaxis decisions, since prior early-onset pre-eclampsia places a woman firmly in the high-risk category warranting low-dose aspirin.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.