A primigravida at 37 weeks has gestational hypertension progressing to pre-eclampsia without severe features: BP 148/96 mmHg on two readings, proteinuria 300 mg/24 hours, normal platelets, liver enzymes, and creatinine. The cervix is favorable. What is the best next step?

• A Continue expectant management until 40 weeks with weekly monitoring
• B Antenatal corticosteroids and delivery at 39 weeks
• C Elective cesarean section
• D Induction of labor ✓

Explanation

For pre-eclampsia without severe features diagnosed at or beyond 37 weeks, delivery is recommended because prolongation adds maternal risk without neonatal benefit. With a favorable cervix, induction of labor is appropriate, and cesarean is reserved for obstetric indications. Expectant management until 40 weeks or 39 weeks applies only to pregnancies remote from term under strict surveillance, and corticosteroids offer no benefit at 37 weeks since fetal lung maturity is assumed.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.