A primigravida at 34 weeks has gestational hypertension with BP 145/92 mmHg, no proteinuria, and normal laboratory values. Fetus is well with normal Doppler studies. What is the recommended plan?

• A Immediate delivery by cesarean section
• B Start atenolol and continue pregnancy to term
• C Expectant management until 40 weeks regardless of progress
• D Expectant management with weekly surveillance until 37 weeks, then delivery ✓

Explanation

Uncomplicated gestational hypertension developing before 37 weeks is managed expectantly with maternal and fetal surveillance, with delivery recommended at 37 weeks of gestation because the risk of progression to pre-eclampsia rises steeply thereafter. Cesarean is not indicated for hypertension alone since vaginal delivery is preferred when obstetrically feasible. Atenolol is avoided in pregnancy because it crosses into the fetal circulation readily and is associated with fetal growth restriction.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.