A 32-year-old woman delivered vaginally at 38 weeks. On postpartum day 3, she presents with severe headache, visual disturbances, and blood pressure of 164/108 mmHg. Urine protein is 2+. Which of the following statements about postpartum pre-eclampsia is correct?
- A Postpartum pre-eclampsia most commonly presents within the first 48 hours after delivery
- B Postpartum pre-eclampsia can present up to 6 weeks after delivery, and magnesium sulfate is indicated for seizure prophylaxis in severe cases ✓
- C Magnesium sulfate is not indicated in postpartum pre-eclampsia since the placenta has been delivered
- D Postpartum pre-eclampsia cannot occur beyond 2 weeks after delivery
Correct answer: B. Postpartum pre-eclampsia can present up to 6 weeks after delivery, and magnesium sulfate is indicated for seizure prophylaxis in severe cases
Explanation
Postpartum pre-eclampsia can occur up to 6 weeks after delivery, though most cases present within 48-72 hours. Magnesium sulfate remains indicated for seizure prophylaxis in severe postpartum pre-eclampsia because the pathophysiology persists after placental delivery. Option A is partially true but incomplete. Option D is incorrect as it can occur up to 6 weeks. Option C is incorrect because magnesium sulfate is still indicated.
Reference: Williams Obstetrics, 26th ed.
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