A 29-year-old woman had severe pre-eclampsia requiring delivery at 32 weeks in her first pregnancy. She is now planning her second pregnancy. Which of the following best describes her recurrence risk for pre-eclampsia in the subsequent pregnancy?

• A Less than 5%, as pre-eclampsia rarely recurs
• B Nearly 100%, as pre-eclampsia always recurs in subsequent pregnancies
• C Approximately 50-60% regardless of gestational age at first occurrence
• D Approximately 15-20% for any pre-eclampsia, and up to 40-50% if the first episode was before 28 weeks ✓

Explanation

The recurrence risk of pre-eclampsia is approximately 15-20% for any pre-eclampsia after one affected pregnancy. If the first episode occurred before 28 weeks, the recurrence risk rises to 40-50%. Early-onset and severe disease carry higher recurrence. Option A underestimates the risk. Option C overestimates the average risk. Option B is incorrect as recurrence is not universal.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.