A 24-year-old woman had an uneventful pregnancy and normal vaginal delivery at term. On day 5 postpartum, she presents with generalized headache, visual blurring, and BP 162/108 mmHg. Urine protein is 2+. What is the most appropriate diagnosis and management priority?
- A Postpartum pre-eclampsia; initiate antihypertensive therapy and magnesium sulfate for seizure prophylaxis ✓
- B Postpartum eclampsia; observe as seizures rarely occur after 48 hours postpartum
- C Cerebral venous thrombosis; urgent CT venography and anticoagulation
- D Idiopathic intracranial hypertension; lumbar puncture and acetazolamide
Correct answer: A. Postpartum pre-eclampsia; initiate antihypertensive therapy and magnesium sulfate for seizure prophylaxis
Explanation
Postpartum pre-eclampsia can present up to 6 weeks after delivery, most commonly within the first 7 days. This woman has hypertension with proteinuria and neurologic symptoms consistent with severe features. Magnesium sulfate is indicated for seizure prophylaxis in severe pre-eclampsia regardless of whether the patient is antenatal or postpartum. Eclampsia can occur postpartum; the risk does not disappear after 48 hours, so observation without treatment is incorrect.
Reference: High Risk Pregnancy: Management Options, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.