A 34-year-old woman with chronic hypertension (on labetalol) since age 28 conceives. At her first-trimester visit, BP is 130/82 mmHg and urinalysis shows no protein. At 28 weeks, her BP rises to 156/102 mmHg and urine protein/creatinine ratio is 0.45. Platelets and liver enzymes remain normal. Which diagnosis best describes her condition?

• A Worsening chronic hypertension
• B Superimposed pre-eclampsia without severe features ✓
• C Gestational hypertension
• D Superimposed pre-eclampsia with severe features

Explanation

In a woman with chronic hypertension, superimposed pre-eclampsia is diagnosed when there is new-onset significant proteinuria (≥300 mg/24 hours or protein/creatinine ratio ≥0.3) after 20 weeks, or a sudden worsening of previously controlled hypertension, or development of severe features. This patient had no proteinuria initially and now has new proteinuria with worsening BP, fulfilling superimposed pre-eclampsia without severe features (platelets and liver enzymes are normal, BP <160/110).

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.