Preeclampsia with severe features — DRCOG MCQ

Correct answer: C — Magnesium sulfate for seizure prophylaxis and plan delivery after stabilisation (≥34 weeks)

This patient has preeclampsia with severe features: severe-range blood pressure (≥160 systolic or ≥110 diastolic), significant proteinuria, headache, and right upper-quadrant pain suggesting hepatic involvement. Management is inpatient maternal stabilisation, including urgent treatment of severe hypertension and magnesium sulfate for eclampsia prophylaxis, with fetal assessment and corticosteroids if preterm. Delivery is the definitive treatment: for preeclampsia with severe features, delivery is recommended once maternal status is stabilised at ≥34 weeks, or earlier if maternal or fetal condition deteriorates. Therefore, the best answer is magnesium sulfate for seizure prophylaxis and plan delivery after stabilisation. Outpatient follow-up, expectant management to 37 weeks, ACE inhibitors, or magnesium alone without delivery planning are inappropriate.

Reference: American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 222, Gestational Hypertension and Preeclampsia, 2020: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia