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Severe Preeclampsia — DRCOG MCQ

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HardObstetrics & GynecologySevere PreeclampsiaDRCOG

At 35+2 weeks, a nulliparous woman has pre-eclampsia, persistent BP 168/112 mmHg, severe right-upper-quadrant pain and brisk reflexes. Fetal assessment is currently reassuring. Which sequence is most appropriate?

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Correct answer: E — Stabilise severe hypertension, consider magnesium sulfate and plan birth

The best answer is “Stabilise severe hypertension, consider magnesium sulfate and plan birth”. Severe hypertension with maternal symptoms requires emergency admission, prompt antihypertensive treatment, senior obstetric review and consideration of magnesium sulfate. At this gestation and severity, birth is planned after maternal stabilisation; fetal reassurance does not neutralise maternal risk. Immediate unstabilised surgery, outpatient care and late aspirin initiation are unsafe substitutes.

Reference: NICE NG133: Hypertension in pregnancy: https://www.nice.org.uk/guidance/ng133/chapter/recommendations