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Pre-eclampsia Management — ESENeph MCQ

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HardPregnancy & RenalPre-eclampsia ManagementESENeph

A 28-year-old woman develops pre-eclampsia at 34 weeks gestation. Her creatinine is 110 umol/L (baseline 60 umol/L), BP is 165/105 mmHg, proteinuria is 5 g/day, and platelets are 135 x 10^9/L. Fetal growth is appropriate. What is the definitive management?

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Correct answer: B — Delivery (the only definitive treatment for pre-eclampsia)

The only definitive treatment for pre-eclampsia is delivery of the baby and placenta. NICE NG133 (2019) recommends delivery when pre-eclampsia is diagnosed after 37 weeks, or earlier if there are severe features. At 34 weeks with significant pre-eclampsia (AKI, severe hypertension, heavy proteinuria, thrombocytopenia), delivery should be seriously considered after corticosteroids for fetal lung maturity. IV MgSO4 is given for seizure prophylaxis. ACE inhibitors are contraindicated in pregnancy.

Reference: NICE NG133 2019 – Hypertension in Pregnancy