skip to main content

Severe Pre-eclampsia — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateObstetric AnaesthesiaSevere Pre-eclampsiaFRCA Final

A 30-year-old woman at 34 weeks' gestation is admitted to obstetric critical care with severe pre-eclampsia. Her blood pressure is 178/112 mmHg, platelet count is 95 × 10⁹/L, and she has brisk reflexes with two beats of clonus. According to NICE NG133, which statement about the immediate pharmacological management of her severe hypertension is correct?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Labetalol, given orally or intravenously, is one immediate antihypertensive option.

Explanation lettering: E = shown as A · A = shown as D · D = shown as E

B is correct. NICE NG133 recommends immediate treatment of severe hypertension in critical care with one of labetalol, given orally or intravenously; oral nifedipine; or intravenous hydralazine. It does not specify a universal first-, second- and third-line sequence among these acute options. A and C therefore incorrectly impose a treatment hierarchy. Methyldopa can be used for hypertension in pregnancy but is not among the listed immediate critical-care treatments for severe hypertension. Magnesium sulfate is an anticonvulsant used for eclampsia and seizure prophylaxis in selected women with severe pre-eclampsia; it is not an antihypertensive. This woman's severe features require separate assessment for magnesium sulfate, but urgent antihypertensive treatment remains necessary.

Reference: National Institute for Health and Care Excellence. NG133, Hypertension in pregnancy: diagnosis and management, recommendation 1.8.6, 2019 (updated 2023). https://www.nice.org.uk/guidance/ng133/chapter/recommendations