skip to main content

Preeclampsia with severe features — MCCQE Part 1 MCQ

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

ModeratePregnancyPreeclampsia with severe featuresMCCQE Part 1

31-year-old woman at 34 weeks' gestation presents with headache and right upper-quadrant pain. BP is 168/112 mmHg, platelets are low and urine protein is positive. Which of the following is the most appropriate next step?

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

Reveal the answer and explanation

Correct answer: E — Admit, give magnesium sulphate, control BP and plan delivery with obstetrics

Admit, give magnesium sulphate, control BP and plan delivery with obstetrics is best because severe hypertension with symptoms and thrombocytopenia indicates preeclampsia with severe features. Discharge without pregnancy-specific safety-netting is suboptimal because pregnancy-related bleeding, pain or hypertension can deteriorate quickly; Perform a digital vaginal examination before excluding placenta previa or instability is suboptimal because digital examination can precipitate haemorrhage when placenta previa is possible; Use a medication contraindicated in pregnancy as first-line therapy is suboptimal because maternal treatment must account for fetal safety and gestational age; Delay obstetric or gynaecologic consultation despite red flags is suboptimal because specialist involvement is needed when maternal or fetal risk is present. Definitive treatment is delivery, balanced against gestational age and maternal stability.

Reference: SOGC Guideline No. 426