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Preeclampsia with severe features — USMLE Step 3 MCQ

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HardOB/GYNPreeclampsia with severe featuresUSMLE Step 3

A 34-year-old woman at 35 weeks' gestation presents with headache and right upper quadrant pain. Blood pressure is 168/110 mm Hg, platelet count is 88,000/mm3, AST is 110 U/L, ALT is 124 U/L, and urine protein-creatinine ratio is 0.6. Fetal testing is reassuring. Which of the following is the most appropriate next step in management?

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Correct answer: E — Magnesium sulfate, antihypertensive therapy, and delivery planning

Severe-range blood pressure with thrombocytopenia and transaminitis indicates preeclampsia with severe features. Management at 35 weeks includes seizure prophylaxis with magnesium, acute BP control, and delivery after stabilization.

Reference: ACOG Gestational Hypertension and Preeclampsia Practice Bulletin