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Pre-eclampsia with severe features — MCCQE Part 1 MCQ

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HardPregnancy ComplicationsPre-eclampsia with severe featuresMCCQE Part 1

A 34-year-old woman at 32 weeks' gestation presents with headache, visual scintillation, and right upper-quadrant pain. BP is 168/112 mmHg, platelets are 86 x 10^9/L, ALT is elevated, and urine protein-creatinine ratio is high. What is the most appropriate next step in management?

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Correct answer: E — Give magnesium sulfate and urgent obstetric assessment for delivery planning

Severe hypertension with neurologic symptoms, thrombocytopenia, liver involvement, and proteinuria indicates pre-eclampsia with severe features; magnesium sulfate prevents seizures and urgent obstetric management is required. Outpatient review is unsafe. Warfarin is contraindicated and does not treat pre-eclampsia. Delivery timing depends on maternal-fetal status, but stabilisation and specialist assessment cannot wait.

Reference: SOGC hypertensive disorders of pregnancy guideline