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Pre-eclampsia — DRCOG MCQ

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HardAntenatal CarePre-eclampsiaDRCOG

A 35-year-old woman at 31 weeks presents with headache and visual flashing lights. Blood pressure is 158/104 mmHg on repeat measurement and urine dipstick shows 2+ protein. She reports right upper quadrant discomfort. What is the most likely diagnosis?

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Correct answer: A — Pre-eclampsia

Headache, visual symptoms, hypertension and proteinuria after 20 weeks are most consistent with pre-eclampsia. Gestational hypertension lacks proteinuria or systemic features, making it less likely here. HELLP syndrome would require characteristic blood test abnormalities, but the clinical syndrome still mandates urgent assessment. The pearl is that symptoms make this more than a routine blood pressure finding.

Reference: NICE NG133; NICE NG201