OB/GYN

A 34-year-old woman G2 P0010 presents at 32 weeks gestation for a routine antenatal appointment.

She reports mild headache, but no right upper quadrant pain or visual disturbance. Physical examination is otherwise unremarkable (see lab result). Blood pressure 150/100 mmHg. Urine dipstick Test Result Normal Value: Protein +3 absent. Which of the following is the best next step of management?

  1. A Admission for observation الإجابة الصحيحة
  2. B Admission for induction of labor
  3. C Outpatient appointment in 1 week time
  4. D Admission for immediate cesarean section

الشرح

Core Concept: Preeclampsia without severe features is defined by new-onset hypertension (BP ≥ 140/90 mmHg) and proteinuria or end-organ dysfunction after 20 weeks of gestation, without severe criteria (BP ≥ 160/110, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral/visual disturbances).

Clinical Presentation:

  • Elevated blood pressure and proteinuria.
  • Mild edema, mild headache.
  • Complications: Progression to severe preeclampsia, eclampsia, placental abruption, and fetal growth restriction.

Diagnosis:

  • First-line diagnostic tool: Blood pressure monitoring and urine dipstick for proteinuria.
  • Most accurate (gold standard) test: 24-hour urine protein collection or urine protein-to-creatinine ratio, along with a comprehensive metabolic panel and CBC.

Management:

  • Acute management: Admission for close maternal and fetal observation, serial blood pressure checks, and laboratory evaluation to rule out severe features.
  • Definitive management: Expectant management until 37 weeks gestation, followed by delivery (induction of labor).

40 سؤالاً مجاناً مع حساب

الأسئلة المنشورة هنا عيّنة ثابتة. أنشئ حساباً مجانياً لتتدرب على بنك الأسئلة الكامل، مع تحليل أدائك حسب التخصص وصفحة لمراجعة أخطائك.

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