A female with 35-week gestation, presents in emergency with complaint of headache and blurring of vision. Her BP is 170/110 mm Hg. How is the patient managed?
## **Core Concept**
The patient presents with symptoms of severe hypertension (high blood pressure) at 35 weeks of gestation, accompanied by headache and blurred vision, which are indicative of preeclampsia with severe features. Preeclampsia is a pregnancy complication characterized by new-onset hypertension and often accompanied by proteinuria after 20 weeks of gestation. The management involves stabilizing the mother and considering delivery of the fetus.
## **Why the Correct Answer is Right**
The correct approach in managing this patient involves immediate stabilization, assessment of the severity of preeclampsia, and decision-making regarding the timing of delivery. For a pregnant woman at 35 weeks gestation with severe preeclampsia (BP ≥160/110 mmHg) and symptoms such as headache and visual disturbances, the recommended management is delivery of the fetus. The stabilization typically involves antihypertensive therapy to control blood pressure and prevent complications such as stroke, but the definitive management at this gestational age is delivery.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option might suggest expectant management, which is generally not recommended for severe preeclampsia at or beyond 34 weeks of gestation due to the risks to both mother and fetus.
- **Option B:** This could imply treatment with certain medications or interventions not directly aimed at delivery, which might delay necessary definitive management.
- **Option C:** Similar to Option A, it might not directly address the need for delivery in a case of severe preeclampsia at 35 weeks gestation.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that in cases of severe preeclampsia at or beyond 34 weeks of gestation, delivery is usually recommended as the definitive management. The decision to deliver is based on balancing the risks of preterm birth against the risks of continuing the pregnancy with severe preeclampsia.
## **Correct Answer:** D. Delivery.