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OBG · Hypertensive disorders: indication for delivery despite prematurity
Sample itemA woman with severe pre-eclampsia at 31 weeks is under expectant management on a high-dependency unit. Which new finding mandates delivery after stabilisation regardless of gestation?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Pulmonary oedema
Expectant management is abandoned for uncontrolled severe hypertension, eclampsia, pulmonary oedema, HELLP, renal failure, abruption or non-reassuring fetal status. The amount of proteinuria alone does not decide timing, and controlled hypertension or a modest weight lag with normal Doppler does not require delivery.
Option by option
A. BP 150/100 mmHg on oral treatment
Blood pressure controlled on treatment can still be managed expectantly.
B. Proteinuria rising to 3 g in 24 hours
The degree of proteinuria alone does not determine the timing of delivery.
C. Pulmonary oedema (correct)
Correct. Pulmonary oedema is a maternal indication for delivery.
D. Estimated fetal weight on the 15th centile
A fetal weight just above the 10th centile is not an indication.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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