A 24-year-old woman with 36 weeks of pregnancy, suddenly complains of headache and blurring of vision. Her B.P. is 170/110 mm of Hg. Urinary albumin is +++ and fundus examination shows areas of retinal hemorrhage. The line of further management would be:
The patient in the question has BP 170 / 110 mm of Hg (i.e. > 160 / 110 mm), Urine albumin +++, Headache, Blurring of vision and fundal examination shows areas of retinal hemorrhage. All these features point towards severe preeclampsia. Now there is a lot of controversy regarding this question. Some feel cesarean section should be done while others feel induction of labor is the correct answer. Rest all believe anticonulsive therapy with MgSO4 is the option of choice. Putting an end to all the controversies. I am quoting text from the latest edition of High Risk Pregnancy
by Fernando Arias 3/e, p 420 – “If the gestational age is > 34 weeks the best approach is to treat with magnesium sulfate for the prevention of seizures, give antihypertensives to control the blood pressure and deliver by cesarean section or by induction of labor if the cervix is ripe.”
So this leaves no doubt that further line of management in this question is Anticonvulsive therapy. If the question would have been – best management then termination of pregnancy would have been the answer.
Conservative treatment
Anticonvulsive therapy
Induction of labour
Cesarean delivery