Hypertensive disorders: postpartum pre-eclampsia: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Hypertensive disorders: postpartum pre-eclampsia

Sample item

A woman who had a normal vaginal delivery 5 days ago after an uncomplicated pregnancy presents with a severe headache and blood pressure 168/112 mmHg, with 3+ proteinuria. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Admit, give magnesium sulphate for seizure prophylaxis, and treat the blood pressure with labetalol or nifedipine

Postpartum pre-eclampsia can present up to 6 weeks after delivery, and with severe-range pressure and neurological symptoms it is treated as severe pre-eclampsia. Magnesium sulphate is given to prevent eclampsia, and acute hypertension is treated with labetalol, nifedipine or hydralazine. Delay can result in eclampsia or stroke.

Option by option

  • A. Start an ACE inhibitor and discharge

    An ACE inhibitor does not control an acute emergency and does not replace magnesium prophylaxis.

  • B. Advise paracetamol and discharge

    Analgesia alone ignores a severe hypertensive emergency.

  • C. Reassure because pre-eclampsia ends at delivery

    Pre-eclampsia can first appear or worsen after delivery.

  • D. Admit, give magnesium sulphate for seizure prophylaxis, and treat the blood pressure with labetalol or nifedipine (correct)

    Correct. Postpartum severe pre-eclampsia warrants magnesium and prompt antihypertensive therapy.

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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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Admit, give magnesium sulphate for seizure prophylaxis, and treat the blood pressure with labetalol or nifedipine. Postpartum pre-eclampsia can present up to 6 weeks after delivery, and with severe-range pressure and neurological symptoms it is treated as severe pre-eclampsia.

Why is "Start an ACE inhibitor and discharge" not the answer?

An ACE inhibitor does not control an acute emergency and does not replace magnesium prophylaxis.

Why is "Advise paracetamol and discharge" not the answer?

Analgesia alone ignores a severe hypertensive emergency.

Why is "Reassure because pre-eclampsia ends at delivery" not the answer?

Pre-eclampsia can first appear or worsen after delivery.

What concept does this question test?

It tests Hypertensive disorders: postpartum pre-eclampsia in OBG. Magnesium sulphate is given to prevent eclampsia, and acute hypertension is treated with labetalol, nifedipine or hydralazine. Delay can result in eclampsia or stroke.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hypertensive disorders: postpartum pre-eclampsia?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.