For women with cHTN without SI PEC, when is delivery recommended

All except which of the following support the diagnosis of SI PEC?

In addition to cHTN, which conditions are considered high risk for developing PEC?

Which of the following medications is preferred for intrapartum prevention of eclampsia?

Results from randomized controlled trials suggest what benefit is gained from low-dose aspirin use during

pregnancy in women with chronic hypertension?

Which of the following comorbidities is most frequently seen in pregnant women with chronic hypertension?

How should a patient whose blood pressure is 120/80 mm Hg at her annual examination be counseled?

Which of the following blood pressure measurements meets the criteria for “prehypertension” as defined by

the Joint National Committee 7?

28-year-old G3P1102 at 9 weeks' gestation presents

for establishment of prenatal care. Her first pregnancy

was complicated by gHTN at term,

and her second was complicated by iatrogenic preterm

delivery at 36 weeks' gestation for preeclampsia. Her

blood pressure was normal at her postpartum visit

2 years ago but has not been assessed since. Today her

body mass index is 46 kg/m2 and her blood pressure

is 158/96 mm Hg. As instructed, she calls back 2 days

after her visit to report that blood pressures have been

in the 146-160/94-100 mm Hg range at home. In

addition to initiation of an amihypertensive agent,

what is the next step in management of her blood

pressure in this pregnancy?

For women with chronic hypertension, what additional factor further increases the risk?

A 32yo G2P1 is sent to LD&D @ 32 weeks with persistent BPs of 200/120. She has a known history of asthma requiring daily meds and cHTN which has been treated with methyldopa. The most appropriate IV med to control her BP is

A 29yo G1P0 @ 31w with twin gestation is sent to L&D because of elevated BPs. On examination, her BP is 160/100, and she has 3+ proteinuria. Labs show a platelet count of 75k, AST/ALT 120/100, Cr of 1.0. Ultrasound shows both fetuses are appropriately grown and FHT is reactive. Most appropriate next step is

A 34yo G4P3 @ 35 weeks presents to L&D reported decreased fetal movement. She recently moved to the area and has not yet established care. She has all of her OB records documenting her 3 prior cesarean deliveries, one of which was a prior classical cesarean at 28 weeks. Her medical history of significant for pregestational DM that is well controlled and the recent development of PEC w/o SF. Her current pregnancy is complicated by previa with accrete. EFW is at 20%. Based on her clinical findings, the indication for a repeat cesarean delivery before 36 weeks of gestation is

A 27yo G1 with a history of SLE presents at 34 weeks gestation. She reports abdominal pain, nausea, vomiting. Her BP is 150/94, HR 110, and Temp of 100.5F. FHT is reassuring. Urine dipstick shows 2+ protein. A bedside FS glucose is 50. While in triage, the patient becomes confused and disoriented. Lab test that best explains the patient's acute symptoms is

What is the underlying etiology for proteinuria that is seen with preeclampsia?

All EXCEPT which of the following increase a woman’s predisposition to develop preeclampsia syndrome?

The typical blood volume of a gravida at term is 4500 mL. In patients with preeclampsia, which of the

following would be the expected blood volume?

In patients with preeclampsia, limited blood volume expansion during pregnancy a􀁷ects maternal cardiac

function by which mechanism?

Which of the following leads to increased uric acid levels in patients with preeclampsia?

Your patient presents with a BP of 160/104 mm Hg, 3+ proteinuria, and RUQ pain at 36 weeks’ gestation. Following induction of labor, she delivers vaginally. She has

uterine atony, and her estimated blood loss is 1500 mL. Her serum creatinine rises from 0.98 mg/dL

predelivery to 1.42 mg/dL. What is the most likely explanation for this finding?

TheCT is obtained on a postpartum hypertensive patient with confusion. Cerebral edema was diagnosed. All EXCEPT which of the following are indicated treatments in the

management of the patient:

Your patient is admitted to the hospital for evaluation of new-onset hypertension at 30 weeks’

gestation. The patient has blood pressures of 140–150/85–100 mm Hg during the next 5 days. Which of the

following should prompt consideration for premature delivery?

Your obstetrical is admitted to the hospital for evaluation of new-onset hypertension at 30 weeks’

gestation. Three days after admission, the patient develops severe preeclampsia and delivery is indicated.

Sonographic evaluation reveals a cephalic presentation and estimated fetal weight of 1405 g. If labor

induction is attempted, what is the approximate rate of successful vaginal delivery?

What salutary effect does dexamethasone possibly have when used in the treatment of HELLP (hemolysis,

elevated liver enzymes, low platelet count) syndrome?

An eclamptic patient who has received a 4-g loading dose of magnesium sulfate has another seizure. Which

of the following medications can be given as adjuvant anticonvulsant therapy?

What is the target magnesium level when used for eclampsia prophylaxis?

A pregnant patient has a seizure at home and is evaluated by an emergency room physician. He consults with

a neurologist who, after excluding other etiologies for the seizure, makes the diagnosis of eclampsia. The

neurologist recommends phenytoin for eclampsia prophylaxis to the on-call obstetrician. What is the best

response to this recommendation?

Antenatal use of nitroglycerin to control severe maternal hypertension can lead to which of the following

complications?

Preeclampsia is a marker for all EXCEPT which of the following morbidities later in life?

A 29-year-old woman, gravida 1, at 31 weeks of gestation with a twin gestation is sent to the

labor and delivery unit because of elevated blood pressure. On examination, her blood pressure

is 160/100 mm Hg and she has 3+ proteinuria. Laboratory evaluation reveals a platelet count of

75,000 mm3, aspartate aminotransferase of 120 international units/L, alanine aminotransferase

of 110 international units/L, lactate dehydrogenase of 800 international units/L, creatinine of

1.0 mg/dL, and a fibrinogen of 300 mg/dL. Ultrasonography reveals that both fetuses are appropriately

grown and the fetal heart tracings are reassuring. The most appropriate next step is

A 29-year-old woman, gravida 1, presents to your office with a known triplet gestation at 12 weeks of gestation after ovulation induction with clomiphene. She declines multifetal pregnancy reduction. The intervention most likely to improve her pregnancy outcome is

A 24-year-old woman whose last menstrual period was 6 weeks ago presents to the emergency department reporting nausea for the past week and heavy vaginal bleeding for the past 24 hours. Her blood pressure is 140/90 mm Hg, and her heart rate is 120 beats per minute. Physical examination demonstrates a 12-week size uterus and a cervix that is long and closed. Serum β-hCG is

400,000 mIU/mL. Pelvic ultrasonography demonstrates intrauterine tissue with a diffuse mixed echogenic pattern without a distinct placenta and no evidence of fetal tissue. The most likely diagnosis is

A patient comes to your office at 28 weeks of gestation for her 1-hour glucose tolerance test. A

complete blood count is done at the same time. Her platelet count is 95,000/mm3. A repeat platelet

count 6 weeks later is 92,000/mm3. She currently feels well with no recent illnesses. She is healthy

and takes only a prenatal vitamin. Her initial prenatal laboratory results show a platelet count of

287,000/mm3. She has normal blood pressure and her urine dipstick test result is negative for protein.

The most likely diagnosis is

A 30-year-old primigravid woman comes to your office for her first prenatal visit at 12 weeks of

gestation. She has mild hypertension that has been treated with pharmacotherapy for the past year.

She reports first-trimester exposure to an angiotensin converting enzyme (ACE) inhibitor. Her renal

function is normal and she had a negative screen result for diabetes mellitus in the past year. The

most appropriate next step to identify fetal abnormalities associated with ACE inhibitor therapy is

A 26-year-old primigravid woman at 36 weeks of gestation has a platelet count of 62,000/mm3

noted on routine blood work. She does not have a history of thrombocytopenia, easy bruising, menorrhagia,

rash, or joint ache. She has a history of Raynaud phenomenon and chronic hypertension.

Her only medication is prenatal vitamins. Her first-trimester laboratory results include a negative

human immunodeficiency virus (HIV) test and a platelet count of 104,000/mm3. Her blood pressure

is 138/86 mm Hg and she has trace protein in her urine. Her hemoglobin and transaminase levels

are normal. Physical examination is significant for mild pedal edema. The diagnosis that most

likely explains her thrombocytopenia is

A 36-year-old woman, gravida 1, para 0, at 32 weeks of gestation with known systemic lupus

erythematosus (SLE) comes to your office for a routine prenatal visit. She has lupus nephritis

with 2 g of protein in 24 hours. Her pregnancy has thus far proceeded normally although she has

experienced mild arthritic symptoms with pain and discomfort in her joints. She has been taking

no medication for her SLE other than nonsteroidal anti-inflammatory drugs. She is now experiencing

headache and increased pedal edema (+3). She is found to have hypertension (blood pressure

150/100 mm Hg) and her temperature is 38.1°C (100.6°F). Her laboratory results show a hemoglobin

level 10.2 g/dL, platelet count 160,000/mm3, glucose level 98 mg/dL, and an increased 24-hour

urinary protein of 4 g. Her levels of ammonia, liver enzymes, lactate dehydrogenase, and bilirubin

are all in the normal range. The most likely diagnosis is

A 30-year-old multiparous woman with a history of chronic hypertension discontinued her usual

medications when she learned she was pregnant. At her prenatal visit at 22 weeks of gestation,

her blood pressure (BP) is 148/90 mm Hg. Urine dipstick shows no protein. She reports no other

medical problems. The best next step in her management is

A 19-year-old nulligravid woman at 34 weeks of gestation comes to your clinic for a prenatal visit. Her blood pressure (BP) to this point has been in the range of 100–110 mm Hg (systolic) over 60–70 mm Hg (diastolic). She is experiencing normal fetal movements and reports no health issues; her BP at this visit is 146/93 mm Hg. Physical examination is otherwise unremarkable. Fetal heart rate is 140 beats per minute. Urine dipstick is negative for protein. Estimated fetal weight is 2,288 g (43rd percentile). She returns 3 days later for another prenatal visit, at which time her BP

is 150/92 mm Hg. A 24-hour urine collection result shows 100 mg of protein in the urine. Platelets are 202,000/mm3. Serum alanine aminotransferase is 20 units/L. Serum aspartate aminotransferase is 23 units/L. The most appropriate next step in management is

A 32-year-old woman, gravida 2, para 0, at 30 weeks of gestation with a dichorionic twin gestation presents with nausea and vomiting, right upper quadrant pain, and moderate vaginal bleeding. She has not experienced contractions or vaginal fluid leak. On examination, her blood pressure (BP) is 152/100 mm Hg and she appears in moderate distress with hyperreflexia and pitting edema of the lower extremities. Fetal tracing is reactive for both twins. Laboratory results show a platelet count

of 64,000/mm3, aspartate aminotransferase of 320 international units/L, alanine aminotransferase

of 280 international units/L, creatinine of 1.3 mg/dL, lactate dehydrogenase of 700 international units/L, fibrinogen of 80 mg/dL, and prothrombin time of 18 seconds. In addition to administration of steroids, the most appropriate next step is

A patient has a blood pressure of 110/72 mm Hg on her first prenatal visit at 8 weeks’ gestation. She develops

hypertension in the third trimester, and at delivery, her blood pressure is 148/94 mm Hg. Urine protein by

dipstick is trace, her creatinine level is 0.76 mg/dL, and her hypertension has resolved by the time of her

hospital discharge. What is her correct diagnosis?

A patient with antepartum baseline blood pressure measurements of 90/65 mm Hg has blood pressures of

130–140/80–86 mm Hg at delivery. She has an increased risk of which of the following obstetric

complications?

In a low-risk population, treatment with which of the following medications resulted in a reduced incidence

of preeclampsia?

In studies evaluating the antenatal use of labetalol for treatment of early mild preeclampsia, which of the

following is reduced?

What clinical sign or test can be used to detect hypermagnesemia prior to development of respiratory

depression?