Case Summary A 25-year-old primigravida at 36 weeks gestation, with pregnancy-induced hypertension since 20 weeks (on tablet amlodipine), presented with headache and upper abdominal pain for the past 4–5 days. On examination: BP: 160/100 mmHg HR: 88/min Edema: Ankles Chest: Clear Heart sounds: Audible Urine protein: Positive She was normotensive, non-proteinuric, and asymptomatic just 2 weeks earlier.
She was posted for elective C-section. Classification of Hypertensive Disorders in Pregnancy (NHBPEP, 2000) Gestational hypertension Pre-eclampsia Eclampsia Pre-eclampsia superimposed on chronic hypertension Chronic hypertension Pre-Eclampsia Minimum criteria: BP > 140 mmHg after 20 weeks gestation Proteinuria > 300 mg/24 hours or 1+ dipstick Severe features: BP > 160/100 mmHg Proteinuria > 2 g/24 hours Serum creatinine > 1.2 mg/dL Platelets < 100,000/mm³ Persistent headache, visual…