Match each maternal clinical presentation occurring during the third trimester with the most accurate obstetric diagnosis.
- A patient at 36 weeks gestation develops acute nausea, jaundice, profound hypoglycemia, and prolonged coagulation times (PT/aPTT).Acute fatty liver of pregnancy
- A patient at 37 weeks gestation presents with a blood pressure of 165/110 mm Hg, right upper quadrant pain, and a platelet count of 75,000/mm³.HELLP syndrome
- A patient at 34 weeks gestation with normal blood pressure reports intense, worsening pruritus exclusively on her palms and soles, especially at night.Intrahepatic cholestasis of pregnancy
- A patient at 38 weeks gestation presents with new-onset blood pressure of 145/95 mm Hg and 350 mg of proteinuria in a 24-hour collection, but is otherwise asymptomatic.Preeclampsia without severe features
Answer
Acute fatty liver of pregnancy pairs with hypoglycemia and coagulopathy; HELLP syndrome pairs with severe hypertension, right upper quadrant pain, and thrombocytopenia; Intrahepatic cholestasis of pregnancy pairs with isolated palmar and plantar pruritus; Preeclampsia without severe features pairs with isolated mild hypertension and proteinuria.
Each diagnosis is identified by its distinct clinical signature: AFLP presents with synthetic liver failure (hypoglycemia, coagulopathy); HELLP presents with microangiopathy (thrombocytopenia, severe hypertension); intrahepatic cholestasis presents with localized palmar/plantar pruritus; and mild preeclampsia presents with isolated hypertension and proteinuria without end-organ damage.
Step-by-Step Solution
Key Concept
Differentiating hepatic and hypertensive complications of pregnancy by clinical features.
Estimated Time:1m 30s