Match each obstetric complication occurring in the third trimester with the clinical and laboratory vignette that best describes its classic presentation.
- Gestational hypertensionBlood pressure of 145/95 mm Hg at 34 weeks; urine protein-to-creatinine ratio is 0.15 mg/mg; normal serum transaminases.
- Preeclampsia with severe featuresBlood pressure of 165/112 mm Hg at 35 weeks; persistent occipital headache; serum creatinine of 1.3 mg/dL.
- HELLP syndromeBlood pressure of 150/90 mm Hg at 37 weeks; platelets 70,000/mm³; AST 350 U/L; indirect bilirubin 2.1 mg/dL.
- Acute fatty liver of pregnancyBlood pressure of 125/80 mm Hg at 36 weeks; blood glucose 45 mg/dL; prolonged prothrombin time; elevated serum ammonia.
Cevap
Gestational hypertension matches with elevated blood pressure without proteinuria; Preeclampsia with severe features matches with severe hypertension and headache/renal impairment; HELLP syndrome matches with hemolysis, elevated liver enzymes, and thrombocytopenia; Acute fatty liver of pregnancy matches with hypoglycemia and coagulopathy.
Each vignette uniquely describes the diagnostic criteria for a specific third-trimester complication. Gestational hypertension lacks proteinuria and end-organ damage. Preeclampsia with severe features involves severe hypertension or end-organ impairment (e.g., headache, elevated creatinine). HELLP syndrome is defined by its namesake lab triad (Hemolysis, Elevated Liver enzymes, Low Platelets). Acute fatty liver of pregnancy is uniquely marked by hepatic synthetic failure (hypoglycemia, coagulopathy).
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Anahtar Kavram
Differentiating hypertensive and hepatic complications of pregnancy requires systematic evaluation of blood pressure severity, proteinuria, end-organ damage, and specific laboratory abnormalities reflecting hepatic synthetic function versus microangiopathic consumption.
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