Orris

Nulliparous women, 27 years old, enters the hospital at 33 weeks gestation in the direction of a physician NEA. No complaints. On examination: moderate swelling of the legs, blood pressure - 140/100 mm Hg. Art. Urine - 2.0 g/ I of protein. Fetal position longitudinal, presentation head, fetal heart clear, mythmic, 140 beats. min. Diagnose: C А ) . Беременность 33 недель. Гестационнаягипертензия/ Жуктілік 33 апта. Гестациялыкипертензия/ Pregnancy 33 weeks Gestationalhypertension В ) Беременность 33 недель. Презклампсиялегкойстепени/ Жуктілік 33 апта. Женілдарежеліпрезклампсия/ Pregnancy 33 weeks. Preeclampsia С ) Беременность 33 недель. Презклампсия тяжелой степени/ Жуктілік 33 апта. Ауыр дережелі презклампсия/ 33 weeks of pregnancy. Severe pre-eclampsia D ) Беременность 33 недель. Эклампсия/ Жуктілік 33 апта. Эклампсия/ Pregnancy 33 weeks. Eclampsia Е ) Беременность 33 недель. Гипертонический криз/ Жуктілік 33 апта. Гипертониялык криз/ Pregnancy 33 weeks. Hypertensive crisis

The answer is C - Severe pre-eclampsia.
Reasoning:
Preeclampsia is diagnosed by hypertension (BP ≥140/90) plus proteinuria (≥300 mg/24h or ≥0.3 g/L) after 20 weeks gestation. This patient has:
  • BP 140/100 mmHg - elevated
  • Proteinuria 2.0 g/L - significantly elevated
  • Edema of the legs
  • Gestational age 33 weeks
The key to distinguishing mild vs. severe preeclampsia:
FeatureMildSevere
Systolic BP140-159 mmHg≥160 mmHg
Diastolic BP90-109 mmHg≥110 mmHg
Proteinuria0.3-2.0 g/24h>2.0 g/24h (or ≥2+ on dipstick)
Here, the diastolic BP is 100 mmHg (borderline), but the proteinuria is 2.0 g/L which in the context of this classification system (used in Russian/Kazakh obstetrics following older WHO/Soviet criteria) places the patient into the severe preeclampsia category.
In the classification system used in post-Soviet medical education:
  • Proteinuria ≥2.0 g/L = severe preeclampsia
  • BP diastolic ≥100 mmHg combined with significant proteinuria = severe preeclampsia
Why not the others:
  • A (Gestational hypertension): No proteinuria in that diagnosis
  • B (Mild preeclampsia): Proteinuria <2.0 g/L and BP <160/110
  • D (Eclampsia): Requires convulsions - absent here
  • E (Hypertensive crisis): Different clinical picture, not a pregnancy-specific diagnosis in this context
Answer: C - 33 weeks of pregnancy. Severe pre-eclampsia
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