Approach to hypertensive disorders in pregnancy Quiz: Ace Your Exams

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A 29-year-old, gravida 1, at 28 weeks of gestation, presents to the clinic for a routine antenatal visit. She has no new symptoms. The pregnancy has been uncomplicated, and the past medical history is noncontributory. On exam, temperature is 36.5°C (97.7°F), pulse is 82/min, respirations are 16/min, and blood pressure is 142/86 mmHg. On exam, the lungs are clear to auscultation, the abdomen is nontender, the symphysis to fundal height is 29 cm, and the fetal heart rate is in the 140s on a handheld Doppler device. A urinalysis is normal. The physician orders appropriate testing and sends the patient to triage for several hours of monitoring. Four hours later, the vital signs and exam are unchanged, and a preliminary diagnosis of gestational hypertension is made. Which of the following laboratory results would alter the diagnosis?

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Creatinine of 1.2 mg/dL

Protein-to-creatinine ratio (P/C) of 0.2

Lactate dehydrogenase (LDH) of 460 IU/L, ALT of 35 IU/L, and platelet count of 125,000/µL

Alanine aminotransferase (ALT) of 35 IU/L

Platelet count of 125,000/µL