system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 25-year-old primigravida woman at 35 weeks estimated gestational age presents with a headache for the past 5 hours. She describes the headache as severe and incapacitating and showing no response to acetaminophen. In the emergency department, her blood pressure is found to be 150/100 mm Hg, pulse is 88/min, respiratory rate is 30/min, and temperature is 37.0°C (98.6°F). Her records show that her blood pressure was the same yesterday during her regular antenatal visit. Chest auscultation reveals bilateral crackles along the lung base. Abdominal examination reveals a gravid uterus consistent with a gestational age of 32 weeks and a floating fetus in a cephalic presentation. Pelvic examination is performed which shows a closed firm cervix with no evidence of bleeding or discharge. Moderate pitting edema is noted and neurologic examination shows generalized hyperreflexia. Laboratory findings are significant for the following:
Hemoglobin 12.5 g/dL
Platelets 185,000/μL
Serum creatinine 0.4 mg/dL
Spot urine creatinine 110 mg/dL
Spot urine protein 360 mg/dL
AST 40 IU/L
Which of the following is the most likely diagnosis in this patient?
assistant
Preeclampsia with severe features