What is the gravest form of pregnancy-induced hypertension characterized by seizures, coma, proteinuria, and edema?

• A. Eclampsia
• B. Preeclampsia
• C. Gestational hypertension
• D. HELLP syndrome

Answer: (A)

The important concept here is that seizures or coma in a pregnant patient with signs of preeclampsia indicate the most dangerous progression, known as eclampsia. Eclampsia is the gravest form of pregnancy-induced hypertension and is defined by new-onset generalized seizures or coma occurring in the setting of preeclampsia (which includes hypertension with proteinuria and often edema). Preeclampsia itself is high blood pressure after 20 weeks with protein in the urine or other organ dysfunction; gestational hypertension is simply high blood pressure without proteinuria; HELLP syndrome is a severe variant involving hemolysis, elevated liver enzymes, and low platelets, and can accompany preeclampsia but is not defined by seizures. So the presence of seizures and coma points to eclampsia.