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A 36-year-old G1P0 woman pregnant with twins presents to her obstetrician for her routine 32-week appointment. She has gained 5.4
kg (12 lb) in the past 2 weeks. When questioned about her weight gain, she states that she has had headaches and some blurred vision
for the past 2 weeks, which she thinks is secondary to dehydration. To circumvent this she has been drinking a lot of water, which she
claims “is not really working, and is making me swell, even my hands!” She also has had some epigastric pain for the past 2 weeks, which she attributes to “all the water I’ve been drinking.” Her vitals are blood pressure 142/90 mm Hg, pulse 105/min, and respiratory rate 18/min. Her urine reveals 1+ glucosuria and 4+ proteinuria. What is the next best step in management?
(A) Administer magnesium sulfate only
(B) Expectant management
(C) Magnesium sulfate therapy, steroids, and induction of labor
(D) Oral antihypertensive therapy
(E) Platelet transfusion
 
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