Which statement best describes the management of preeclampsia with severe features?

• A. BP control and delivery planning are key priorities.
• B. Delivery is never indicated in preeclampsia with severe features.
• C. Magnesium sulfate is contraindicated in preeclampsia with severe features.
• D. Proteinuria alone defines the severity requiring emergency cesarean delivery.

Answer: (C)

In preeclampsia with severe features, the primary focus is keeping the mother safe while planning delivery. This means stabilizing blood pressure to reduce the risk of stroke and end-organ damage, and using magnesium sulfate to prevent seizures (eclampsia) when severe features are present. Magnesium sulfate is a standard, evidence-based part of care for severe preeclampsia and is not contraindicated in this context unless there are specific safety concerns (like respiratory depression or kidney failure), in which case its use would be carefully weighed.

Delivery is the definitive treatment for preeclampsia with severe features, but the timing and mode depend on how well the mother and fetus are doing after stabilization. The goal is to deliver when it’s safest for both, balancing gestational age, fetal status, and maternal condition. Proteinuria by itself does not determine severity or require emergency cesarean delivery, and saying that delivery is never indicated also isn’t true.