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High-Risk Obstetrics Case Report #OG-2026-09

Management of Severe Preeclampsia with Twin Gestation at 34 Weeks (HRP A+++ Protocol)

Lead Obstetrician: Dr. P. Shankari (Coordinator HRP A+++ Assessment)

Patient History & Presentation

A 29-year-old primigravida with diamniotic dichorionic (DADC) twin pregnancy presented at 33+4 weeks gestation with sudden-onset headache, visual scotoma, blood pressure 170/110 mmHg, and 3+ proteinuria.

Clinical Management (HRP A+++ Protocol)

Emergency admission under Coordinator HRP A+++ Assessment protocols. Intravenous Labetalol titration and Magnesium Sulfate seizure prophylaxis were instituted alongside continuous electronic fetal monitoring and corticosteroid administration for fetal lung maturation.

Clinical Outcome & Follow-Up

Elective emergency Caesarean delivery at 34+2 weeks yielded healthy Twin 1 (2.1 kg) and Twin 2 (1.95 kg) with APGAR 8/9 and 9/10. Maternal blood pressure stabilized post-partum with complete resolution of proteinuria by Day 5.