Which condition is commonly associated with third-trimester onset, sudden weight gain, visual disturbances, facial or hand swelling, headaches, and hypertension?

• A. Eclampsia
• B. Preeclampsia
• C. Pregnancy induced hypertension
• D. Supine hypotensive syndrome

Answer: (B)

The main concept here is understanding hypertensive disorders of pregnancy, specifically preeclampsia. In the third trimester, new-onset hypertension accompanied by signs of end-organ involvement—such as headaches, visual disturbances, and swelling in the face or hands—points to preeclampsia. The sudden weight gain you see is typically due to edema from widespread vasospasm and fluid retention. Visual changes occur because the same vascular dysfunction can affect the brain and eyes, leading to symptoms like blurred vision or scotomas.

This condition is distinct from gestational (pregnancy-induced) hypertension, which is simply high blood pressure after 20 weeks without the additional end-organ findings or significant edema. It’s also different from eclampsia, which is preeclampsia that has progressed to seizures. Supine hypotensive syndrome, on the other hand, causes hypotension from vena cava compression when the mother lies on her back, not hypertension with edema and headaches.

So, the presentation described best fits preeclampsia, a new-onset hypertension after 20 weeks of gestation with end-organ signs such as severe headaches, visual disturbances, and edema.