During the third trimester, a patient presents with headache, visual disturbances, rapid weight gain, edema, and high blood pressure. Which condition is most likely?

• A. Retinal detachment
• B. Hypertensive crisis
• C. Pre-eclampsia
• D. Eclampsia

Answer: (C)

New-onset hypertension after 20 weeks of gestation with signs of end-organ involvement points to pre-eclampsia. The headaches and visual disturbances indicate central nervous system involvement, while edema and rapid weight gain reflect fluid retention and vascular dysfunction typical of this condition. In the third trimester, these features together—hypertension plus CNS symptoms and edema—are classic for pre-eclampsia. Retinal detachment is unrelated to pregnancy in this context. A hypertensive crisis is a broad term for dangerous BP elevations, but without the pregnancy-specific context and end-organ signs, it’s less specific. Eclampsia would include seizures, which aren’t described here. Therefore, pre-eclampsia is the most likely diagnosis.