A 15-year-old female at 28 weeks' gestation presents with dependent edema, morning ring tightness, a 10-pound weight gain, +1/4 pedal edema, +3 deep tendon reflexes, and trace protein on dipstick. The most likely diagnosis is

• A. Eclampsia.
• B. Pre-eclampsia.
• C. Chronic hypertension.
• D. Transient hypertension.

Answer: (B)

Preeclampsia presents as new-onset hypertension after 20 weeks of gestation with either proteinuria or signs of end-organ dysfunction. Edema, rapid weight gain, and hyperreflexia can accompany the condition and help raise suspicion, even if proteinuria is only trace on a dipstick. In this scenario, a 28‑week gravida with dependent edema, significant weight gain, +3 deep tendon reflexes, and trace protein aligns with preeclampsia.

Eclampsia would involve seizures, which aren’t described here. Chronic hypertension implies preexisting high blood pressure before 20 weeks, which isn’t indicated. Transient hypertension resolves and lacks ongoing risk features. So the presentation is most consistent with preeclampsia.