A woman at 34 weeks of gestation presents with a blood pressure of 170/110mmHg, a severe headache, and visual disturbance. How do you manage her?

Tips to guide your answer

- Pre-eclampsia: new-onset hypertension (diastolic BP >90mmHg) with proteinuria or end-organ dysfunction after 20 weeks of gestation

- Severe features: BP >160/110, headache, visual disturbance, epigastric pain, hyperreflexia/clonus, HELLP syndrome, renal impairment

- First-line antihypertensives: IV labetalol (avoid if asthmatic) or oral nifedipine

- Magnesium sulphate: 4g IV loading dose over 15 - 20 minutes, then 1g/hour maintenance for 24 hours - for seizure prophylaxis in severe PE and treatment of eclampsia (MAGPIE trial evidence)

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How to approach this Obstetrics & Gynaecology interview question

This quality improvement question is common in Obstetrics & Gynaecology NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A woman at 34 weeks of gestation presents with a blood pressure of 170/110mmHg, a severe..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.

What the panel is testing

A strong quality-improvement answer uses method as well as enthusiasm. Be clear about the problem, baseline measurement, intervention, re-measurement, and how the change was made sustainable. For obstetrics and gynaecology, show that you can balance urgency, consent, escalation, and multidisciplinary working. Labour ward, theatre, safeguarding, and communication with women and families may all be relevant.

Separate audit, QI, research, and clinical governance clearly so the panel can follow your reasoning.
Use a real cycle: baseline, intervention, re-measurement, learning, and sustainability.
Link the project back to patient safety, service reliability, or measurable outcomes.

How to structure your answer

For a quality improvement prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.

Open by naming the main issue in the question.
Give a structured response rather than a memorised script.
End with escalation, documentation, learning, or follow-up.

Common mistakes to avoid

The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.

Pre-eclampsia: new-onset hypertension (diastolic BP >90mmHg) with proteinuria or end-organ dysfunction after 20 weeks of gestation
Severe features: BP >160/110, headache, visual disturbance, epigastric pain, hyperreflexia/clonus, HELLP syndrome, renal impairment
First-line antihypertensives: IV labetalol (avoid if asthmatic) or oral nifedipine