In preeclampsia, a 4+ patellar reflex indicates risk of which complication?

• A. Impending seizure
• B. Preterm labor
• C. Fetal distress
• D. Hypertension

Answer: (A)

A 4+ patellar reflex shows hyperreflexia, a sign of CNS irritability that can accompany severe preeclampsia. When reflexes are markedly brisk, it indicates the brain and spinal cord are more excitable, which raises the risk of a seizure—progression to eclampsia. So the risk associated with this finding is an impending seizure, and it calls for close monitoring and seizure prevention (commonly magnesium sulfate) along with ongoing assessment of blood pressure and other symptoms. While hypertension, fetal distress, or preterm labor can occur with preeclampsia, the specific hyperactive reflex best points to seizure risk rather than those other complications.