OET Writing practice · Medicine
Rising blood pressure and proteinuria at 30 weeks – obstetrician
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
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Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 13/09/2026 Time: 10:15 You are a GP providing shared antenatal care at Portlestone Family Practice, 28 Harbour View, Portlestone. Patient: Mrs Laila Haddad, DOB 08/06/1994 (32 yrs) Social background: - Pharmacy assistant; plans maternity leave from 01/10/2026 - Married; husband works offshore (2 weeks on/2 off), currently away until 20/09 - Daughter aged 4 attends nursery. Sister lives nearby and is with pt today - Non-smoker, no alcohol Obstetric history: - G2 P1. 2022: uncomplicated vaginal delivery at 39 weeks, 3.2 kg - Current pregnancy: EDD 22/11/2026 (dating scan). Today 30+0 weeks - Booking (10 weeks): BP 112/70, BMI 31. Risk factors for pre-eclampsia: BMI >30, mother had pre-eclampsia - Aspirin 150 mg nocte from 12 weeks; pt stopped at 24 weeks due to nosebleeds (not discussed with GP until today) - Anomaly scan 20 weeks: normal, placenta posterior, not low - OGTT 26 weeks: normal - Blood group O RhD positive Medical history: - Iron deficiency anaemia in pregnancy, Hb 108 g/L (07/2026) - Carpal tunnel symptoms R hand since 28 weeks - NKDA Medications: - Ferrous fumarate 210 mg daily - Gaviscon PRN for heartburn Antenatal visits: 16/08/2026 (26+0): BP 118/74. Urine NAD. SFH 26 cm 30/08/2026 (28+0): BP 132/84. Urine NAD. SFH 28 cm. FM normal 13/09/2026 (30+0): - 2-day mild frontal headache, eased by paracetamol. Swelling of hands and face (rings tight) × 3 days - No visual disturbance, no epigastric or RUQ pain, no vomiting - Fetal movements normal - Heartburn occasionally, as before - O/E: BP 148/96, repeated after 15 min 146/94. Urine dipstick protein 2+. Facial and hand oedema. Reflexes normal, no clonus. Abdomen: non-tender, SFH 30 cm, cephalic. FHR 144 bpm - Urine sent for protein:creatinine ratio (result pending) - Bloods (FBC, U&E, LFT, urate) not yet taken – no same-day lab collection at practice Plan: - Suspected pre-eclampsia → same-day referral to Maternity Assessment Unit, Queen Adelaide Hospital - Sister to drive pt directly; expected arrival 11:15 - Pt told to call ambulance if severe headache, visual changes, abdominal pain or reduced fetal movements - Husband to be contacted by pt Writing Task: Using the information in the case notes, write a letter to Dr Helena Voss, Consultant Obstetrician, Maternity Assessment Unit, Queen Adelaide Hospital, 5 Wharf Road, Portlestone, referring Mrs Haddad for urgent same-day assessment. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.