<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 27-year-old woman presents to her primary care physician for a concern about her pregnancy. This is her first pregnancy, and she is currently at 33 weeks gestation. She states that she has experienced diffuse swelling of her ankles and legs and is concerned that it is abnormal. Otherwise, she has no concerns. The patient has a past medical history of obesity and diabetes. Her temperature is 98.5F 36.9C, blood pressure is 14792 mmHg, pulse is 80min, respirations are 15min, and oxygen saturation is 97 on room air. Physical exam reveals bilateral edema of the lower extremities. Which of the following is the best next step in management?? A: A 24 hour urine protein, B: Echocardiography, C: Reassurance and followup in 1 week, D: Spot protein to creatinine ratio, E: Urinalysis and urine protein,  <response>: This is a question about a pregnant woman with edema or swelling in her legs. The key details are that she is 33 weeks pregnant, has a history of obesity and diabetes, and has new onset bilateral leg swelling. The main concern would be preeclampsia, which can present with edema and hypertension in pregnancy. Other causes could include deep vein thrombosis, heart failure, or simply dependent edema from obesityinactivity. To evaluate, we need to check for signs of preeclampsia such as protein in the urine and high blood pressure. A spot urine proteincreatinine ratio, 24 hour urine protein, or urinalysis with urine protein would be appropriate next steps. Echocardiography may be needed if heart failure is suspected. Reassurance alone without checking for proteinuria would not be adequate.D: Spot protein to creatinine ratio 