A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 165/110 mmHg, persistent severe frontal headache, visual scotomata, and epigastric tenderness. Urinalysis demonstrates 3+ proteinuria, and laboratory testing reveals platelets 85,000/microL and elevated transaminases. What is the immediate pharmacological intervention to prevent maternal seizures?
Answer and explanation
Correct answer: A. Intravenous magnesium sulfate
- Step 1: The patient presents with severe preeclampsia (or HELLP syndrome features) with impending eclampsia.
- Step 2: Intravenous magnesium sulfate (4-6 g loading dose over 20 minutes, followed by 1-2 g/h maintenance) is the undisputed first-line agent for the prevention and treatment of eclamptic seizures.
Answer
Intravenous magnesium sulfate.
Why not the others: 'Intravenous diazepam infusion' is significantly less effective than magnesium sulfate and causes maternal and neonatal respiratory depression; 'Oral phenytoin loading dose' is inferior to magnesium for eclampsia prophylaxis; 'Intravenous sodium valproate' is teratogenic and ineffective for eclampsia.
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