A 28-year-old primigravida at 34 weeks gestation presents with headache, visual blurring, BP 165/110 mmHg, and 3+ proteinuria on dipstick. Platelet count is 140,000/mm3. What is the first-line medication to prevent maternal eclamptic seizures?
Answer and explanation
Correct answer: D. Intravenous magnesium sulfate infusion
- Step 1: The patient has preeclampsia with severe features (BP >= 160/110 mmHg and neurological symptoms).
- Step 2: Intravenous magnesium sulfate is the undisputed drug of choice for seizure prophylaxis in preeclampsia and treatment of eclampsia.
- Step 3: Trial evidence (Magpie trial) demonstrates magnesium sulfate is superior to phenytoin and diazepam in preventing seizures and reducing maternal mortality.
Answer
Intravenous magnesium sulfate infusion.
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