A 32-year-old G1P0 at 36 weeks gestation presents with severe persistent headache, blurred vision, and epigastric tenderness. Blood pressure is 172/114 mmHg. Urinalysis shows 3+ protein. What is the immediate pharmacological intervention to prevent maternal eclamptic seizures?
Answer and explanation
Correct answer: C. Intravenous Magnesium Sulfate loading and maintenance infusion
- Step 1: Blood pressure >= 160/110 mmHg with proteinuria and end-organ cerebral/visual symptoms confirms preeclampsia with severe features.
- Step 2: The imminent life threat is progression to eclamptic seizures.
- Step 3: Intravenous magnesium sulfate (4-6 g IV loading dose followed by 1-2 g/hr continuous infusion) is the gold standard for seizure prophylaxis, superior to benzodiazepines and phenytoin.
Answer
Intravenous Magnesium Sulfate loading and maintenance infusion.
Why not the others: The landmark Magpie trial proved magnesium sulfate is vastly superior to phenytoin and diazepam; hydralazine lowers BP but does not prevent seizures.
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