A 30-year-old woman at 32 weeks of gestation develops tonic-clonic seizures. She has had no prior prenatal care. On examination, BP is 170/110 mmHg and 3+ proteinuria is noted. After controlling the airway, which drug should be administered FIRST?
- A Magnesium sulfate 4 g IV bolus over 15–20 minutes ✓
- B Phenytoin 1 g IV loading dose
- C Diazepam 10 mg IV bolus
- D Labetalol 20 mg IV bolus
Correct answer: A. Magnesium sulfate 4 g IV bolus over 15–20 minutes
Explanation
Eclamptic seizures are managed primarily with magnesium sulfate, which is superior to phenytoin and diazepam for both treatment and prevention of recurrent eclamptic seizures. The standard loading dose is 4 g IV given slowly over 15–20 minutes, followed by a maintenance infusion of 1–2 g/hour. Labetalol addresses hypertension but does not prevent seizures and should be given after seizure control is initiated.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.