A woman with eclampsia at 30 weeks is stabilised on magnesium sulphate. She has a persisting BP of 170/115 mmHg despite two doses of IV hydralazine 5 mg each. The next drug of choice for acute BP control in this scenario is:

• A Oral labetalol 200 mg
• B Sublingual nifedipine 10 mg
• C IV sodium nitroprusside
• D IV labetalol 20 mg bolus ✓

Explanation

IV labetalol (20 mg bolus, repeated every 10 minutes up to 300 mg) is a first-line alternative to hydralazine for acute severe hypertension in pregnancy. Sublingual nifedipine is avoided due to unpredictable precipitous BP drops. Sodium nitroprusside carries risk of fetal cyanide toxicity and is reserved for refractory cases. Oral labetalol has too slow an onset for a hypertensive emergency.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.