A pre-eclamptic woman develops sudden dyspnoea and oxygen saturation of 88 percent at 33 weeks. Chest examination shows bilateral crepitations. The immediate next step after calling for senior help is:
- A Immediate loading dose of magnesium sulfate for seizure prophylaxis only
- B Intravenous furosemide and stopping all crystalloid infusions ✓
- C Nebulised salbutamol as first-line treatment
- D Fluid bolus to improve placental perfusion
Correct answer: B. Intravenous furosemide and stopping all crystalloid infusions
Explanation
Pulmonary oedema complicates severe pre-eclampsia due to low oncotic pressure from hypoalbuminaemia plus capillary leak, often iatrogenically worsened by excessive crystalloid. Management is loop diuretic, strict fluid restriction, and oxygen. Magnesium sulfate is still needed for seizure prophylaxis, but the immediate life-threatening problem here is the pulmonary oedema itself. B fluid bolus would be harmful.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.