A 26-year-old woman with severe pre-eclampsia at 32 weeks is being induced with oxytocin. She develops a seizure lasting 90 seconds. After securing the airway and giving oxygen, the next immediate step is to:
- A Administer IV lorazepam 4 mg to terminate the seizure
- B Give IV magnesium sulfate 6 g loading dose over 20 minutes if not already on it ✓
- C Perform emergency cesarean section immediately
- D Administer IV nifedipine 10 mg sublingually
Correct answer: B. Give IV magnesium sulfate 6 g loading dose over 20 minutes if not already on it
Explanation
Magnesium sulfate is the first-line anticonvunctant for eclampsia and is superior to diazepam, phenytoin, or lorazepam in preventing recurrent seizures. If the patient is not on magnesium, a loading dose should be given. If already on magnesium and seizing, an additional 2 g bolus may be given. Emergency cesarean section is not the immediate next step; maternal stabilization takes priority. Nifedipine is an antihypertensive, not an anticonvulsant.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.