A 33-year-old woman delivered vaginally at 38 weeks after an uncomplicated pregnancy. On postpartum day 3, she develops a generalized tonic-clonic seizure lasting 90 seconds. Her blood pressure recorded at discharge was 138/86 mmHg. Current BP is 164/108 mmHg with 2+ proteinuria. Which of the following is the most appropriate statement regarding this condition?
- A Postpartum eclampsia is rare and occurs in less than 1% of pre-eclamptic women
- B Magnesium sulfate is contraindicated postpartum due to risk of uterine atony
- C Postpartum seizures are more likely due to hypertensive encephalopathy than eclampsia
- D Eclampsia can occur postpartum and magnesium sulfate remains the treatment of choice ✓
Correct answer: D. Eclampsia can occur postpartum and magnesium sulfate remains the treatment of choice
Explanation
Approximately 40-50% of eclampsia cases occur postpartum, most within 48 hours but up to 4 weeks after delivery. Magnesium sulfate remains the drug of choice for seizure treatment and prevention in postpartum eclampsia, as confirmed by the MAGPIE trial and WHO recommendations. Option A underestimates the frequency. Magnesium sulfate does not cause significant uterine atony at therapeutic doses.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.