A 28 year old woman has been admitted at 38 weeks gestation. Her BP is 190/120mmHg and proteinuria +++. Immediately following admission she has a grand-mal seizure. What is the single most appropriate initial management?

The key is E. Magnesium sulphate IV. [patient has established eclampsia. So she should be treated

with Magnesium sulphate as with 4g magnesium sulfate in 100mL 0.9% saline IVI over 5min +

maintenance IVI of 1g/h for 24h. Beware depressed respiration. If recurrent seizure give 2g IVI

magnesium sulfate over 5 min. Check tendon reflexes and respiratory rate every 15min. Stop

magnesium sulfate IVI if respiratory rate <14/min or tendon reflex loss, or urine output <20mL/h].

[OHCS, 9th edition, page 49].