A 29-year-old primigravida at 30 weeks has persistent severe-range blood pressures (170/110 mm Hg on two occasions 15 minutes apart) with severe heada...

Question

A 29-year-old primigravida at 30 weeks has persistent severe-range blood pressures (170/110 mm Hg on two occasions 15 minutes apart) with severe headache. Fetal testing is reassuring. What is the most appropriate first-line medication to acutely lower blood pressure?

Accepted Answer

Labetalol 20 mg IV bolus (repeat/escalate as needed)

Answer

Magnesium sulfate 4 g IV load, then 1-2 g/h

Answer

Methyldopa 250 mg PO

Answer

ACE inhibitor (lisinopril) 10 mg PO

Answer

Nitroprusside infusion

us-abem MCQ (SBA): Hypertensive Emergency in Pregnancy

A 29-year-old primigravida at 30 weeks has persistent severe-range blood pressures (170/110 mm Hg on two occasions 15 minutes apart) with severe headache. Fetal testing is reassuring. What is the most appropriate first-line medication to acutely lower blood pressure?