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Eclampsia drug — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesEclampsia drugDipIMC

A 31-year-old at 38 weeks has a recurrent generalised seizure, blood pressure 178/116 mmHg and no alternative cause apparent. After ABC support and urgent obstetric pre-alert, which anticonvulsant regimen is appropriate if within governed scope?

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Correct answer: A — Give intravenous magnesium sulfate 4 g over 5–15 minutes

The best answer is “Give intravenous magnesium sulfate 4 g over 5–15 minutes”. This is eclampsia until proved otherwise. NICE specifies a 4 g intravenous magnesium sulfate loading dose over 5 to 15 minutes, followed by monitored obstetric care and further treatment under protocol. Benzodiazepines can terminate ongoing convulsions but do not replace magnesium sulfate; phenytoin and levetiracetam are not the recommended eclampsia regimen.

Reference: NICE NG133, Hypertension in pregnancy: https://www.nice.org.uk/guidance/ng133/chapter/Recommendations