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Eclampsia — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesEclampsiaDipIMC

A woman at 36 weeks has eclampsia treated with magnesium sulfate. She is no longer convulsing but blood pressure remains 180/116 mmHg during resuscitation and transfer preparation. What additional treatment principle is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Treat severe hypertension immediately with a protocolled pregnancy-indicated agent

The best answer is “Treat severe hypertension immediately with a protocolled pregnancy-indicated agent”. Magnesium sulfate treats and prevents eclamptic seizures but does not control severe hypertension. NICE requires immediate treatment with labetalol, oral nifedipine or IV hydralazine in the appropriate monitored setting, selected according to clinical circumstances and governance. Response and maternal-fetal effects require monitoring. Sedation, routine volume expansion and diuresis do not replace targeted antihypertensive treatment.

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