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Paediatric anaphylaxis age 3 — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesPaediatric anaphylaxis age 3DipIMC

A 26-year-old at 34 weeks has a generalised seizure, BP 170/110 mmHg, headache and ankle clonus. The seizure has stopped and she is breathing spontaneously. Which definitive anticonvulsant should be started during urgent obstetric transfer if in scope?

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Correct answer: A — IV magnesium sulfate using the eclampsia regimen

The best answer is “IV magnesium sulfate using the eclampsia regimen”. A late-pregnancy seizure with severe hypertension is eclampsia until proved otherwise. Magnesium sulfate is the recommended anticonvulsant to prevent recurrent seizures, alongside ABC care and urgent obstetric transfer. Antihypertensives treat blood pressure but not seizures. Diazepam or phenytoin do not replace magnesium, and cessation of the visible convulsion does not remove the recurrent-seizure risk.

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