A pregnant woman at eight months gestation presents with a seizure. Which medication should be administered?

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Multiple Choice

A pregnant woman at eight months gestation presents with a seizure. Which medication should be administered?

This scenario centers on seizures in late pregnancy, which raises concern for eclampsia. The treatment of choice to prevent further seizures in preeclampsia or eclampsia is magnesium sulfate. It specifically reduces cerebral excitability and stabilizes the patient, providing anticonvulsant protection for both mother and fetus. Benzodiazepines like diazepam or lorazepam can stop seizures but tend to cross the placenta and can cause neonatal respiratory depression or sedation, making them less desirable as first-line management in this setting. Phenytoin is another anticonvulsant but carries teratogenic risks and is not the preferred choice for preventing seizures in preeclampsia/eclampsia. Magnesium sulfate is favored because it effectively prevents further seizures with a comparatively safer fetal profile. Monitor closely for signs of magnesium toxicity—loss of reflexes, respiration changes, or decreased consciousness—and have calcium gluconate ready as an antidote if toxicity appears.

This scenario centers on seizures in late pregnancy, which raises concern for eclampsia. The treatment of choice to prevent further seizures in preeclampsia or eclampsia is magnesium sulfate. It specifically reduces cerebral excitability and stabilizes the patient, providing anticonvulsant protection for both mother and fetus. Benzodiazepines like diazepam or lorazepam can stop seizures but tend to cross the placenta and can cause neonatal respiratory depression or sedation, making them less desirable as first-line management in this setting. Phenytoin is another anticonvulsant but carries teratogenic risks and is not the preferred choice for preventing seizures in preeclampsia/eclampsia. Magnesium sulfate is favored because it effectively prevents further seizures with a comparatively safer fetal profile. Monitor closely for signs of magnesium toxicity—loss of reflexes, respiration changes, or decreased consciousness—and have calcium gluconate ready as an antidote if toxicity appears.

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