Wed3November0832PM 10

A 35-year-old woman who is 34 weeks pregnant and who is known to have pregnancy induced hypertension is admitted to the Emergency Department following headaches and a seizure at home.

On arrival, GCS is 9/15 and she has neurological signs consistent with an intracerebral bleed. Blood pressure is 195/85 mmHg.

What is the most appropriate immediate course of action?

(Please select 1 option)

Labetalol infusion

Phenytoin loading dose

4 g magnesium bolus This is the correct answer

Immediate Caesarean section

Bolus of 20% mannitol Incorrect answer selected

Explanation

This woman has severe pre-eclampsia with a likely either and intracerebral bleed or cerebral oedema. The most important initial therapy is to control any further seizures and control her blood pressure - intravenous magnesium is the therapy of choice.

She is likely to need intubation and controlled ventilation. She may require further measures to obtund the pressor response to laryngoscopy.

Answer Statistics

1

15%

2

1%

3

60%

4

13%

5

12%

Times answered: 310