A 28-year-old G1P0 woman at 38 weeks gestation is brought to the emergency department after experiencing a generalized tonic-clonic seizure at home. Her blood pressure is 168/112 mm Hg. She is currently postictal and breathing spontaneously. Continuous fetal monitoring shows a baseline heart rate of 135/min with moderate variability and no decelerations. Arrange the following management steps in the most appropriate chronological sequence for this patient.
- 1Place the patient in a lateral decubitus position and ensure airway patency
- 2Administer intravenous magnesium sulfate
- 3Administer intravenous labetalol or hydralazine
- 4Proceed with delivery of the fetus
Answer
The correct sequence is: stabilize airway and position laterally, administer magnesium sulfate, control severe blood pressure, and finally proceed with delivery.
In the management of eclampsia, maternal life support is the primary focus. The correct chronological approach is ABCs (Airway, Breathing, Circulation) first, which includes placing the patient in a lateral decubitus position to prevent aspiration and relieve aortocaval compression. Second, recurrent seizures must be prevented with intravenous magnesium sulfate. Third, severe hypertension (≥ 160/110 mm Hg) must be aggressively treated to prevent maternal stroke using agents like labetalol or hydralazine. Finally, after the mother is stabilized, the definitive cure for eclampsia—delivery of the fetus—is performed.
Step-by-Step Solution
Key Concept
The management of eclampsia follows a strict physiological sequence: maternal stabilization (airway/positioning), seizure control (magnesium sulfate), blood pressure control (antihypertensives), and finally definitive cure (delivery).
Estimated Time:1m 0s