A 31-year-old primigravida at 38 weeks gestation is admitted to the labor and delivery triage unit for evaluation of severe preeclampsia. While speaking with the physician, she suddenly loses consciousness and begins exhibiting generalized tonic-clonic movements. Her blood pressure was recorded as 174/112 mm Hg five minutes prior to this event. Arrange the following steps in the most appropriate sequential order for the acute management of this patient's condition.
- 1Protect the maternal airway and position the patient in the left lateral decubitus position.
- 2Administer intravenous magnesium sulfate.
- 3Administer an intravenous antihypertensive agent such as labetalol or hydralazine.
- 4Proceed with definitive delivery of the fetus.
Cevap
The correct sequence for managing an eclamptic seizure prioritizes basic life support (airway and positioning), followed by targeted seizure cessation/prophylaxis (magnesium sulfate), then severe blood pressure control (antihypertensives), and ultimately concludes with definitive management (delivery) once the mother is stable.
The correct algorithm for eclampsia begins with supportive maternal care (airway protection and left lateral positioning). This is immediately followed by medical management to stop and prevent seizures using magnesium sulfate. Once seizures are addressed, severe hypertension is controlled with agents like labetalol to prevent stroke. Delivery is the definitive cure but is only initiated after the mother has been medically stabilized.
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The management of eclampsia strictly follows a sequence of maternal stabilization: ABCs (Airway/Positioning) first, followed by magnesium sulfate for seizure control, antihypertensives for severe blood pressure elevation, and finally, definitive delivery.
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