Hypertensive disorders: eclamptic seizure management: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Hypertensive disorders: eclamptic seizure management

Sample item

A woman at 35 weeks with severe pre-eclampsia has a seizure on the ward. It stops after 90 seconds. After securing the airway, what should be done next?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Give magnesium sulphate loading dose, control blood pressure, and plan delivery once she is stabilised

Eclampsia is managed by airway and breathing support, left lateral position and magnesium sulphate as the anticonvulsant of choice, which is superior to diazepam and phenytoin. Severe hypertension is controlled and delivery is planned after maternal stabilisation, since delivery is the definitive treatment but should not be done in the middle of a seizure. Mode of delivery depends on obstetric factors.

Option by option

  • A. Give diazepam only and discharge

    Diazepam alone is inferior and discharge is unsafe.

  • B. Give phenytoin and observe for 48 hours without delivery

    Phenytoin is less effective than magnesium and delay in delivery risks complications.

  • C. Immediate caesarean section during the seizure

    Emergency surgery during a seizure carries high anaesthetic risk and is delayed until stable.

  • D. Give magnesium sulphate loading dose, control blood pressure, and plan delivery once she is stabilised (correct)

    Correct. Magnesium, blood pressure control and delivery after stabilisation are the cornerstones.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Give magnesium sulphate loading dose, control blood pressure, and plan delivery once she is stabilised. Eclampsia is managed by airway and breathing support, left lateral position and magnesium sulphate as the anticonvulsant of choice, which is superior to diazepam and phenytoin.

Why is "Give diazepam only and discharge" not the answer?

Diazepam alone is inferior and discharge is unsafe.

Why is "Give phenytoin and observe for 48 hours without delivery" not the answer?

Phenytoin is less effective than magnesium and delay in delivery risks complications.

Why is "Immediate caesarean section during the seizure" not the answer?

Emergency surgery during a seizure carries high anaesthetic risk and is delayed until stable.

What concept does this question test?

It tests Hypertensive disorders: eclamptic seizure management in OBG. Severe hypertension is controlled and delivery is planned after maternal stabilisation, since delivery is the definitive treatment but should not be done in the middle of a seizure. Mode of delivery depends on obstetric factors.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hypertensive disorders: eclamptic seizure management?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.