First Things First

• Eclampsia is defined by new-onset grand mal seizures in a woman with preeclampsia.
• Stop the seizure: magnesium sulfate 6 gm IV bolus is preferred treatment; other choices include benzodiazepines or barbiturates
• Evaluate airway, breathing, circulation.
• Preeclampsia is defined by
  • Onset after 20 weeks’ gestation
  • Hypertension: >140 systolic or 90 diastolic
  • Proteinuria: 1+ on dipstick or 300 mg/24 hours
• Severe preeclampsia (presence of any of the following)
  • Hypertension: >160 systolic or 110 diastolic
  • Proteinuria: 3+ on dipstick or >5 gm/24 hours
  • Oliguria: <500 cc/24 hours
  • Cerebral or visual disturbances
  • Pulmonary edema
  • Epigastric or RUQ pain
  • Elevated liver enzymes
  • Thrombocytopenia
  • Fetal growth restriction
  • Oligohydramnios
• Evaluate and/or monitor fetus.