How are seizures managed in women with preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Seizure treatment and prophylaxis

  • The basic principles of airway, breathing, and circulation (ABC) should always be followed

  • Magnesium sulfate is the first-line treatment for primary and recurrent eclamptic seizures

  • Treat active seizures with IV magnesium sulfate [5] : A loading dose of 4 g is given by infusion pump over 5-10 minutes, followed by an infusion of 1 g/hr maintained for 24 hours after the last seizure

  • Treat recurrent seizures with an additional bolus of 2 g or an increase in the infusion rate to 1.5 or 2 g per hour

  • Prophylactic treatment with magnesium sulfate is indicated for all patients with preeclampsia with severe features

  • Lorazepam and phenytoin may be used as second-line agents for refractory seizures

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