Key Points
- Confirm diagnosis early with highest-yield tests (e.g., MRV for CVST, CTA for mesenteric ischemia).
- Dose-and-route precision for high-risk medications; monitor for adverse effects.
- Explicit ICU criteria and consultation triggers.
Clinical Synopsis & Reasoning
New-onset generalized seizures in pregnancy or postpartum related to preeclampsia; secure airway, give magnesium sulfate, control severe BP, and proceed to delivery after maternal stabilization.
Treatment Strategy & Disposition
Stabilize airway/breathing/circulation; initiate guideline-concordant first-line therapy; tailor escalation or de-escalation to clinical response and objective metrics; define clear disposition criteria (e.g., ICU triggers, ward acceptability, outpatient safety).
Epidemiology / Risk Factors
- Risk varies by comorbidity and precipitating factors
Investigations
| Test | Role / Rationale | Typical Findings | Notes |
|---|---|---|---|
| CBC | Anemia/leukocytosis | Context-specific | Trend with therapy |
| BMP | Electrolytes/renal | Derangements common | Renal dosing |
| Condition-specific imaging | See topic | Diagnostic hallmark | Do not delay when red flags present |
Pharmacology
| Medication | Mechanism | Onset | Role in Therapy | Limitations |
|---|---|---|---|---|
| Magnesium sulfate | Anticonvulsant of choice | Minutes | 4–6 g IV load, then 1–2 g/h | Monitor reflexes/respiration |
| Labetalol / Hydralazine / Nifedipine | Antihypertensives | Minutes-hours | Severe BP control (e.g., ≥160/110) | Hypotension, fetal effects |
Prognosis / Complications
- Outcome depends on timeliness of diagnosis and definitive therapy
Patient Education / Counseling
- Explain red flags, adherence, and follow-up plan
References
- Authoritative guideline/review; see internal bibliography — Link