Preeclampsia & Eclampsia

Trauma & Pregnancy · ICU Decoded chapter 71 · Locked — free with a referral

By Dr Javed Akhtar · Last reviewed 3 October 2026

Cited to ACOG 2020.

Key points

Load MgSO₄ 4–6 g then run 1–2 g/h for seizure prophylaxis and treatment; repeat a 2–4 g bolus for recurrent seizures.
At BP ≥160/110 give labetalol, hydralazine, or nifedipine urgently to prevent stroke, then aim for ≤135/85 mm Hg (NICE).
Definitive fix is delivery; HELLP (platelets falling, hemolysis, LFTs rising): deliver, Mg, platelets if bleeding/<20.
Watch Mg toxicity via reflexes and RR; antidote is calcium gluconate 1 g IV.

Investigations

First tests: Repeated BP and neurological/respiratory assessment, Full blood count, Sodium, potassium, bicarbonate, urea and creatinine, Liver biochemistry, Urine protein:creatinine or albumin:creatinine ratio.

Only if indicated: LDH, film and hemolysis tests, Fetal assessment, Noncontrast CT head.

Repeat monitoring: Full blood count, Clinical magnesium-toxicity assessment.

Management pathways in this chapter

Treatment of Severe Preeclampsia/Eclampsia
HELLP Syndrome

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