A fictional 34-year-old at 35 weeks’ gestation has a generalised seizure, severe hypertension and headache with visual disturbance.
Listen for the assumption.
We need to deliver the baby immediately before treating the seizure.
What must be stabilised first, and which treatment is guided by NICE?
I will call obstetrics, anaesthetics and senior help, stabilise airway/breathing/circulation and follow the current magnesium-sulfate and severe-hypertension pathway.
Choose an answer below and reveal the reasoning to see consultant feedback at every checkpoint. The full consultant-led synthesis follows after all three decisions.
Go to the first decision ↓The picture develops.
- Generalised seizure with post-ictal confusion
- Severe hypertension
- Headache and visual symptoms before the event
Commit before you reveal.
After you select an option, reveal the model reasoning and the consultant’s feedback.
Hear the senior team refine the plan.
The registrar tests the plan, the consultant synthesises the key principle, and the SHO confirms the safer next steps.
Watch for recurrent seizure, airway compromise, severe hypertension and magnesium toxicity under the active protocol.
The task is not merely ‘give magnesium’; it is coordinated maternal resuscitation and a safe birth plan.
I will document seizure timing, treatment, blood-pressure trend and senior obstetric/anaesthetic plan.
What must remain explicit.
- Use the current local maternity emergency pathway.
- Call senior obstetric, anaesthetic and critical-care help immediately.
- This case does not provide drug doses.
Where reasoning fails.
- Focusing on delivery before resuscitation
- Using remembered protocols
- Underestimating post-ictal airway risk
Eclampsia with seizure [time/recovery], BP [trend], treatment [time/response], gestation [weeks] and obstetric/anaesthetic plan [names].
How would you frame maternal stabilisation when family members ask immediately about delivery?