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MgSO4
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1st line tx of eclampsia
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Prophylaxis against eclampsia if severe preeclampsia
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Consider for prophylaxis if non-severe preeclampsia with: severe HTN, headache, visual symptoms, RUQ pain, epigastric pain, plt <100, progressive renal insufficiency, and/or elevated liver enzymes
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Dose: 4g IV loading dose then 1g/hr
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No routine monitoring of Mg levels
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No phenytoin or BDZs for eclampsia prophylaxis or tx unless contraindications to MgSO4 or MgSO4 is ineffective
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If pre-existing or gestational HTN, consider MgSO4 for fetal neuroprotection if imminent preterm birth (w/in 24 hrs) @ ≤31+6 wks gest
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Don’t delay delivery to give MgSO4 if maternal and/or fetal indications for emergency delivery
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Adapted from SOGC Clinical Practice Guideline. Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy: Executive Summary. J Obstet Gynaecol Can 2014;36(5):416–438
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