MgSO4

1st line tx of eclampsia
Prophylaxis against eclampsia if severe preeclampsia
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
Dose: 4g IV loading dose then 1g/hr
- No routine monitoring of Mg levels
- Monitor reflexes, vital signs, urine output regularly
If pre-existing or gestational HTN, consider MgSO4 for fetal neuroprotection if imminent preterm birth (w/in 24 hrs) @ ≤31+6 wks gest
- Don’t delay delivery to give MgSO4 if maternal and/or fetal indications for emergency delivery

Reference: Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: Hypertensive Disorders of Pregnancy: Diagnosis, Prediction, Prevention, and Management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002

MgSO4

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1st line tx of eclampsia

Prophylaxis against eclampsia if severe preeclampsia

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

Dose: 4g IV loading dose then 1g/hr

No routine monitoring of Mg levels

Monitor reflexes, vital signs, urine output regularly

If pre-existing or gestational HTN, consider MgSO4 for fetal neuroprotection if imminent preterm birth (w/in 24 hrs) @ ≤31+6 wks gest

Don’t delay delivery to give MgSO4 if maternal and/or fetal indications for emergency delivery