Eclampsia
Seizures in pregnancy (after 20 weeks) or up to 6 weeks postpartum are eclampsia until proven otherwise. Magnesium sulphate, blood pressure control and delivery planning save mother and baby. Follow national obstetric guidance.
Checklist— tick steps as you go
0/17 steps done
1During the seizure
2Magnesium sulphate
3Blood pressure
4Deliver and refer
Decision flowchart
Seizure in pregnancy or within 6 weeks postpartum
Left lateral, protect airway, O2, IV access
MgSO4 loading: 4 g IV + 10 g IM (5 g each buttock)
BP 160/110 or higher?
Yes
Labetalol 20 mg IV or hydralazine 5 mg IV; recheck in 15 min
Further seizure?
Yes
MgSO4 2 g IV over 5 min
MgSO4 5 g IM 4-hourly; check reflexes, RR and urine before each dose
Stable between fits?
Yes
Refer to CEmONC with escort; SBAR call ahead
Delivery is the definitive treatment
No
No
MgSO4 5 g IM 4-hourly; check reflexes, RR and urine before each dose
Stable between fits?
Yes
Refer to CEmONC with escort; SBAR call ahead
Delivery is the definitive treatment
No
No
Further seizure?
Yes
MgSO4 2 g IV over 5 min
MgSO4 5 g IM 4-hourly; check reflexes, RR and urine before each dose
Stable between fits?
Yes
Refer to CEmONC with escort; SBAR call ahead
Delivery is the definitive treatment
No
No
MgSO4 5 g IM 4-hourly; check reflexes, RR and urine before each dose
Stable between fits?
Yes
Refer to CEmONC with escort; SBAR call ahead
Delivery is the definitive treatment
No
Educational guidance only — adapt to your resources, scope of practice and local policy. Last updated 12 August 2026.