Facharzt FMH Gynäkologie Und Geburtshilfe Practice Questions - Facharzt FMH Für Gynäkologie Und Geburtshilfe Spécialiste FMH En Gynécologie Et Obstétrique Exam

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A 29-year-old primigravida at 34+2 weeks of gestation presents to the labor ward with a severe throbbing frontal headache, visual scotoma, and epigastric discomfort. Her blood pressure is 168/112 mmHg on two measurements taken 15 minutes apart. Urinalysis shows 3+ proteinuria (protein-to-creatinine ratio 0.8 mg/mg). Laboratory analysis reveals platelet count 145,000/µL, serum creatinine 75 µmol/L, AST 38 U/L, and LDH 210 U/L. Fetal cardiotocography (CTG) is reassuring with a normal baseline of 135 bpm. In accordance with SGGG and international guidelines, what is the most urgent and appropriate initial pharmacotherapy regimen?

Intravenous magnesium sulfate loading dose (4–6 g over 20 minutes) plus intravenous labetalol (or oral rapid-acting nifedipine) for acute blood pressure lowering Immediate intravenous hydralazine bolus alone without magnesium sulfate, withholding seizure prophylaxis unless hyperreflexia is documented Oral diazepam 10 mg for seizure prophylaxis combined with oral furosemide 40 mg for diuresis Immediate urgent cesarean delivery under general anesthesia prior to initiating maternal blood pressure stabilization

Correct Answer:

Intravenous magnesium sulfate loading dose (4–6 g over 20 minutes) plus intravenous labetalol (or oral rapid-acting nifedipine) for acute blood pressure lowering

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