March 2025
First line management of eclampsia and severe hypertension in preeclampsia is stabilisation. Airway, breathing, circulation assessment and stabilisation, then expedient magnesium sulphate loading and infusion, and blood pressure stabilisation to less than 160/110 mm Hg should occur.
Where severe hypertension or eclampsia occurs prior to birth, it is important to carefully plan timing of birth with input from senior obstetric staff. Depending on clinical features, the woman may need urgent coagulation correction prior to birth.
Urgent caesarean section is not recommended until the above steps are completed and the woman is assessed as safe and stable for birth.