BP control (target <135/85)
- ›Labetalol 200 mg PO (or 20–50 mg IV bolus over 2 min, repeat q10 min, max 300 mg).
- ›Nifedipine MR 10–20 mg PO (avoid sublingual — hypotension).
- ›Hydralazine 5 mg IV over 5 min, repeat q20 min (max 20 mg).
Seizure prophylaxis / treatment
- ›MgSO₄ 4 g IV loading over 5 min → 1 g/h IV maintenance for 24 h post-delivery/last seizure.
- ›Monitor: RR ≥12, patellar reflexes present, urine output ≥25 mL/h.
- ›Toxicity: calcium gluconate 1 g IV over 10 min.
Delivery
- ›Deliver at 37/40 for pre-eclampsia without severe features; earlier if severe or HELLP.
Common mistakes
- •ACE inhibitors / ARBs in pregnancy → renal dysgenesis, oligohydramnios.
- •Sublingual nifedipine → precipitous hypotension.
- •Stopping MgSO₄ at delivery — continue 24 h post-partum.