A 35-year-old woman in her third trimester presents with hypertension and proteinuria. She has swelling in her hands and feet. What is the most appropriate management for her condition?
- a) Immediate cesarean section
- b) Administration of magnesium sulfate ✓
- c) Induction of labor
- d) Bed rest and monitoring
The clinical presentation of a 35-year-old woman in her third trimester with hypertension, proteinuria, and swelling in her hands and feet is suggestive of preeclampsia. Preeclampsia is a pregnancy-related condition characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. The presence of proteinuria further supports this diagnosis.
In managing preeclampsia, the primary goal is to prevent progression to severe disease, which can lead to complications such as eclampsia (seizures), stroke, or placental abruption. The management options include:
- Administration of Magnesium Sulfate: This is indicated for the prevention of seizures in women with severe preeclampsia or eclampsia. It acts as a central nervous system depressant and helps to stabilize the patient.
- Induction of Labor: If the preeclampsia is severe or if there are signs of fetal distress or maternal complications, induction may be necessary to deliver the baby and alleviate symptoms.
- Bed Rest and Monitoring: While bed rest may be recommended for mild cases, it does not address the underlying issues associated with severe preeclampsia.
- Immediate Cesarean Section: This option is typically reserved for cases where there are acute complications that necessitate immediate delivery.
Given these considerations, the most appropriate management for this patient would be b) Administration of magnesium sulfate, especially if she shows signs of severe preeclampsia or if there are concerns about seizure activity.
