Skip to content
Browse cases

Case 08 · Obstetrics

Eclampsia at 36 weeks

A 23-year-old first-time mother with almost no antenatal care is brought in with a headache and blurred vision, and fits as she reaches the trolley. Her BP is 172/114. Protect her airway, give magnesium sulfate by a recognised regimen, bring her blood pressure down safely, and stabilise her before the baby is delivered.

PlayableClinical review pendingIntermediateAbout 30–90 simulated minutesHindi · English · both
Start Case 08All cases

About this case

What you will practise

Learning objectives

  • Manage the airway during and after an eclamptic fit: left lateral, no restraint, suction and oxygen.
  • Give magnesium sulfate by the Pritchard or Zuspan regimen, and treat a recurrent fit.
  • Monitor for magnesium toxicity with reflexes, respiratory rate and urine output, and treat it with calcium gluconate.
  • Treat severe hypertension within 30–60 minutes with labetalol, hydralazine or nifedipine, without dropping BP too far.
  • Restrict fluids, look for HELLP, and assess the baby once the mother is stable.
  • Plan delivery after maternal stabilisation.

Key decisions this case tests

  • Diazepam or magnesium for the fit?
  • How fast, and how far, should the BP come down?
  • When is it safe to give the next magnesium dose?
  • The fetal heart is slow after the fit. Theatre now?
  • Do fluid boluses help a woman with pre-eclampsia?

Reference basis

  • World Health Organization. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia, 2011.
  • Ministry of Health and Family Welfare, Government of India: maternal health guidance on magnesium sulfate (Pritchard regimen).
  • ACOG Practice Bulletin 222 (2020) and Committee Opinion 767 (2019) on hypertension in pregnancy and acute severe hypertension.
  • Eclampsia Trial Collaborative Group. Lancet 1995;345:1455–63.

Content version 1.0 · November 2026 · clinical review pending. See the Clinical content policy.

Before you start

The physiology is a simplified teaching model: magnesium levels, BP responses, fit timing and stroke risk are timed for learning, not prediction. Doses follow the cited guidelines but have not yet been signed off by a clinician.

Visle is for education only and is not medical advice. Severe headache, blurred vision, upper abdominal pain or a fit in pregnancy needs emergency care.

Ready for another emergency?

Case 07 puts you in charge of septic shock from a hidden source that antibiotics alone cannot fix.

Play Case 07Case library