A 23-year-old woman underwent cesarean delivery at 34 weeks’ gestation because of severe preeclampsia. Nearly 72 hours after delivery, she experiences a generalized tonic–clonic seizure. Which of the following anticonvulsants is most appropriate?
Eclampsia is described as seizures or coma occurring in the presence of preeclampsia and in the absence of any other neurologic pathology or other causative factors. It occurs in 0.1 to 5.5 of every 10,000 pregnancies in Western countries and has been associated with a maternal mortality rate of approximately 2 percent. A majority of patients with eclampsia have an established diagnosis of preeclampsia before the onset of seizures; however, in approximately a third of patients with eclampsia, the seizure is the initial presentation. The severity of hypertension does not reliably predict the risk of developing eclampsia. Eclamptic seizures are tonic–clonic in nature, typically self-limiting and of short duration, and do not usually recur. For the majority...
