Diuretics are never indicated. These patients are already hypovolemic. ACE inhibitors are also not to be used during pregnancy. Seizure prophylaxis is indicated in all preeclamptic patients during labor and delivery and for a minimum of 24 hours post partum. Some perinatologists continue IV magnesium therapy in preeclamptic patients until the patient begins to diurese.
Magnesium sulfate is the drug of choice.
Treatment of seizures. If this fails, see Chapter 1 for management of status epilepticus. Serum levels of magnesium sulfate are of dubious value, since infusions rarely go longer than 2 days. Magnesium toxicity may be signaled by excessive drowsiness and absence of patellar reflexes. Continue magnesium sulfate therapy at least 24 hours post partum.