A 28 year old eclamptic woman develop convulsions.The first measure to be done is:
Give MgSO4
Sedation of patient
Immediate delivery
Care of airway
Preeclampsia when complicated with convulsion and / or coma is called eclampsia.
Fits occurring in eclampsia are Generalised tonic clonic seizure.
In most cases seizures are self limited, lasting for 1 to 2 minutes.
Management:
“The first priorities are to ensure that the airway is clear and to prevent injury and aspiration of gastric content
COGDT 10/e, p 326
Initial management during eclamptic fit:

Patients should be kept in an isolated room to protect from noxious stimulus which might provoke further fits.
Mouth gag is placed between teeth to prevent tongue bite.
Air passage is cleared off the mucus.
Oxygen is given.
Catheterization is done to monitor urine output.

Specific management:
A. Medical management
i. Seizure treatment

The drug of choice for the control and prevention of convulsions is magnesium sulphate (Pritchard’s regimen) Previously used anticonvulsant regimen for eclampsia was ‘Lytic cocktail regimen’ given by Menon using pethidine, chlorpromazine and phenargen. but now it is not used.

ii. Treatment of hypertension

DOC in eclampsia is labetalol.
2nd DOC in eclampsia is hydralazine.

B. Obstetric management in antepartum cases:

Immediate termination of pregnancy should be done.
Vaginal delivery is preferred but “In current obstetrical practice the large majority of eclamptic women are delivered by cesarean section. The most common exception to cesarean delivery are women with a fetal demise and the rare ones with a very ripe cervix.”

Fernando Arias 3/e, p 427