<prompt> Which of the following is the earliest warning sign of Magnesium Sulphate toxicity?Respiratory rate 12Loss of DTRsAltered sensoriumUrine output 25-30 cchour  <response>: Ans. B. Loss of DTRs. Ref Textbook of Obstetrics D.C. Dutta 6th ed, 229SEIZURE PROPHYLAXIS IN PIH - MAGNESIUM SULFATE Is not a hypotensive agent Works as a centrally acting anticonvulsant Also blocks neuromuscular conduction Serum levels: 6-8 mgdL Magnesium sulfate Monitor urine output and DTRs- Cervical dilatation of 3 to 5 cm or more, in the presence of uterine contractions, can be taken to reliably represent the threshold for active labor. With renal dysfunction, may require a lower doseToxicity Respiratory rate 12 respiratory depression develops when levels go lOmEgL DTRs not detectable earliest warning sign of toxicity 10 mEqL Altered sensorium Urine output 25-30 cchour Respiratory paralysis arrest 3 12 mEqL Antidote: 10 ml of 10 solution of calcium gluconate IV over 3 minutes- The therapeutic level of serum magnesium is 4-7 mEqL.- The normal level of serum blood magnesium is 1.5 - 2.0 mEqL 1-2 mgdl.Hypertension in pregnancy CommentsRxGestational hypertension pregnancy-induced hypertensionBP 14090 mmHg after the 20th week of gestation. No preexisting hypertension. No proteinuria or end-organ damage.Treatment: antihypertensives a- methyldopa, labetalol, hydralazine, nifedipine, deliver at 39 weeks.Preeclampsia- Defined as hypertension 14090 mmHg and proteinuria 300 mg24 hr after 20th week of gestation to 6 weeks postpartum 20 weeks suggests molar pregnancy.Severe features include BP 160110 mmHg with or without end-organ damage, e.g., headache, scotoma, oliguria,AST ALT, thrombocytopenia.- Caused by abnormal placental spiral arteries, results in maternal endothelial dysfunction, vasoconstriction, or hyperreflexia.- Incidence 