Cardiac arrest following magnesium sulfate administration in a patient with severe preeclampsia: A case report

Magnesium sulfate is the standard prophylactic treatment for seizures in severe preeclampsia, but its use requires careful monitoring due to potential toxicity, particularly when combined with antihypertensive agents. We report a 29-year-old primigravida at 35 + 6 weeks gestation with severe preeclampsia who developed sudden cardiac arrest approximately 20 min after receiving intramuscular magnesium sulfate, 23 h post-emergency cesarean delivery. Her recovery was complicated by acute kidney injury, respiratory distress requiring emergency tracheostomy, and rib fractures with intrathoracic hematoma from resuscitation efforts. This case highlights the rare but potentially life-threatening complications of magnesium sulfate therapy, even in patients with normal baseline renal function. It emphasizes the need for vigilant monitoring, readiness for resuscitation, and awareness of individual susceptibility factors. The complex post-arrest course underscores the multidisciplinary expertise required for optimal maternal outcomes in such critical situations.