A 36-week pregnant patient presents with sudden-onset generalized tonic-clonic seizure and prior history of elevated BP and proteinuria. Which immediate step best differentiates management priorities for eclampsia versus isolated seizure etiologies and initiates appropriate care?

• A. Administer oral anti-seizure medication only and discharge home for outpatient neurology evaluation because seizures in pregnancy are rarely related to preeclampsia or eclampsia.
• B. Treat only with aggressive intravenous insulin infusion as first-line because all seizures during pregnancy are caused by severe hyperglycemia.
• C. Delay any seizure-specific treatment until a full MRI is obtained because immediate seizure control is not necessary in pregnant patients with hypertension.
• D. Assume eclampsia as likely; secure airway, give IV magnesium sulfate to prevent recurrent seizures, control severe hypertension, and prepare for urgent delivery as definitive therapy if maternal or fetal status warrants.

Answer: (D)