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8862 Gynaecology & Obstetrics

A 36-year-old G1P0 at 35 weeks gestations presents with several days H/O generalised malaise, anorexia, nausea emesis and abd. discomfort. She has loss of apetite and loss of several pounds wt in 1 week. Fetal movements are good. There is no headache, visual changes, no vaginal bleeding, no regular uterine contractions or rupture of membranes. She is on prenatal vitamins. No other medical problem. On exaeration she is mild jaundiced and little confused. Her temp is 100 degree F, PR- 70, BP- 100/62, no significant edema, appears dehydrated. FHR is 160 and is nonreactive but with good variability. Her WBC- 25000, Hct- 42.0, platelets- 51000, SGOT/SGPT-287/ 350, GLUCOSE-43, Creatinine- 2.0, fibrinogen-135, PT/PTT- 16/50, S. Ammonia level- 90 micromol/L. Urine is 3+ Proteins with large amount of ketones.What is the the recommened treatment for this patient

AImmediate delivery
BCholecystectomy
CIntravenous diphenhydramine
DMgSO4 therapy
Gynaecology & Obstetrics
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