A twenty years old woman has been brought to casualty with history of acute pain in abdomen and bleeding per vaginum since 6 hrs . On examination, she is drowsy BP is 70/40 mm Hg, pulse rate 120/min. and a positive urine pregnancy test. She should be managed by :-

**Core Concept**
The patient is presenting with signs of severe hemorrhagic shock, likely due to a ruptured ectopic pregnancy, which is a life-threatening obstetric emergency. The patient's drowsiness, hypotension, and tachycardia indicate compromised circulatory status.

**Why the Correct Answer is Right**
The immediate management of a ruptured ectopic pregnancy involves stabilizing the patient's vital signs through fluid resuscitation and administering medications to control the bleeding. The patient should be given intravenous fluids to maintain her blood pressure, and **oxytocin** or **methergine** can be administered to cause uterine contractions and reduce bleeding. Additionally, **surgical intervention** is often required to repair or remove the damaged fallopian tube.

**Why Each Wrong Option is Incorrect**
**Option A:** Administering **mifepristone** would be incorrect as it is an anti-progestin used for medical abortion and would not be effective in controlling the bleeding in this scenario.
**Option B:** Performing **laparoscopic surgery** without first stabilizing the patient's vital signs could worsen her condition and is not the initial management step.
**Option C:** Administering **antibiotics** alone would not address the immediate need to control bleeding and stabilize the patient's vital signs.

**Clinical Pearl / High-Yield Fact**
In cases of suspected ruptured ectopic pregnancy, a **FAST (Focused Assessment with Sonography for Trauma) ultrasound** can be quickly performed to confirm the diagnosis and guide further management.

**Correct Answer:** C. Administering oxytocin or methergine and preparing for surgical intervention.

✓ Correct Answer: A. Immediate laparotomy