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161203 Surgery

A 26-year-old woman in her sixth month of pregnancy is brought to the emergency department. She had been punched in the abdomen. She is found to have generalized abdominal pain, tenderness, abdominal distention, ileus, and absent fetal heart sounds. The patient’s blood pressure is 80/60 mm Hg; despite administration of 3 L of Ringer’s lactate, her blood pressure only comes up to 90/60 mm Hg. What is the next step in management?

AApplication of PASG
BTransfusion of 2 U of blood and reevaluate
CExploratory laparotomy and vaginal hysterectomy
DExploratory laparotomy with evacuation of the uterus and closure of the uterus disruption
Surgery
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