A 27-year-old G2P1 woman at 34 weeks' gestation presents to the emergency department following a motor vehicle collision. In the trauma bay her heart rate is 130/min and blood pressure is 150/90 mm Hg. She is alert and oriented to person, place, and time. She complains of severe abdominal pain that began immediately after the collision. Physical examination reveals bruising over her abdomen, along with a hypertonic uterus and dark vaginal bleeding. A sonogram reveals a placental abruption, and the fetal heart tracing reveals some declerations. Emergency laboratory tests reveal an International Normalized Ratio of 2.5, with elevated fibrin degradation products. Which of the following is the most appropriate first step in management:
In the question again patient at 34 weeks of gestation is involved in a car accident and presented with high B/P and abdominal pain. Her USG shows placental abruption. As discussed in the previous question. DIC is a complication of abruptio. In this patient INR is 2.5 and fibrin degradation products are raised which means she already is in DIC.
Administer a tocolytic
Administer a corticosteroid.
Administer fresh frozen plasma.
Deliver the fetus immediately by LSCS