Best of Five 3.45

 

   

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BOF: 3.45

A 28-year-old female is admitted to the obstetric unit. She is in her 35th week of gestation. She complains of pain in her right upper quadrant, nausea vomiting and headache.

Since her 28th week of gestation she has had hypertension, oedema and proteinuria. On examination there is tenderness in the right upper quadrant, no other physical signs.

Investigations reveal:

Hb 9.5 g /dL

The blood film shows deformed red cells

Platelet count 75 x 109/l

LDH 650 u/l

AST 165 IU/l

Serum bilirubin 55 mmol/L

In this patient the best course of action would be:

a)      Urgent delivery of the baby by caesarean section

b)      Low dose aspirin

c)     Corticosteroids

d)      Plasma volume expansion

e)      Vasodilatation

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