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 35^th week of gestation. She complains of pain in her right upper quadrant, nausea vomiting and headache.

Since her 28^th 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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