During a labor induction for preeclampsia with severe features, a patient at weeks and days gestation begins experiencing acute, severe shortness of breath and a cough producing pink-tinged sputum. The patient, who is years old and nulliparous, has been receiving continuous intravenous infusions of magnesium sulfate and oxytocin for the past eight hours. Her medical history is otherwise unremarkable, and she has not received regional anesthesia. Vital signs show a temperature of (), blood pressure of , pulse of , and respirations of . Pulse oximetry indicates an oxygen saturation of on room air. Physical examination reveals pitting edema of the lower extremities and bilaterally hyperactive () patellar reflexes. Auscultation of the lungs reveals diffuse bilateral crackles extending to the apices. Pelvic examination indicates the cervix is dilated and effaced. Fetal heart rate monitoring demonstrates a baseline of , moderate variability, and occasional variable decelerations that recover rapidly to baseline. Which of the following is the most appropriate next step in management?
- Intravenous furosemide administrationAnswer
- BImmediate cesarean delivery
- CInhaled albuterol therapy
- DReassurance and supplemental oxygen
- EIntravenous ceftriaxone and azithromycin