Soru

A $29$-year-old G1P0 woman at $32$ weeks gestation is brought to the emergency department due to the acute onset of severe shortness of breath and a cough productive of pink, frothy sputum. She recently emigrated from a developing country and had limited prenatal care. She reports a history of frequent, untreated sore throats during childhood. Her temperature is $37.8^\circ\text{C}$ ($100.0^\circ\text{F}$), blood pressure is $110/68\text{ mmHg}$, pulse is $135/\text{min}$ and irregularly irregular, and respirations are $28/\text{min}$. Pulse oximetry shows $86\%$ on room air. Physical examination reveals elevated jugular venous pressure. Lung auscultation demonstrates bibasilar crackles and diffuse expiratory wheezes. Cardiac examination reveals a loud S1 and a low-pitched, rumbling, mid-diastolic murmur heard best at the apex.

Laboratory results are as follows:

Continuous fetal heart rate monitoring shows a baseline of $150/\text{min}$ with moderate variability and recurrent late decelerations. Which of the following is the most appropriate next step in management?