Soru

While rounding on the labor and delivery unit, an attending physician evaluates a full-term pregnant woman undergoing a trial of labor after a previous low transverse cesarean section. The pregnancy has been entirely uncomplicated to date. Over the last six hours, her labor progressed normally, and the fetal head was documented at a $+1$ station. Suddenly, the patient reports a severe, tearing pain in her lower abdomen that persists between contractions. On physical examination, the fetal presenting part is now palpated at a $-2$ station. The continuous fetal heart rate monitor, which previously showed a category I tracing, now demonstrates a sustained fetal heart rate of $80$ beats per minute lasting for over four minutes. Vaginal bleeding is scant, but the patient's heart rate has increased to $115$ beats per minute and her blood pressure is $90/55$ mmHg. Which of the following is the most appropriate next step in the management of this patient?