Soru

A 31-year-old woman, gravida 2 para 1, at 37 weeks and 4 days gestation, presents to the emergency department reporting unremitting lower back pain for the past three hours. She has not experienced any vaginal bleeding, leakage of fluid, or recent trauma. Her medical history is significant for chronic hypertension managed with oral labetalol. Vital signs are temperature 37.1°C, pulse 115/min, blood pressure 152/92 mm Hg, and respirations 18/min. Physical examination reveals a firm, tense uterus that is tender to deep palpation. There is no visible blood in the vaginal vault on speculum examination, and the cervix is closed. Continuous electronic fetal monitoring demonstrates a baseline heart rate of 165/min, absent baseline variability, and repetitive late decelerations. The tocodynamometer shows high-frequency, low-amplitude uterine contractions occurring every 1 to 2 minutes with an elevated resting tone. Initial laboratory studies show a hemoglobin of 10.4 g/dL, platelet count of 105,000/mm³, and fibrinogen of 190 mg/dL. Which of the following is the most appropriate next step in management?