A 34-year-old woman at 33 weeks in her third pregnancy, who smokes and has chronic hypertension, presents with two hours of constant severe abdominal pain that came on suddenly, and a small amount of dark vaginal bleeding. Her pulse is 118/min and blood pressure 92/58 mmHg. The uterus is hard and exquisitely tender throughout and does not relax between the frequent contractions. The fetal heart rate is 95/min with late decelerations. Her blood group is O RhD negative. An ultrasound at 20 weeks showed a fundal placenta.
Which one of the following is the most appropriate management?
Keep going — a set of ten like this one, one at a time.
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