MS Is 34 Weeks Gestation and Has Had Heartburn During

Multiple Choice

M.S. is 34 weeks gestation and has had heartburn during her pregnancy that thus far has been relieved by lifestyle modification and calcium carbonate. Today she drops in to your office stating that her symptoms have worsened in the last 24 hours. She looks very sick and states that she now has midepigastric pain with nausea, vomiting, and malaise. She says the pain is constant and not food related. Which of the following would be the best management at today's visit?

A) Begin omeprazole and call in 24 hours if symptoms don't resolve
B) Consult with physician to rule out HELLP syndrome
C) Order ultrasound to rule out gallbladder disease
D) Prescribe ranitidine and begin IV hydration with 1-2 liters