<prompt> A 26-year-old woman in her sixth month of pregnancy is brought to the emergency department. She had been punched in the abdomen. She is found to have generalized abdominal pain, tenderness, abdominal distention, ileus, and absent fetal heart sounds. The patients blood pressure is 8060 mm Hg; despite administration of 3 L of Ringers lactate, her blood pressure only comes up to 9060 mm Hg. What is the next step in management?Application of PASGTransfusion of 2 U of blood and reevaluateExploratory laparotomy and vaginal hysterectomyExploratory laparotomy with evacuation of the uterus and closure of the uterus disruption  <response>: Exploratory laparotomy with evacuation of the uterus and closure of the uterus disruption is the procedure of choice despite continued hypotension. Blood administration should be instituted but is not as critical as gaining surgical hemostasis. A PASG may have a limited temporizing effect but should not be used as an alternative to exploratory laparotomy. Any patient with abdominal trauma who is hypotensive should not be sent for a CT scan. 