Review Question - QID 217659

A 32-year-old G2P1 woman presents to the emergency room at 14 weeks of gestation with vaginal bleeding and abdominal pain. She states that the bleeding started the prior evening and since then, she has soaked through multiple pads. The pain is mild, crampy, and intermittent in nature. Her previous pregnancy was uncomplicated with a spontaneous vaginal delivery. Her past medical history is significant for essential hypertension treated with lifestyle modifications only. Her temperature is 98.6°F (37.0°C), blood pressure is 90/60 mmHg, pulse is 131/min, and respirations are 20/min. Pelvic examination is significant for a cervix dilated to 3 cm with visible products of conceptions through the cervical os. Fetal Doppler ultrasound shows absent fetal cardiac activity. Laboratory studies show a hemoglobin of 6.5 g/dL and A-positive blood type. A previous hemoglobin level from 3 months ago was 11.2 g/dL. Which of the following is the most appropriate next step in management?