A 32-year-old woman, gravida 2 para 1, at 35 weeks of gestation, presents to the emergency department with complaints of severe epigastric and right upper quadrant (RUQ) pain for the past 8 hours. She also reports nausea, fatigue, and a headache that has not improved with acetaminophen. She denies seizures, visual disturbances, or vaginal bleeding. Her prenatal care had been uneventful until this visit. Examination Findings: Vital Signs: BP 170/110 mmHg, HR 96 bpm, Temp 98.9°F. General Exam: The patient appears uncomfortable and fatigued. Abdominal Exam: RUQ tenderness without rebound or guarding. Neurological Exam: No focal deficits or signs of clonus. Investigations: 1.Laboratory Results: Test Result Reference Alanine aminotransferase (ALT) 140 10 – 40 U/L Aspartate aminotransferase (AST) 120 12 – 38 U/L Platelet count 85,000 150,000 – 400,000/mm³ Lactate dehydrogenase 680 45 – 200 U/L Peripheral smear: Schistocytes Urine 3+ proteins 2.Imaging: Liver Ultrasound: Normal, with no evidence of hematoma or rupture. Fetal Monitoring: Non-stress test shows a reassuring fetal heart rate pattern.What is the definitive treatment for this disorder?
