C is the correct answer. Why?

Explanation

A resuscitative hysterotomy (perimortem cesarean section) is performed in pregnant patients in cardiac arrest with uterine size above the umbilicus (gestational age > 20–24 weeks, depending on the reference text). This procedure might increase venous return and cardiac output in the patient and could improve maternal hemodynamics and allow for fetal resuscitation. A scalpel, large scissors, and hemostats are needed. Immediate and emergent consultation with general surgery and obstetrics for assistance is optimal but should not delay the procedure. 

This procedure first requires prepping the entire abdomen with chlorhexidine and using the scalpel to make a long midline incision from the uterine fundus to just above the pubic symphysis. Next, enter the peritoneal cavity using the scissors and make an incision into the uterine cavity with the scalpel, using the scissors to advance the incised opening. Deliver the fetus, clamp the umbilical cord, cut the cord, and hand the fetus off to the neonatal team. Follow with the delivery of the placenta, and then pack the uterus with sterile gauze before resuming cardiopulmonary resuscitation. The resuscitation should be continued until all possible causes are addressed or there are signs of a futile resuscitation.

Consulting obstetrics (A) could be helpful, but the emergency physician should also perform a resuscitative hysterotomy, which should not be delayed for a consult. The best chance of resuscitating the patient and fetus would be to perform an emergency hysterotomy early in the resuscitation course. It should be performed within 4 minutes of cardiac arrest and be completed within 5 minutes of arrest.

A low horizontal incision just above the pubis (B) is the location of a traditional cesarean section. It would not be the appropriate location to perform a resuscitative hysterotomy.

Terminating resuscitation efforts (D) is premature at this stage prior to attempting a resuscitative hysterotomy.