What are the priorities of care for suspected placental abruption?

• A. Administer broad-spectrum antibiotics
• B. Monitor mom for fluid status and fetal heart tones bc it can cause maternal hemorrhage and/or fetal oxygen supply interruption
• C. Place patient in Trendelenburg position
• D. Administer calcium channel blocker for tocolysis

Answer: (B)

Prioritizing maternal stabilization and fetal status is essential when placental abruption is suspected. The most important action is to monitor and support the mother’s fluid status while continually tracking the fetal heart rate, because the abrupt separation of the placenta can lead to maternal hemorrhage and diminished placental blood flow, risking fetal oxygen delivery.

Antibiotics aren’t the immediate focus unless there’s an infection present. Placing the patient in Trendelenburg isn’t appropriate in pregnancy due to risks of worsening blood flow to the uterus and technical concerns with venous return. Tocolysis isn’t used here because delaying delivery can worsen maternal bleeding and fetal distress; in abruption, delivery is often necessary, especially if the mother is unstable or the fetus shows distress.

In practice, this scenario requires rapid IV access, possible blood product support, continuous maternal and fetal monitoring, and preparation for delivery if indicated.