1. A woman needs a large-gauge intravenous catheter inserted for fluid replacement 2. oxygen by mask to limit fetal anoxia. 3. Monitor fetal heart sounds externally and record maternal vital signs every 5 to 15 minutes to establish baselines and observe progress. 4. The baseline fibrinogen determination will be followed by additional determinations up to the time of birth. 5. Keep a woman in a lateral, not supine, position to prevent pressure on the vena cava and additional interference with fetal circulation. 6. do not perform any abdominal, vaginal, or pelvic examination on a woman with a diagnosed or suspected placental separation. Other considerations • Unless the separation is minimal (grades 0 and 1), the pregnancy must be ended because the fetus cannot obtain adequate oxygen and nutrients. • If vaginal birth does not seem imminent, cesarean birth is the birth method of choice. • If DIC has developed, cesarean birth may pose a grave risk because of the possibility of hemorrhage during the surgery and later from the surgical incision. • Intravenous administration of fibrinogen or cryoprecipitate (which contains fibrinogen) can be used to elevate a woman’s fibrinogen level prior to and concurrently with surgery. • With the worst outcome, a hysterectomy might be necessary to prevent exsanguination.