PICC

Peripherally Inserted Central Catheter

Therapeutic Management for Abruptio Placenta

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.