The patient described in the question presents with a classic history for abruption-that is, the sudden onset of abdominal pain accompanied by bleeding. Physical examination reveals a firm, tender uterus with frequent contractions, which confirms the diagnosis. The fact that a clot forms within 4 min suggests that coagulopathy is not present. Because abruption is often accompanied by hemorrhaging, it is important that appropriate fluids (i.e., lactated Ringer solution and whole blood) be administered immediately to stabilize the mother's circulation. Cesarean section may be necessary in the case of a severe abruption, but only when fetal distress is evident or delivery is unlikely to be accomplished vaginally Internal monitoring equipment should provide an early warning that the fetus is compromised. The internal uterine catheter provides pressure recordings, which are important if oxytocin stimulation is necessary. Generally, however, patients with abruptio placentae are contracting vigorously and do not need oxytocin.