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In placental abruption, maternal hemorrhage and coagulopathy can rapidly compromise both mother and fetus. The priority is maternal resuscitation—establishing two large-bore IVs, initiating balanced resuscitation with crystalloid judiciously, and ensuring blood products are available or pre-notified at the receiving facility. Restoration of maternal perfusion improves uteroplacental blood flow and fetal oxygenation. Routine tocolysis is contraindicated in abruption due to risk of masking bleeding and worsening outcomes. Trendelenburg does not meaningfully enhance uterine perfusion and may impair ventilation and aspiration risk. Magnesium sulfate is indicated for severe preeclampsia/eclampsia or fetal neuroprotection in imminent preterm delivery at specific gestational ages, but it does not address acute hemorrhagic shock from abruption. During flight, continuous fetal monitoring may be limited; prioritize maternal ABCs, hemodynamics, Rh status if relevant, and rapid transport to a facility with obstetric and neonatal capability. Maternal stabilization remains the most effective fetal intervention in hemorrhagic obstetric emergencies.