What criteria should I use to determine whether a patient with placental abruption requires immediate referral to a specialist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Criteria for immediate referral of a patient with placental abruption to a specialist include:

  • Signs of haemodynamic instability such as pallor, tachycardia, hypotension, shock, or collapse, indicating urgent need for hospital admission and specialist care.
  • Significant concern about the degree of bleeding or pain, which requires emergency assessment and management in secondary care.
  • Presence of placental abruption with adverse outcomes or complications, as this condition is listed among factors indicating increased risk and suggesting planned birth at an obstetric unit.
  • Any evidence of fetal compromise or maternal complications related to placental abruption, necessitating specialist obstetric input.

Referral should be urgent and directed to maternity services or an obstetric unit equipped to manage high-risk pregnancies and emergencies.

Educational content only. Always verify information and use clinical judgement.