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

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.