What are the recommended monitoring protocols for a patient diagnosed with placental abruption in a primary care setting?

Recommended monitoring protocols for a patient diagnosed with placental abruption in a primary care setting:

• Immediate referral to secondary care is essential as placental abruption is an obstetric emergency requiring specialist management and continuous monitoring NICE NG121.

• While in primary care, initial maternal monitoring should include establishing venous access if possible and recording vital signs such as pulse, blood pressure, respiratory rate, temperature, and urine output to assess maternal stability NICE NG121.

• Continuous monitoring of vaginal blood loss should be performed to assess the severity of haemorrhage NICE NG121.

• Fetal monitoring with continuous cardiotocography (CTG) is indicated if available, to assess fetal heart rate and wellbeing, as placental abruption poses a high risk of fetal compromise NICE NG121,NICE NG229.

• Blood tests including full blood count and cross-matching should be arranged urgently if significant bleeding is suspected, to prepare for possible transfusion and to assess maternal haemoglobin and coagulation status NICE NG121.

• Urgent intravenous fluid resuscitation should be initiated if there is large blood loss or maternal instability, but this is typically managed in secondary care NICE NG121.

• Primary care providers should ensure rapid escalation and transfer to a hospital with obstetric and neonatal facilities for ongoing intensive surveillance and management NICE NG121.

In summary, primary care's role is to perform initial maternal observations, monitor vaginal bleeding, initiate fetal heart rate monitoring if possible, and urgently refer to secondary care for definitive management of placental abruption NICE NG121,NICE NG229.