Abstract
Background and Aims: Embrace, combined paediatric and neonatal transport service for Yorkshire and Humber, facilitates in-utero transfers for a region with 75,000births/year. Our aim was to evaluate in utero transfer requests - indications for transfer, time spent locating cot/ bed, fibronectin use and outcomes.
Methods: Prospective audit of in-utero requests during 1/10/2010 - 7/01/2011. Data obtained via audit proforma and phone calls to maternity units.
Results: 86 transfers were facilitated out of 120 in-utero requests. The main reasons for requests were lack of neonatal cots 54% (65/120), maternal conditions requiring specialist care 2.5% (3/120), preterm gestation 24% (29/120) and impending preterm labour 7.5% (9/120).
13/120 of total requests - out of region cot located.
34 did not result in transfer despite cot/bed being located. The reasons were:
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Mother deteriorated/ went into labour 41%
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Unit unwilling to accept out of region cot 12%
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Local NNU arranged cot 15%
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Referring hospital arranged transfer 6%
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Changed decision re transfer need 20.7%
Tertiary perinatal centres accepted 41% transfers.
Mean time facilitating transfers - 82 minutes.
Mean number of phone calls - 6.3.
On average to organise 1 successful IUT, 2.1 maternity units and 3.4 neonatal units contacted.
50% of mothers delivered within 24 hrs of transfer.
13.3 % referrals used fibronectin.
Conclusion: IUT are a significant part of Embrace's workload. Increased use of fibronectin in impending deliveries would enhance appropriateness of transfers.
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Babarao, S., Harrison, C. & Hancock, S. Profile Of In-Utero Transfers in Yorkshire & Humber - Embrace Transport Service. Pediatr Res 70 (Suppl 5), 611 (2011). https://doi.org/10.1038/pr.2011.836
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DOI: https://doi.org/10.1038/pr.2011.836