Embrace, combined paediatric and neonatal transport service for Yorkshire and Humber, is also a cot locator to facilitate in-utero transfers for a region with 75 000 births/year.
Aims To evaluate in utero transfer requests – indications for transfer, time spent locating cot/bed, fibronectin use and outcomes.
Prospective audit of all in-utero requests 1 October 2010–7 January 2011. Data obtained via audit proforma and phone calls to maternity units.
Results 120 in-utero transfers requested.
Reasons for requests:
▶ lack of neonatal cots 54% (65/120).
▶ maternal conditions requiring specialist care 2.5% (3/120).
▶ preterm gestation 24% (29/120).
▶ impending preterm labour 7.5% (9/120).
86 transfers facilitated resulting in mother being transferred for care.
13/120 of total requests – out of region cot located.
34 did not result in transfer despite cot/bed being located by Embrace.
▶ Mother deteriorated/went into labour 41% (14/34).
▶ Unit unwilling to accept out of region cot 12% (4/34).
▶ Local NNU arranged cot 15% (5/34).
▶ Referring hospital arranged transfer 6% (2/34).
▶ Changed decision re transfer need 20.7% (7/34).
Tertiary perinatal centres accepted 41% transfers, level 2 units 59%.
Mean time facilitating transfers – 82 min.
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 h of transfer.
No reported fetal /maternal morbidity following transfer.
13.3% referrals used fibronectin.
Conclusion IUT are a significant part of Embrace's workload. Enhanced use of fibronectin may enhance appropriateness of transfers.
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