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In utero transfers across yorkshire and the humber by embrace transport service
  1. S Babarao1,2,
  2. C M Harrison1,2,3
  1. 1Embrace Transport Service, Sheffield, UK
  2. 2Sheffield Children's Hospital, Sheffield, UK
  3. 3Leeds Teaching Hospitals Trust, Leeds, UK

Abstract

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.

Reasons:

  • 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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