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.