In-utero transfer is too difficult: Results from a prospective study

• Published in: Early human development Vol. 88; no. 3; pp. 147 - 150
• Main Authors: Gale, C., Hay, A., Philipp, C., Khan, R., Santhakumaran, S., Ratnavel, N.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2012; Elsevier
• Subjects: Advanced Basic Science; Biological and medical sciences; Embryology: invertebrates and vertebrates. Teratology; Emergency Medical Services; Female; Fundamental and applied biological sciences. Psychology; Humans; In-utero transfer; London; Neonatal and Perinatal Medicine; Patient transfer; Post-natal transfer; Pregnancy; Preterm birth; Prospective Studies; Transportation of Patients; London; Patient transfer; Preterm birth; In-utero transfer; Post-natal transfer; Human; Pregnancy disorders; Prematurity; Premature delivery; Transfer; In utero
• ISSN: 0378-3782; 1872-6232; 1872-6232
• DOI: 10.1016/j.earlhumdev.2011.07.016

Perinatal transfer is an unavoidable part of neonatal care. In-utero as opposed to postnatal transfer is recommended whenever possible. To quantify prevalence of in-utero transfers, determine the duration of time spent arranging in-utero transfers and whether failures in the organisation of potential in-utero transfers were occurring. Prospective study of in-utero transfers referred and completed, and questionnaire study of failed potential in-utero transfers. Women referred to the Emergency Bed Service (EBS), women undergoing in-utero transfer by London Ambulance Service (LAS), and preterm infants undergoing postnatal transfer where in-utero transfer had been potentially achievable, in the London area, over a six month period in 2009. Number of in-utero transfers being undertaken, duration of time spent arranging in-utero transfer, and number of failed in-utero transfers. Over the study period LAS undertook 438 in-utero transfers and there were 338 referrals for in-utero transfer to EBS, of which 180 (53%) were successful. Of 69 emergency postnatal transfers of preterm infants (<29weeks gestational age), 11 were classified as failed in-utero transfers. Median (IQR) duration of EBS involvement in in-utero referrals was 340 (200–696)min. A median (IQR) of 240 (150–308)min was spent contacting a median (IQR) of 7 (6–8)units when attempting to arrange in-utero transfer in the failed in-utero transfer group. Arranging in-utero transfer consumes considerable clinical time; an important number of in-utero transfer attempts fail for non-clinical reasons; establishment of a centralised in-utero transfer planning service will save clinical time and may improve outcomes.