Is there a role for the obstetric flying squad in Peninsula Malaysia?

The Obstetric Flying Squad (OFS) has been operating in Peninsular Malaysia for over three decades. In the light of current controversies regarding its role in modern day obstetric practice, its status in Malaysia over the last 12 years is reviewed.

Statistics from three Malaysian states (Kelantan, Trengganu and Malacca) were reviewed with regard to the numbers and places of delivery as well as OFS and ambulance call out rate (per 1000 deliveries). These statistics were obtained from the annual reports of the three state hospitals. Improvement in socioeconomic development was reviewed in order to study its impact on the requirement of OFS service.

The last decade has witnessed a marked decrease in home deliveries, a higher proportion of high risk pregnancies delivering under medical supervision and a dramatic increase in the availability of telecommunication, transport and rural medical facilities. The OFS callout rate has fallen significantly, though the principal indication for calls were due to post-partum haemorrhage and retained placenta. The average time taken to reach a patient is 47 minutes for an OFS call compared to 26 minutes for an ambulance call in Kelantan.

Given the disadvantages of longer response time and the requirement for a skilled specialist to man the service, the OFS service can be completely replaced by the ambulance service (with training of drivers in first aid) in the general Malaysian setting. However, there may still be a limited role for the OFS in the isolated rural communities where access by land transport is extremely difficult.