Maternal transport of patients with advanced cervical dilatation--to fly or not to fly?

Emergency maternal transport of women in advanced preterm labor often involves difficult decisions about whether to transport or not. A retrospective review of maternal transports performed in northern Arizona by Samaritan Air Evac covered a 21-month period. Of the 1080 patients transported for preterm labor, 54 calls for transport (5%) were received when the patient was 7 cm or more dilated. Five women were delivered at the referring hospital and 49 were transported, none of whom delivered en route. Only 21 (39%) of them delivered in the first hour after arrival at the tertiary center. The decision to transport patients in advanced preterm labor should be based on such factors as distance between hospitals, time required to cover that distance, personnel on the transport, facilities available at the transporting hospital, gestational age, and speed with which labor has progressed.