Emergency air transport of obstetric patients

To review the indications and outcomes of pregnant women requiring emergency air transfer to the Women's Hospital, IWK Health Centre, Halifax, Nova Scotia.

A two-year (2003 and 2004) review of all antenatal and intrapartum air transfers to the Women's Hospital, IWK Health Centre, Halifax, via the Nova Scotia Department of Health Emergency Health Services (EHS) LifeFlight Program. Charts were reviewed for indications for maternal transfer and perinatal outcomes.

There were 121 maternal air transfers, representing 1.3% of all deliveries at the Women's Hospital. The primary reasons for transfer were threatened preterm labour (PTL) (41%); preterm premature rupture of the membranes (PPROM) (21%); hypertensive disease/hemolysis, elevated liver enzymes, and low platelets (HELLP) (16.5%); antepartum hemorrhage (13%); and others (8.5%). Of the women transferred, 63% delivered at the Women's Hospital, and 37% returned for delivery to their home hospital. Women transferred for threatened PTL were significantly less likely than those transferred for all other reasons to need delivery at the Women's Hospital (RR 0.44 [0.30-0.65], P < 0.0001).

In almost two thirds of cases, the indications for emergency air transport of pregnant women are threatened PTL or PPROM. The application of fetal fibronectin testing in cases of suspected PTL has the potential to reduce the need for maternal air transfer.