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

C Gale1, A Hay, C Philipp

  • 1Neonatal Transport Team, Royal London Hospital, London, United Kingdom. christopher.gale@imperial.ac.uk

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Summary

In-utero transfers are crucial for neonatal care but often face organizational delays and failures. A centralized planning service could improve efficiency and outcomes for these critical neonatal transports.

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Area of Science:

  • Neonatal care
  • Maternal-fetal medicine
  • Healthcare logistics

Background:

  • Perinatal transfer is a critical component of neonatal care.
  • In-utero transfer is preferred over postnatal transfer when feasible.

Purpose of the Study:

  • Quantify the prevalence of in-utero transfers.
  • Determine the time expenditure in arranging these transfers.
  • Identify failures in the organization of potential in-utero transfers.

Main Methods:

  • Prospective study of referred and completed in-utero transfers.
  • Questionnaire study of failed potential in-utero transfers.
  • Analysis of data from London Ambulance Service (LAS) and Emergency Bed Service (EBS) over six months in 2009.

Main Results:

  • 438 in-utero transfers were undertaken by LAS; 180 (53%) of 338 referrals to EBS were successful.
  • 11 of 69 emergency postnatal transfers of preterm infants (<29 weeks) were classified as failed in-utero transfers.
  • Median time for EBS involvement was 340 minutes; arranging failed transfers involved contacting a median of 7 units and took 240 minutes.

Conclusions:

  • Arranging in-utero transfers is time-intensive.
  • A significant number of in-utero transfer attempts fail due to non-clinical reasons.
  • A centralized in-utero transfer planning service could save clinical time and potentially improve neonatal outcomes.