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In-utero transfer is too difficult: results from a prospective study
1Neonatal Transport Team, Royal London Hospital, London, United Kingdom. christopher.gale@imperial.ac.uk
Early Human Development
|August 13, 2011
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.
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.
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