Profile Of In-Utero Transfers in Yorkshire & Humber - Embrace Transport Service

Background and Aims: Embrace, combined paediatric and neonatal transport service for Yorkshire and Humber, facilitates in-utero transfers for a region with 75,000births/year. Our aim was to evaluate in utero transfer requests - indications for transfer, time spent locating cot/ bed, fibronectin use and outcomes. Methods: Prospective audit of in-utero requests during 1/10/2010 - 7/01/2011. Data obtained via audit proforma and phone calls to maternity units. Results: 86 transfers were facilitated out of 120 in-utero requests. The main reasons for requests were lack of neonatal cots 54% (65/120), maternal conditions requiring specialist care 2.5% (3/120), preterm gestation 24% (29/120) and impending preterm labour 7.5% (9/120). 13/120 of total requests - out of region cot located. 34 did not result in transfer despite cot/bed being located. The reasons were: Mother deteriorated/ went into labour 41% Unit unwilling to accept out of region cot 12% Local NNU arranged cot 15% Referring hospital arranged transfer 6% Changed decision re transfer need 20.7% Tertiary perinatal centres accepted 41% transfers. Mean time facilitating transfers - 82 minutes. Mean number of phone calls - 6.3. On average to organise 1 successful IUT, 2.1 maternity units and 3.4 neonatal units contacted. 50% of mothers delivered within 24 hrs of transfer. 13.3 % referrals used fibronectin. Conclusion: IUT are a significant part of Embrace's workload. Increased use of fibronectin in impending deliveries would enhance appropriateness of transfers.