Maternal morbidity associated with in utero transfer

Abstract

Objective - To determine the extent of maternal morbidity associated with in utero transfer. Design - Retrospective study of 190 consecutive cases over two years. Setting - Liverpool Maternity Hospital. Patients - 190 Pregnant women were transferred to the hospital under the in utero transfer arrangements from district general hospitals both within and outside the Mersey region. The women admitted were divided into two categories: those in threatened or established uncomplicated preterm labour and those who may or may not have been in threatened or established preterm labour but who had coexisting complicating factors affecting the mother or fetus, or both. Interventions - Planned delivery of the fetus if indicated and arrangements for appropriate postpartum care of the mother. Main outcome measure - Assessment of the progress of labour and, if appropriate, resuscitation of the mother. Results - Women who were transferred with no coexisting disease (124) had relatively uncomplicated deliveries whereas those transferred with coexisting diseases (66) exhibited considerable morbidity and 17 of these required prolonged intensive monitoring after delivery. Conclusions - In utero transfer in healthy mothers may have benefits for babies born very prematurely. If mothers have coexisting disease, however, the desirability of transfer should be reviewed urgently in the light of the considerable maternal morbidity associated with these problems. In these cases transfer may introduce an additional hazard.