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Honan B, Spring B, Gardiner FW, Durup C, Venkatesh A, McInnes J, Schultz R, Ullah S, Johnson R. Air Medical Retrieval of Central Australian Women in Labor: A Retrospective Observational Study. Air Med J 2024; 43:28-33. [PMID: 38154836 DOI: 10.1016/j.amj.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The aim of this study was to describe the characteristics and outcomes of remote-dwelling pregnant women with threatened labor referred for air medical retrieval to a regional birthing center as well as factors associated with birth within 48 hours. METHODS This was a retrospective observational study of all pregnant women in the remote Central Australian region referred to the Medical Retrieval Consultation and Coordination Centre for labor > 23 weeks' gestation between February 12, 2018, and February 12, 2020. Univariate and multivariate statistical analyses were performed. RESULTS There were 116 women referred for retrieval for labor. There were no births during transport, and less than half of the cases resulted in birth within 48 hours of retrieval. Tocolysis was frequently used. Predictors of birth within 48 hours were cervical dilatation ≥ 5 cm, preterm gestational age, and ruptured membranes in the univariate analysis. Nearly one third of this cohort required intervention or had complications during birth. CONCLUSION Birth during transport for threatened labor did not occur in this cohort, and more than half of the retrievals did not result in birth within 48 hours; however, the high risk of birth complications may offset any benefit of avoiding air medical transport from remote regions. Retrieval clinicians should consider urgent transfer in cases of ruptured membranes, cervical dilatation of 5 cm or more, or gestational age less than 37 weeks.
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Affiliation(s)
- Bridget Honan
- Central Australian Retrieval Service, Alice Springs, Northern Territory, Australia.
| | - Breeanna Spring
- Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia; Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Fergus William Gardiner
- Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia; University of Western Australia, Crawley, Western Australia, Australia
| | - Cheryl Durup
- Central Australian Retrieval Service, Alice Springs, Northern Territory, Australia; Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Ajay Venkatesh
- Central Australian Retrieval Service, Alice Springs, Northern Territory, Australia; Alice Springs Hospital, Alice Springs, Northern Territory, Australia; School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
| | - Jessica McInnes
- Royal Flying Doctor Service of Australia, Canberra, Australian Capital Territory, Australia
| | - Rebecca Schultz
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia; Edith Cowan University, Joondalup, Western Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Richard Johnson
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia; Baker Institute, Melbourne, Victoria, Australia
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