The continuing impact of capacity on a region's in utero transfer requests.

Abstract

The Yorkshire and Humber operational delivery network (ODN) aims to ensure 85% of preterm babies are delivered in tertiary centres. Auditing in utero transfers provides key data for streamlining this process. Our study aimed to determine reasons and outcomes of in utero transfers as well as review the impact of staffing on capacity transfer requests. All in utero transfer referrals between September 2014 and August 2015 were reviewed, and delivery outcome data were sought from the national data platform, Badgernet. ODN records provided cot occupancy and staffing data. A total of 479 referrals were made, and 379 transfers were completed. The majority of requests were due to reduced capacity which was linked to poor staffing levels (51.3%). Patients travelled significant distances, with a mean distance of 42.3 miles within network, and 70.3 miles, out of network. Despite the travel burden, only 35.1% of women delivered within 48hours of transfer. In utero transfers remain difficult and time-consuming to facilitate. Neonatal staffing at referral units contributes significantly to the decision to transfer women. Challenges remain in predicting which women will deliver after an in utero transfer, as well as obtaining outcome data for these cases.