Transport of Peripartum Patients for Medical Management: Predictors of Any Intervention During Transport.

Abstract

Background When obstetricpatients present to a hospital without obstetric consultants for medical care, they are often transferred for a higher level of care. Factors associated with patientcare during transport between hospitals are unknown. Our study investigated factors associated with care intensity. Methods We retrospectively reviewed charts from peripartum adult patientswho were transported to our academic quaternary center between January 1, 2012, and April 19, 2020. We excluded patients transported for gynecologic or fetus-related complications. We defined any transport interventions as any ventilator management, any titration of continuous infusions, and any continuation or initiation of medication during transport. Results We included 126 patients, and the mean age (SD) was 29 (7) years. There were 87 (695) antepartum patients, with nine (7%) requiring mechanical ventilation. Of the patients, 98 (78%) received at least one intervention during transport. Transport time (OR: 1.03, 95% CI: 1.001-1.06, P = 0.040), preeclampsia (OR: 3.8, 95% CI: 1.1-12.7, P = 0.030), and any obstetric hemorrhage (OR: 8.3, 95% CI: 1.03-68, P = 0.047), either antepartum or postpartum, were associated with higher likelihood of receiving any intervention. Conclusions Peripartum patients often received interventions during transport. Preeclampsia and hemorrhage were associated with the likelihood of interventions. Transport clinicians should be prepared when transporting these patients. Further studies are needed to confirm our observations.