Highlights
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Obstetric retrievals make up approximately 8.2% of air medical retrievals in the Northern Territory. Of these, < 1% progress to in-flight births.
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In utero transfer is the main aim for air medical retrieval services due to better outcomes.
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Increased retrieval distances, health care access for remote populations, and tocolytic choice are key factors for in-flight birth rates.
Abstract
Objective
There has been much newspaper and online news coverage of in-flight obstetric births
on commercial aircraft over several decades. This case series reviews several cases
of in-flight birth and immediate maternal and neonatal outcomes from air medical retrievals
in the Northern Territory of Australia over a 3-year period.
Methods
This is a retrospective written case note and electronic medical retrieval record
analysis of 4 patients undergoing in-flight, at altitude, obstetric birth.
Results
Four premature births are recorded by CareFlight Operations over a 4-year period from
January 2011 to January 2015. All patients involved were preterm; term ranged from
22 weeks to 36 weeks. Tocolysis was implemented on all 4 patients according to local
obstetric guidelines. Maternal complications included 1 patient suffering antepartum
hemorrhage and 2 patients suffering postpartum hemorrhage. Three neonates born at
altitude needed neonatal resuscitation including positive-pressure ventilation. One
neonate, 22 weeks’ gestation, died approximately 2 hours after delivery. Maternal
follow-up showed no morbidity or mortality at 1 to 6 days after birth.
Conclusion
In-flight deliveries are rare events in air medical medicine. This case series includes
patients of variable preterm gestation and correlates poor outcomes to prematurity
of neonates. Close communication between remote clinics, obstetric centers, and air
medical teams plus up-to-date early labor guidelines are essential for safe practice
and to limit the risk of in-flight births.
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References
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Article Info
Publication History
Published online: July 25, 2016
Identification
Copyright
Copyright © 2016 by Air Medical Journal Associates
