Transfer of the critically ill obstetric patient: experience of a specialist team and guidelines for the non-specialist

Transfer of the critically ill obstetric patient between hospitals is increasingly common. The specialist transfer team based at the Western Infirmary Intensive Therapy Unit, Glasgow has transported 60 such patients in the years 1985-1994. Monitoring was by direct arterial pressure measurement in 56 patients and central venous pressure measurement in 45. Forty-one patients were mechanically ventilated in transit. There were no deaths in transit but 3 patients died later in intensive care. The majority of patients had pregnancy induced hypertension or had suffered a post partum haemorrhage. A clinical impression that these two groups had different treatment requirements and outcomes was not substantiated. We conclude that the transfer of even the sickest obstetric patient is feasible and safe and suggest guidelines to non-specialists for the management of these patients before and during interhospital transfer.