Ambulance Transfer in Case of Postpartum XXXX after Birth in Primary Midwifery Care in The Netherlands: A Prospective Cohort Study.

@entity1 @entity548 @entity190 @entity772 @entity551 @entity130
BACKGROUND: The objective of this prospective cohort study was to assess whether the 45-minute prehospital limit for ambulance transfer is met in case of postpartum @entity548 (PPH) after midwifery-supervised home birth in The Netherlands and evaluate the process of ambulance transfer, maternal condition during transfer, and outcomes in relation to whether this limit was met. METHODS: Using ambulance report forms and medical charts, ambulance intervals, urgency coding, clinical condition (using the lowest Revised @entity130 Score, [RTS]), and maternal outcomes were collected. From April 2008 to April 2010, midwives reported 72 cases of PPH. Associations between duration of the ambulance transfer, maternal condition during ambulance transfer and outcomes were analyzed. The main outcome measures were duration of ambulance transfer, RTS, @entity190 , surgical procedures, and blood transfusions. RESULTS: Seventy-two cases were reported, 18 (25%) were excluded: 54 cases were analyzed. In 63 percent, the 45-minute prehospital limit was met, 75.9 percent received a RTS of 12, indicating optimal Glasgow @entity772 Scale, systolic blood pressure, and respiratory frequency. In 24.1 percent a @entity551 was found (RTS 10 or 11). We found no difference in outcomes between @entity1 with different RTS or in whom the 45-minute prehospital limit was or was not met. CONCLUSIONS: We found no relation between the duration of ambulance transfer and maternal condition or outcomes. All @entity1 fully recovered. The low-risk profile of @entity1 in primary care, well-organized midwifery, and ambulance care in The Netherlands are likely to contribute to these findings.
