Regionalisation of perinatal care in Basse-Normandie, France: Evolution over 5 years

Objectives. - To compare evolution and characteristics of in utero transfers (IUT) in Basse-Normandie area, France, between 2004 and 2008, and to describe characteristics of IUT in 2008. Materials and methods. - Analysis of data from the IUT registry, collected prospectively since 2004. Results. - An average of five IUT per week was observed. The rate of IUT regularly increased (P=0.003) and reached 16.2 per 1000 pregnancies in 2008. Extra network IUT decreased steadily (P=0.04). For level 3 units, the proportion of IUT from level 2 units increased (P < 10(-3)). Before 32 weeks of gestational age, all IUT were done towards a level 3 unit. Median time between IUT and delivery and caesarean section rates were variable according to IUT indication (for threats of premature delivery, respectively 5 days and 23.3%). The rate of retransfer towards initial unit of towards a birth site of relevant level was 5.3%. Conclusion. - The IUT registry gives useful information on evolution and characteristics of IUT in our area. An increased regionalisation and more frequent adequate IUT were observed. The registry must now serve as a basis for practices assessment. (C) 2010 Elsevier Masson SAS. All rights reserved.