This is one of the most emotive and difficult situations that we ever have to deal with. A tiny baby who through no fault of their own arrives early and a family who did not plan on having a baby on their holiday and so are completely unprepared for it.Learn more
A baby who is born before 37 weeks of pregnancy will be called a premature baby. The neonatal team have different words for different levels of premature birth. They may also use the word ‘preterm’ to talk about a baby being born early.
The clinical complications can be significant, some may not present immediately. Poorly timed repatriations of infants who may not have fully developed can result in longer term damage and cognitive issues, as well as presenting an immediate risk to health.
Our consideration is firstly ensuring mother and baby are in an appropriate facility that can support the needs of a premature baby. Our second consideration, is the timing of when it is safe for baby to return back to the UK.
Premature labour is usually an emergency and so the focus is around getting mum to a hospital, any hospital, as quickly as possible.
In some instances, we understand that this may be a private facility initially, who may well be able to handle an uncomplicated labour however in our experience they are unlikely to have the facilities to support an early baby requiring neo-natal care.
In the event that mum and baby are in a private facility, our doctors will assess the clinical situation and possibly arrange a transfer safely to a facility that has a specific neo-natal intensive care unit. This is so that there is access to the best doctors, medical facilities and range of specialisms should the baby suffer any complications as a result of their early arrival, which can be extremely complex.
In areas of the world where state facilities are not adequate the medical team will work to ascertain which private facility could be best to support the medical situation.
The risks associated with putting a premature baby into an aviation environment too soon, when their organs, specifically their lungs, may have not fully developed is something we strongly want to avoid.
An example of complications that could occur is that, premature babies often suffer from anaemia due to the fact that their hematopoietic system (blood formation) is not mature yet. Due to the lack of oxygen (O2) that their body sends to their tissues, babies are put in an incubator and given extra oxygen.
This can be done during flight and in a specific Air Ambulance however, the hyperoxygenation (higher than usual concentration of O2) may provoke the body to produce more blood vessels, specifically in their eyes. This in an aviation environment and at increased pressure can then damage their ability to see long term. This is just one example of what may not present as an ‘immediate’ concern but could create a critical outcome for the baby and is a lifechanging effect of a poorly timed transfer air ambulance transfer.
When a baby is born prematurely, it can be expected that we, tifgroup, will not look to repatriate the baby by any method of transport before he or she is ‘term’, this does mean some parents have to stay in resort for some time, weeks even months. Depending on how early the baby is.
Whilst in UAE a mother went into premature labour and gave birth by emergency c-section, to a baby girl at 26 weeks gestation, making her extremely pre-term.
The little girl was born with and suffered, numerous complications of a perforated bowel, necrosing enterocolitis, ileostomy, ileostomy closure, haemorrhage into her cerebral ventricles, ventriculitis, hydrocephalus, with numerous procedures to release pressure by removing intracerebral fluid, and haemorrhage into lungs.
We, tifgroup, recommended that the baby, who was not fit to be transferred back to the United Kingdom, should remain in resort where she was receiving excellent care.
She stayed in UAE for 3 months after she was born, after which she then required surgery to insert a ventricular peritoneal shunt from brain to abdomen. This treatment in UAE would have then required another stay of up to 4 months before she would be safe to transfer back to the UK. A clinical assessment was made as to whether the little girl was suitable for transfer by Air Ambulance pre-surgery and were advised that there was a small window of opportunity. This possibility was discussed with the parents who were understandably keen to return back to the United Kingdom and allowed us to safely repatriate them and their little girl to Birmingham Children’s Hospital to continue with her treatment.