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Maternal Transport and Preterm Labor Algorithm
Maine’s high infant mortality rate (IMR), which, at 6.3 deaths per 1,000 live births as of 2020, is the highest in New England. In 2020, a group of partners representing health care, public health, and state sectors designed and published a report titled Understanding and Addressing the Drivers of Infant Mortality (“IM report”) in Maine.
Two priority recommendations in the report were to identify tools to ensure consistency of risk assessment and to learn more about decision-making and logistics of transporting pregnant people so that all births occur in the most appropriate setting. Both tools are intended to reduce the risk of preterm births, which are a leading cause of infant mortality in Maine.
Inconsistent adoption of standardized evidence-informed guidelines among hospitals can lead to confusion and delays in care in transferring pregnant patients with potential medical problems to the appropriate maternity center for delivery. These delays can contribute to infant mortality when births do not occur in the ideal setting. Most infant deaths in Maine are due to causes related to being born too early. Since that time, an algorithm for triage of pregnant patients in the emergency room of non-birthing hospitals has been developed for statewide use.
Toolkits
Preterm Labor Tools:
Preterm Labor Assessment Tools for Birthing Hospital
Preterm Labor Assessment Tool for Nonbirthing Hospitals
After the intial pilot project, MainHealth Maternal Fetal Medicine and the Perinatal Outreach Program published an Algorithm for Pregnant Patients in an Emergency Department without Obstetrical Services which can be found on the Obstetrical and Perinatal Guidelines website at MaineHealth
Maternal Transport Tools: