Transferring at-risk babies in-utero or neonatally: a decade's experience from a peripheral consultant maternity unit.

All maternity cases in which babies were transferred in-utero (n = 82) or neonatally (n = 273) from the William Smellie Memorial Maternity Hospital to a regional neonatal intensive care unit during 1980-89 were studied to detect changing trends and outcomes. The proportion of babies transferred in-utero has increased and most of these transfers appear to have been justified. Forty-seven per cent of babies transferred neonatally were mature infants (greater than 37 weeks) so that the need for intensive neonatal care would have been difficult to predict. Perinatal mortality has fallen in line with national rates, mainly due to the decline in mortality of premature babies transferred neonatally. The results do not sustain the argument for further increasing in-utero transfers.