Maternal and Fetal Physiology in Flight

In this episode of the FlightBridgeED Podcast: MDCAST, Dr. Michael Lauria is joined by Dr. Elizabeth Garchar, MD, FACOG, an OB/GYN and Maternal Fetal Medicine (MFM) specialist who has a particular interest in obstetric critical care and is unique in that she flies regularly with our
critical care transport teams as a retrieval OBGYN/MFM. They are also joined by Dr. Alixandria Pfeiffer, an MFM Fellow at the University of Texas in San Antonio. Together, they dive into the complex and underexplored world of obstetric critical care transport. With maternal mortality rates on the rise in the U.S., this episode addresses the vital role critical care transport teams play in improving outcomes for high-risk pregnancies.

The discussion focuses on monitoring pregnant patients during transport, exploring topics such as flight physiology, continuous fetal monitoring (CFM), and the challenges posed by different transport environments. Dr. Pfeiffer shares her groundbreaking research on the feasibility of fetal monitoring during transport and its potential impact on both maternal and fetal outcomes.

Key Takeaways:

• In obstetric transport, continuous fetal monitoring (CFM) is feasible and can provide critical insights during maternal transport, though it poses unique challenges depending on transport type (flight, ground).
• Flight transport often results in a slight decrease in maternal oxygen saturation and systolic blood pressure, suggesting the need for standardized oxygen therapy protocols during transport.
• Understanding fetal physiology and monitoring techniques is essential, especially in high-risk pregnancy transports where the health of both mother and baby is at stake.

Whether you're a seasoned critical care provider or just beginning your journey in EMS or critical care transport medicine, this episode delivers insights into the practical realities of OB transport.

Listen now on any podcast platform or directly from our website at flightbridgeed.com. While you're there, explore our highly successful and award-winning courses, designed to elevate your career in critical care medicine. Thank you so much for listening! We couldn't make this podcast without you.

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References

1. Pfeiffer AF, Munter BT, Munoz J, Ramsey PS, Byrne JJ. Maternal Physiologic Adaptations During Transport. Am J Obstet Gynecol. 2023; 228(1): S259-S260.
2. Pfeiffer AF, Munoz JL, Neuhoff BK, Boyd AR, Moreno A, Ramsey PS. Fetal Cardiotocographic Monitoring During Maternal Transport. Am J Obstet Gynecol. 2022; 226(1): S609.
3. Foley MR, Strong, Jr TH, Garite TJ. eds. Obstetric Intensive Care Manual, 5e. McGraw Hill; . Accessed May 24, 2022. https://obgyn.mhmedical.com/content.aspx?bookid=2379&sectionid=185956675

H.R.315 - Improving Access to Maternity Care Act, (2018). Available at: https://www.congress.gov/bill/115th-congress/house-bill/315.