Characteristics and outcomes of women using emergency medical services for third-trimester pregnancy-related problems in India: a prospective observational study

ObjectivesCharacterise the demographics, management and outcomes of obstetric patients transported by emergency medical services (EMS).DesignProspective observational study.SettingFive Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014.ParticipantsThis study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a ‘pregnancy-related’ problem for free-of-charge ambulance transport. Calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival and patients refusing care were excluded.Main outcome measuresEmergency medical technician (EMT) interventions, method of delivery and death.ResultsThe median age enrolled was 23 years (IQR 21–25). Women were primarily from rural or tribal areas (1550/1684 (92.0%)) and lower economic strata (1177/1684 (69.9%)). Time from initial call to hospital arrival was longer for rural/tribal compared with urban patients (66 min (IQR 51–84) vs 56 min (IQR 42–73), respectively, p