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Recording available 2/16-5/2

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Poster Session 2

Category: Physiology/Endocrinology

Poster Session 2

(409) The Obstetrical Transport Score: A Novel Tool for Guiding Transport Decisions and Predicting Maternal-Fetal Acuity

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Alixandria F. Pfeiffer, DO

Maternal-Fetal Medicine Fellow
University of Texas Health San Antonio
University of Texas health San Antonio, Texas, United States

Coauthor(s)

MS

Mikaela Simmang, BS

University of Texas Health San Antonio
San Antonio, Texas, United States
SP

Sarah A. T. Poor, BS

University of Texas Health San Antonio
San Antonio, Texas, United States
MK

Michaela M. Kelly, BS

University of Texas Health San Antonio
San Antonio, Texas, United States
Leslie C. Omeire, BS

MD/MPH Candidate '27
University of Texas Health San Antonio, Long School of Medicine
San Antonio, Texas, United States
AB

Arianna Braddom, BS

University of Texas Health San Antonio
San Antonio, Texas, United States
AM

Allison Moreno, BS, RN

University Health System
San Antonio, Texas, United States
Patrick S. Ramsey, MD, MSPH (he/him/his)

Professor, Vice Chair Inpatient Obstetrics
Department of Obstetrics and Gynecology University of Texas Health Science Center in San Antonio
San Antonio, Texas, United States
JB

John J. Byrne, MD, MPH

Assistant Professor
University of Texas Health Science Center in San Antonio
San Antonio, Texas, United States

Objective:
To develop and evaluate a novel scoring system designed to predict maternal acuity and optimize triage during interfacility transport to a tertiary center.

Study Design:
We conducted a retrospective cohort study of pregnant patients transported by a maternal transport team to a tertiary care center between 6/2020 and 7/2024. Patients were included if they were transported by our institutional maternal transport team and were excluded if they had incomplete pre-transport records. The Obstetrical Transport Score (OTS) was developed using eight maternal-fetal acuity domains: vaginal bleeding, cervical dilation, rupture of membranes, contraction frequency, intensive care unit (ICU) status, pre-transport medications, EFM category, and MEWS triggers. Each domain was scored 0–3. Patients were stratified into OTS Levels 1–5: triage, antepartum, L&D, ICU/operating room (OR) readiness, and contraindicated transport. A non-blinded reviewer retrospectively assigned OTS scores. The primary outcome was escalation of care, defined as L&D or ICU admission and/or delivery within 24 hours. Secondary outcomes included delivery within 4 hours and concordance (“match rate”) between OTS level and actual location of admission. Statistical analyses included Chi-Square testing and receiver operating characteristic (ROC) curve analysis.

Results:
Of 936 maternal transports, 304 met inclusion criteria. An OTS ≥3 was significantly associated with escalation of care (sensitivity 94.0%, specificity 73.0%, PPV 89.5%, NPV 81.0%; p< 0.001). ROC analysis showed excellent discrimination (AUC 0.91). Higher OTS levels correlated with shorter time to delivery (p< 0.01). Delivery within 4 hours occurred in 12.8% of cases and was more likely at OTS Level 4 vs. Levels 1–2 (p=0.004). Match rate between assigned OTS level and actual admitting unit (e.g., L&D, antepartum, ICU) was 84.5%.

Conclusion:
The OTS demonstrated excellent predictive performance for maternal-fetal acuity and appropriate unit triage. Its structured scoring of maternal-fetal indicators can support triage decision-making during obstetrical transport.