Apa V1, Masta R, Stinshoff J
1Santos, Papua New Guinea
Biography:
Dr Vivienne Apa, MB BS, UPNG, is a Medical Officer at Santos with over 11 years of clinical experience since 2013. She holds a Bachelor of Medicine and Bachelor of Surgery from the University of Papua New Guinea and has special interest in emergency medicine. Dr Apa has three years of dedicated experience conducting aeromedical retrievals in the Southern Highlands of Papua New Guinea, providing critical care in remote and challenging environments. Her clinical background includes extensive practice as a general medical officer with particular focus in emergency department settings.
Abstract
Objective: To describe obstetric aeromedical evacuations in Papua New Guinea, evaluating maternal and neonatal outcomes and assessing operational factors influencing care delivery.
Methods: Retrospective observational study of PNG Santos Medical Team aeromedical operations (2022–2025). Variables included patient demographics, primary diagnosis, retrieval logistics, time metrics, in-flight interventions and outcomes.
Results: Of 350 total aeromedical evacuations (fixed wing 110, rotary wing 210, road 24), 50 were obstetric emergencies. Most patients were community cases (45). Primary indications included retained placenta (14), prolonged labour (10), antepartum haemorrhage (6), postpartum haemorrhage (5), breech presentation (4) and pre-eclampsia (4). In-flight clinical interventions were rare with no in-flight deliveries or critical deterioration. No maternal deaths were recorded. Neonatal outcome data was unavailable.
Operational Challenges: Short flight times (30-40 minutes for >90% cases) necessitated 'scoop-and-run' protocols with minimal ground intervention due to security threats, weather constraints and remote terrain. Rotor-wing flights ceased at 4:30pm, fixed-wing by 5:30pm. Many villages lacked landing areas or were difficult to locate.
Conclusions: Obstetric emergencies represent significant aeromedical workload in remote settings. Timely air retrieval improves outcomes despite operational constraints. Recommendations include enhanced pre-flight stabilisation, crew training, equipment optimisation, improved rural healthcare facilities, Village Birth Assistant programmes and family planning services for high-risk women in remote communities.