Obstetric emergencies at the United States-Mexico border crossings in El Paso, Texas.
OBJECTIVE
To describe the frequency, characteristics, and patient outcomes for women who accessed Emergency Medical Services (EMS) for obstetric emergencies at the ports of entry (POE) between El Paso, Texas, United States of America, and Ciudad Juárez, Chihuahua, Mexico.


METHODS
A descriptive study of women 12-49 years of age for whom an EMS ambulance was called to an El Paso POE location from December 2008-April 2011 was conducted. Women were identified through surveillance of EMS records. EMS and emergency department (ED) records were abstracted for all women through December 2009 and for women with an obstetric emergency through April 2011. For obstetric patients admitted to the hospital, additional prenatal and birth characteristics were collected. Frequencies and proportions were estimated for each variable; differences between residents of the United States and Mexico were tested.


RESULTS
During December 2008-December 2009, 47.6% (68/143) of women receiving EMS assistance at an El Paso POE had an obstetric emergency, nearly 20 times the proportion for Texas overall. During December 2008-April 2011, 60.1% (66/109) of obstetric patients with ED records were admitted to hospital and 52 gave birth before discharge. Preterm birth (23.1%; No. = 12), low birth weight (9.6%; No. = 5), birth in transit (7.7%; No. = 4), and postpartum hemorrhage (5.8%; No. = 3) were common; fewer than one-half the women (46.2%; No. = 24) had evidence of prenatal care.


CONCLUSIONS
The high proportion of obstetric EMS transports and high prevalence of complications in this population suggest a need for binational risk reduction efforts.
College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico, United States of America.
Jill A
JA
McDonald
College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico, United States of America.
Karen
K
Rishel
Division of Global Migration and Quarantine, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, El Paso, Texas, United States of America.
Miguel A
MA
Escobedo
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Danielle E
DE
Arellano
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Timothy J
TJ
Cunningham
D000293:Adolescent; D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data; D002648:Child; D004630:Emergencies; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D013781:Texas / Q000453:epidemiology; D014592:Uterine Hemorrhage / Q000453:epidemiology; D055815:Young Adult