Medical emergency evacuation: life-saving care for mother and baby in Asia Pacific

A mother-to-be develops preeclampsia and is flown hundreds of miles for a life-saving emergency c-section

By their very nature, emergencies and accidents aren’t predictable. When your health or life is under threat, you need the strength and expertise of a clinical team that can mobilise immediately to get you the care you need, in the right place and at the right time. For example, Aetna International’s Care and Response Excellence (CARE) team is a round-the-clock service for accidents and emergencies wherever you are, whenever you need.

This is the story of one member and the emergency airlift that saved their life and that of their unborn baby. Read Rachel’s* story to see how our members benefit from our global experience and local expertise.

Life-threatening

One afternoon in 2018, Australian national Rachel was admitted to hospital in Ho Chi Minh city, Vietnam, where she was living with her family. She was 26 weeks pregnant with her second child and experiencing pain in her upper abdomen. The hospital quickly ran tests which suggested she was preeclamptic — a condition marked by hypertension/very high blood pressure that can threaten the life of the mother as well as the baby.

At 10am the following morning, Rachel’s husband, Chris*, called the CARE team. With a very ill wife and concerned about the level of local care, Chris requested assistance with a medical evacuation.

Enter Ciaran, a Clinical Case Manager and expert nurse at Aetna International with more than 12 years’ experience in acute medicine and emergency care. Ciaran immediately contacted the treating doctor at the hospital in Ho Chi Minh.

Travel for treatment

“The local doctor was very approachable, and I had several conversations with him about Rachel and her condition,” explains Ciaran.

Rachel’s hypertension meant that she was at risk from stroke which could threaten both her life and her baby’s. The only way to resolve preeclampsia is to deliver the baby as quickly as possible. Preeclampsia can be managed if it’s caught early.

The hospital could have conducted an emergency caesarean but the Ho Chi Minh hospital didn’t have the facilities to care for a baby born before its 30^th week and Rachel and Chris’ baby was 26 weeks.

“The treating doctor and I worked together, in discussion with the family, to work out the best course of action,” says Ciaran. “The doctor and I were of the same mind: we needed to transfer Rachel as quickly as possible.

The CARE team contacted several hospitals in Bangkok, the family’s nearest centre of excellence — 500 miles away — and found one with the facilities to treat and care for mother and baby.

“We compiled all the clinical details and case information and referred it to our Medical Director, Dr Mitesh Patel. He wasted no time in agreeing to the evacuation. So – together with the husband - the decision was taken to transfer the mother there as quickly as possible.”

Ciaran and the team set about organising the evacuation, from sourcing quotes to putting the logistics in place. The decision was made to use the air ambulance (AA) arranged by the hospital in Bangkok, who have their own air ambulance company.

Ciaran says: “It’s absolutely critical to know the calibre of AA providers and their capabilities as well as the capabilities of the hospitals in region and local medical centres of excellence. Our Medical Directors travel extensively in the region to review hospitals, providers and facilities to build up our knowledge and relationships with them. We knew Rachel and her baby would be in safe hands.”

With Ciaran’s direct number, Chris and Rachel could remain in close contact throughout with any queries or concerns.

The evacuation

The air ambulance was due to leave Bangkok to fly to Ho Chi Minh at 12:30pm. Meanwhile a ground ambulance was dispatched to pick Rachel up from Binh Duong Province and bring her to the capital — a round trip of five hours.

After the pick up in Ho Chi Minh the air ambulance was due to leave for Bangkok at 6pm followed by another ground ambulance to the hospital.

At approximately 5pm, a weather system moved over Vietnam and the air ambulance couldn’t take off as planned. It was a tense time for the family and the CARE team, who were in regular communication with both Chris and with the AA treating staff to monitor Rachel’s condition to keep him updated on progress. After a tense delay, the plane took off.

Developments in-flight

During the flight Rachel was diagnosed with HELLP syndrome (or hemolysis). With elevated liver enzymes and a low platelet count Rachel was at risk of internal bleeding, stroke, lung and heart failure and permanent liver or kidney damage. As such, when she arrived in Bangkok, she was rushed from the air ambulance to ground ambulance and straight to the operating theatre.

It’s a girl!

Having arrived in theatre, surgeons worked to safely deliver a baby girl who was stable and placed in neo-natal intensive care.

Rachel’s preeclamptic emergency stopped as soon as the baby was delivered but their baby remained in hospital for several months until she was declared fit to fly.

The CARE team arranged transfers for the family to fly back to Australia so Rachel could enjoy the support of her family before eventually returning to Vietnam.

Afterwards, Rachel wrote to Ciaran to say: “Your compassion, care and professionalism helped us through the scariest time in our lives. Thank you for everything you did, because executing the plan not only saved our lives, but put us in the best possible hands with the amazing team at Bangkok Hospital.”

The CARE team continue to look after the family under their plan cover. This gives them access to the Bangkok hospital for a follow up to monitor the baby’s health.

Rachel tells Ciaran: “I thought you might like an update. I am fully recovered and doing great. Our baby is a growing, healthy, happy, cheeky baby girl. She has a few ongoing health issues from her harrowing start to life but it’s all manageable and she will be just fine.”

Rachel sent a photo of the family adding: “I thought you might like to put some faces to the names and our experience. Please pass on my infinite gratitude to the team. Thank you again for everything.”

We believe in being there, no matter what.

In the event of a medical emergency (emergency prescription refill, critical illness or accident), contact the CARE team.

For more information about the CARE team and the other benefits and services available through your plan, login to (or register for) the Health Hub.

Are you an employer? Find out more about how Aetna International’s CARE team can help you support your international employees and help to keep them healthy, happy, safe and productive.

* Name changed to protect the identity of the member

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