Neonatal Transportation: A Community Hospital Experience
Journal
Clinical Neonatology
Journal Volume
15
Journal Issue
1
Pages
26
Date Issued
2008
Author(s)
Abstract
Objective: Well organized perinatal regionalization has not been established in Taiwan. Neonatal transportation usually depends on medical centers. The purpose of this study was to provide experience from a community hospital in Taipei County. Methods: We retrospectively reviewed the transportation and medical chart records at Cardinal Tien Hospital's Yung Ho Branch. The patients were transported from level I hospitals located in Taipei County and northern Taoyuan County. Results: There were a total of 397 transportations from January 1, 2004 through December 31, 2005. The majority of them (365, 91.9%) were from Taipei County and the rest (32, 8.1%) were from northern Taoyuan County. Most of the mothers (357, 89.9%) were healthy, without any systemic disease. About one-third of the transported infants (124, 31.2%) had low birth weight (≤ 2500 gm). One hundred and ninety-two (48.3%) were full term and 157 (37.6%) were of gestational age 34 to 37 weeks, and 48 (12.1%) were ＜ 34 weeks old. The average CRIB and NTISS scores were 1.2 and 15.2, respectively. The common reasons for transportation were neonatal respiratory distress (47.4%), jaundice (13.1%), gastrointestinal tract problems (10.1%), and prematurity without symptoms or signs (7.3%). Two hundred and forty-nine neonates (62.7%) had indications sufficient to be admitted to the neonatal intensive care unit (NICU). Seventeen (4.3%) neonates were further transferred to tertiary medical centers, mainly due to congenital heart disease or other congenital anomalies. No death occurred during transportation. The mortality rate was 2.5%. Conclusion: Maternal transport is not always possible in high risk pregnancies. Postnatal transportation to a NICU remains essential because preterm labor and perinatal illness cannot always be anticipated, and the most common cause is respiratory distress. It is hard to identify which infants need level III care directly in transportation cases. A tendency to high mortality in fetal distress cases was noted in this study. A professional, efficient transport team from non-tertiary centers available on a 24-hour basis may provide effective and safe transportation until a well-organized regionalization is established in Taiwan.
SDGs
Publisher
中華民國新生兒科醫學會
Type
journal article