Transport of sick neonates to a tertiary care hospital, south India: condition at arrival and outcome

OBJECTIVE: To describe the transport of sick neonates to a tertiary care hospital and evaluate their condition at arrival and outcome. METHODS: This descriptive study included 303 extramural neonates who were transported to a tertiary care hospital in south India. Demographic parameters, transport details and clinical features at arrival were recorded. All neonates were followed up till discharge or death. Transport and clinical variables were correlated with outcome. RESULTS: Sepsis and birth asphyxia were the major indications for transport. Only 11% were transported by 108 ambulances (free government service). One-fifth of all neonates died and among them 76% were hypothermic and 10% hypoglycemic on admission. Prematurity, pregnancy induced hypertension (PIH), prolonged rupture of membranes (PROM), respiratory distress, grunting, bleeding, abdominal distension and a positive blood culture correlated with a poor outcome. CONCLUSION: Stabilisation prior to transport is essential and the principles of neonatal transportation are independent of distance. Hypothermia and hypoglycaemia should be prevented in neonates during transport as they adversely affect the outcome.