A study on status of neonatal transport to a level III neonatal intensive care unit

P. Sampathkumar Sampathkumar, S. Gobinathan


Background: In the past decade, great advancements in Neonatal care contributed to a fall in IMR. A further fall in IMR can only be achieved by improving the neonatal transport facilities. Hence to assess the current status of neonatal transport we undertook this study.

Methods: This is a cross-sectional study of 75 neonates transported to our NICU. For all the babies, data regarding the place of birth, mode of delivery, mode of transport, etc. were collected. On admission parameters like blood glucose, temperature, CRT, SPO2, the presence of cyanosis, shock was assessed.

Results: In the present study 64% of neonates came to our NICU on their conveyance. 67% of referrals from PHCs did not utilize ambulance facility. 30% of neonates had hypothermia on arrival. 35%had hypoglycemia on arrival. 15% had a low oxygen saturation on arrival. 15% had prolonged CRT on arrival. Only 8% of neonates received prior treatment. 11% babies did not have any referral slip. Only a very few had complete and proper referral advice.

Conclusions: To further reduce the neonatal mortality rate, the neonatal transport facilities should be upgraded. A standard protocol should be formulated for interfacility transport. A separate fleet of neonatal ambulances well equipped and manned by trained personnel is the need of the hour.


Ambulance, Infant mortality rate, Neonatal intensive care unit, Neonatal transport, Pre-hospital stabilization

Full Text:



Blackmon L. The role of the hospital of birth on survival of extremely low birth weight, extremely preterm infants. Neo Reviews.2003;4:e147-57.

Bowman E, Doyle LW, Murton LJ, Roy RN, Kitchen WH. Increased mortality of preterm infants transferred between tertiary perinatal centers. BMJ. 1988;297:1098-100.

Castles AG, Milstein A, Damberg CL. Using employer purchasing power to improve the quality of perinatal care. Pediatr.1999;103:248-54.

Chien LY, Whyte R, Aziz K, Thiessen P, Matthew D, Lee SK. Improved outcome of preterm infants when delivered in tertiary care centers. Obstet Gynecol. 2001;98:247-52.

Lecoeur C, Thibon P, Prime L, et al. Frequency, causes and avoidability of out-born births in a French regional perinatal network. Eur J Obstet Gynecol Reprod Biol. 2014;179:22-6.

McNamara PJ, Mak W, Whyte HE. Dedicated neonatal retrieval teams improve delivery room resuscitation of outborn premature infants. J Perinatol. 2005;25:309-14.

Cors WK. Physician executives must leap with the frog. Accountability for safety and quality ultimately lie with the doctors in charge. Physician Exec. 2001;27 (6):14-6.

Goodman DG, Fisher ES, Little GA, Stukel TA, Chang CH, Schoendorf KS. The relation between the availability of neonatal intensive care and neonatal mortality. N Engl J Med. 2002;346:1538-44.

Hannan EL. The relation between volume and outcome in health care. N Engl J Med. 1999;340:1677-9.

Lee SK, McMillan DD, Ohlsson A. The benefit of preterm birth at tertiary care centres is related to gestational age. Am J Obstet Gynecol. 2003;188:617-22.

Menard MK, Liu Q, Holgren EA, Sappenfield WM. Neonatal mortality for very low birth weight deliveries in South Carolina by the level of hospital perinatal service. Am J Obstet Gynecol. 1998;179:374-81.

Fenton AC, Leslie A, Skeoch CH. Optimising neonatal transfer. Arch Dis Child Fetal Neonatal Ed. 2004;89:F215–F219.

Sanderson M, Sappenfield WM, Jespersen KM, Liu Q, Baker SL. Association between the level of delivery hospital and neonatal outcomes among South Carolina Medicaid recipients. Am J Obstet Gynecol. 2000;183:1504-11.

Shaffer ER. State policies and regional neonatal care: progress and challenges 25 years after TIOP. White Plains, NY: March of Dimes;2001;21:342-345.

Van Marter LJ. Perinatal section surveys and databases. Perinat Sect News. 2000;26:8-9.