Long distance perinatal transport

Mortality, incidence of intraventricular hemorrhage (IVH), and complications were evaluated in a perinatal transport system involving patient movement over distances from 1500 to 3700 km over a 3-year period. Of 179 transports, 60% involved neonatal transport, and 58% of the transports involved infants delivering at 32 weeks' gestation or less. Mortality rates were similar between inborn, maternal, and neonatal transports with a trend toward improved survival in all inborn infants 1000 gm or less at birth. IVH occurred in 32% of infants 32 weeks or less gestation; a higher incidence of grades III/IV bleeding were seen in transported infants between 1001 and 2000 gm compared with maternal transports and all inborn infants. Complications occurred in 20% of transports. The frequency of complications were significantly lower when transport was accomplished by the Level III team. In utero transport of selected high-risk pregnancies is preferred despite the ability to provide safe, effective transport of ill neonates over extremely long distances.