Outcome of neonatal transport in newborn with weight less than 1.5 kg and role of TOPS score as mortality predictor

Abstract

Background: Neonatal period is the most vulnerable time for individual survival and newborn with weight <1.5 kg are having more morbidity then newborn with appropriate weight for age. Many of these are easy to manage and neonatal mortality can be decrease with regionalization of perinatal care and transportation in stable condition. Methods: The study was conducted at B. J. Medical College, Ahmedabad and Civil Hospital, Ahmedabad. A prospective, observational study consisting of total 140 patients, admitted in neonatal intensive care unit during the period from October 2022 to September 2023 with inclusion criteria of newborn <1.5 kg and ≤28 days of life. Study was questionnaire based, TOPS scoring was done on admission (temperature by digital thermometer, SpO2 by pulse oximeter, perfusion by CRT in midsternum, blood sugar by reagent strip). Analysis of outcome done using Chi square. Results: Out of 140 enrolled patients 134(95.8%) neonates were hospital delivered and 6 (4.3%) home delivered. Most common indication of referral was respiratory distress syndrome (27.8%). 85 (60.7%) of neonates were transferred in ambulance and 44 (31.4%) neonates were transferred in private vehicle. 58 (41.4%) were given intra-transport support in form of O2 prongs, Incubator, bag and tube ventilation and IV fluids. 72 (51.5%) and 68 (48.6%) transferred with untrained and trained personal respectively. 30.7% of the patients were expired and 69.3% of neonates were either discharged or took LAMA. Conclusions: To reduce neonatal mortality rate, neonatal facility should be upgraded, intra transport stabilization, proper referral notes and specialised neonatal ambulance will be helpful.