Transportation of the pathological newborn

Martin Vavřina, MD, Martin Janků, MD, Kateřina Machanová, Tereza Urbánková

Childbirth is a common part of human life and it can unfortunately be accompanied by complications of the mother or child. In our algorithm, we will look at the prolonged birth of twins, after which it will be necessary to evaluate the condition and decide on the transport of one of the children. Where to transfer a pathological newborn to be provided with adequate care? How to proceed in securing vital functions along the way? How to react to the deterioration of the condition? If you do not know the answers to these questions, we believe that after mastering our story, you will be prepared for such situations.


Kateřina Fabichová, MD Chief Physician of the Perinatological centre, Hospital Most, Most, Czech Republic

The algorithm describes a completely real situation of childbirth in the neonatal unit I, type. Childbirth is risky for gemini, but already in a favorable gestational week. While the adaptation of twin A is completely physiological, in twin B, after a prolonged pelvic delivery, a disorder of postpartum adaptation and subsequent further complications occur. The algorithm didactically emphasizes the solution of the current clinical condition and values ​​of vital functions, which leads to further steps. The first is the treatment of hypoxia and then the indication of the transfer of the newborn to a neonatological workplace of a higher type using equipment to ensure a thermoneutral environment according to the gestational week of the child with the possibility of both oxygen therapy and respiratory support. An integral part of transport to a higher workplace is the form of passing on all information about the patient. The steps in the algorithm follow each other logically and the team is able to anticipate and react immediately to changes in the newborn's health. As a result, the student realizes how quickly the clinical condition of the newborn can deteriorate. Each decision is sufficiently reasoned in the explanatory text.

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inserted: 5. 6. 2021 | last modified on: 20. 7. 2021