Perinatal Transport
Recommendations by Pathology:
I. Congenital Diaphragmatic Hernia
a. transport with head elevated and affected side down
b. NG tube to evacuate air in stomach
c. never bag and mask ventilate
d. intubate
II. Tracheoesophageal Fistula
a. elevate head
b. place feeding tube in esophageal pouch
c. avoid mechanical ventilation if possible to prevent GI tract
distention
III. Gastrointestinal Anomalies
a. Omphalocele
i. herniation of the intestine into the base of the
umbilical cord
ii. organs are covered by a transparent sac
b. Gastroschisis
i. organs herniate through the abdominal wall to the
right of the umbilicus
ii. organs not covered by a sac
c. Recommendations
i. maintain aseptic environment
ii. prevent aspiration
iii. prevent heat loss
iv. provide respiratory support as needed
v. prevent vascular compromise of organs (kinking of
intestine)
vi. NG tube
vii. cover bowel with warm sterile NS soaked gauze
viii. sac wrapped with kling gauze
ix. place lower half of body in a sterile plastic bag or
wrap with plastic
x. incubator temp 36.5 - 37.0C
xi. IV fluid replacement 2-4 x maintenance
xii. broad spectrum antibiotic
xiii. elevate head
IV. Meningomyelocele, Spina Bifida
a. external sac contains meninges, CSF and portion of spinal
cord or nerve roots
b. avoid contamination with stool or environment
c. if membranes intact avoid rupture
d. cover with sterile saline-soaked gauze and plastic shield to
provide protection and thermoregulation
e. procedure to protect the lesion
V. Congenital Heart Defects
a. may need prostaglandin E1 to keep PDA during transport