Centralisation of neonatal care in Finland

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Centralisation of neonatal care in Finland

• 40 delivery hospitals
• 5 University hospitals
• Antenatal centralisation
• Postnatal centralisation

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Centralisation of newborn care

• Selfevident and important
• Resources needed
• -knowhow
• -experience
• -people
• -equipment

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Antenatal

• Intrauterine care
• -feto-fetal transfusions Oulu
• -Rh-transfuions Univ Hospitals
• -trombocytes Helsinki
• Prematurity
• -all premature delieries are centralised
• From h.lt35-32 depending on local level of care

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Antenatal

• Malformations
• -sent to pediatric care hospital if detected
• --50 of HLHS detected prenatally
• --most polyhydramnion-disorders are detected
  before delivery,

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Postnatal

• Few prematures are transferred after delivery
• Most urgent transport cases are major
  malformations
• -cardiac
• -at Univ Hospitals
• -open heart surgery only in Helsinki
• intestinal at local Univ hospitals

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Centralisation of care

• Best example
• Cheilopalatoschisis
• -ALL cases are sent to ONE center
• -about 50/year
• -excellent results
• (there has been occasional disturbances)