Extended perinatal outreach.

The perinatal outreach plan of the Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, and the Naples Community Hospital is described. From June 1988 through May 1989, 79 high-risk pregnant patients were evaluated at a monthly clinic at the hospital. The main indications for referral were intrauterine growth retardation (10), twin gestation (9), gestational diabetes (9) and possible fetal anomaly (8). With one exception, all babies were delivered at Naples. The high-risk patients had a 21% incidence of newborns less than 2500 gr, cesarean section rate of 30%, average maternal hospital charge of $2,403/patient, and an average neonatal hospital charge of $1,777/patient. There was a definite change in transport trends from Naples with three more maternal transports and seven fewer neonatal transports over the preceding year. Comprehensive perinatal outreach programs can be implemented at a reasonable cost and provide support and services that strengthen the entire local perinatal health delivery system.