Garite T J, Snell B J, Walker D L, Darrow V C
Department of Obstetrics and Gynecology, University of California Irvine Birthing Center, USA.
Obstet Gynecol. 1995 Sep;86(3):411-6. doi: 10.1016/0029-7844(95)00156-L.
To describe our experience with a freestanding birthing center established in conjunction with a university medical center, and to determine the safety and effectiveness of such a program.
The University of California Irvine Medical Center opened a freestanding birthing center 2 miles from the hospital. The unit provides prenatal, labor, delivery, postpartum and well-baby care 24 hours/day. All direct patient care is provided by certified nurse-midwives. Data were collected prospectively to provide a descriptive account and to evaluate maternal and perinatal morbidity and mortality to determine the safety and efficacy of this approach.
During the first 20 months of operation, the University of California Irvine Birthing Center cared for 1830 patients. Approximately 90% were indigent, 85% were Hispanic, and 35% were nulliparas. Of the total patients, 12% were transferred antenatally for high-risk conditions and 19% were transferred intrapartum. The cesarean rate for all patients was 10% (6.5% for those whose intrapartum care began at the birthing center). The perinatal mortality rate was six per 1000. Neonatal morbidity rates, neonatal intensive care unit admissions, and maternal complications were not greater than expected.
The first 20 months of experience with a university-based, freestanding birthing center suggests that this alternative is safe for delivering obstetric and newborn care to low-risk patients.
描述我们与一所大学医学中心联合设立的独立分娩中心的经验，并确定该项目的安全性和有效性。
加利福尼亚大学欧文医学中心在距离医院2英里处开设了一家独立分娩中心。该科室提供每天24小时的产前、分娩、产后及新生儿护理服务。所有直接的患者护理均由认证的助产士提供。前瞻性收集数据以进行描述性记录，并评估孕产妇和围产期的发病率及死亡率，以确定这种方法的安全性和有效性。
在运营的前20个月里，加利福尼亚大学欧文分娩中心照料了1830名患者。约90%为贫困患者，85%为西班牙裔，35%为初产妇。在所有患者中，12%因高危情况在产前转诊，19%在产时转诊。所有患者的剖宫产率为10%（在分娩中心开始产时护理的患者为6.5%）。围产期死亡率为每1000例中有6例。新生儿发病率、新生儿重症监护病房收治率及孕产妇并发症均未高于预期。
基于大学的独立分娩中心的前20个月经验表明，这种方式对于为低风险患者提供产科和新生儿护理是安全的。
