Pacific Coast Obstetrical and Gynecological Society. Annual meeting. Scottsdale AZ USA, 1994/10/24.
The purpose of this study was to compare the obstetric outcome of a primary-care access clinic staffed by certified nurse-midwives, supervised by a private practice group of four obstetricians, with the obstetric outcome of that group's private practice patients.
A retrospective cohort study was performed.
Obstetric outcomes as measured by (1) perinatal morbidity and mortality, (2) Apgar score, (3) birth weights, and (4) prematurity rates were comparable between the two groups.
Significant was the cesarean section rate of 13.1% (10.5% primary) for the clinic patients and 26.4% (18.5% primary) for the private patients and the high percentage (81.8%) of private patients who elected to have repeat cesarean sections.
(1) Low-income, uninsured, and underinsured women who have access to excellent prenatal care with supervised certified nurse-midwives can have obstetric outcomes similar to women having prenatal care with private obstetricians. (2) Prenatal care with supervised certified nurse-midwives can reduce the cesarean section rate without compromising infant outcome. (3) Utilization of certified nurse-midwives supervised by obstetricians may provide the optimum model for perinatai care, particularly for those women who are at high risk because of social and economic factors and who are currently underserved. (AM J OBSTET GYNECOL 1995 ; 172 : 1864-71.).
Mots-clés Pascal : Pronostic, Périnatal, Mère, Foetus, Accouchement, Césarienne, Taux, Etude comparative, Homme, Femelle, Sage femme, Médecin, Obstétrique, Soin santé primaire, Clinique, Chirurgie
Mots-clés Pascal anglais : Prognosis, Perinatal, Mother, Fetus, Delivery, Cesarean section, Rate, Comparative study, Human, Female, Midwife, Physician, Obstetrics, Primary health care, Clinic, Surgery
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0411080
Code Inist : 002B30A01A2. Création : 01/03/1996.