Managing High-Risk Obstetric Cases and Analyzing Neonatal Outcome: The KP Northern California Regional Perinatal Service Center.

Located in Santa Clara, California, the Kaiser Permanente (KP) Northern California Regional Perinatal Service Center provides obstetric care to high-risk women throughout Northern California. Services designed to prevent preterm birth began in 1991, and the center has expanded to include home hypertension management, home diabetes management, hyperemesis support, and home nonstress testing programs. The goals of the center are to provide clinical services, to coordinate and maximize resources via telecommunications, to emphasize patient education, to empower patients in self-assessment and lifestyle change, and to support clinicians in the delivery of care. The center also conducts perinatal outcome studies and clinical trials. Donald Dyson, MD, a maternalfetal medicine specialist who was then at KP Santa Clara, identified a causal connection between preterm birth and perinatal mortality and morbidity in our Health Plan members. From 1986 through 1989, Dr Dyson conducted a study that evaluated care of patients at risk for preterm labor or delivery. Results of the study suggested that patient outcomes were improved through use of an Managing High-Risk Obstetric Cases and Analyzing Neonatal Outcome: The KP Northern California Regional Perinatal Service Center