Obstetrics

In the labor and delivery unit of Olive View-UCLA Medical Center, budget cuts will mean real pain. Specifically, the layoffs of two obstetrical anesthesiologists will mean more painful childbirths. The reason, said Dr.

The infection rate among some laboring mothers at UCI Medical Center is more than twice an acceptable rate because of patient overcrowding, the hospital's acting chief of obstetrics said Sunday. Dr. Thomas J. Garite said 30% to 40% of the obstetrical ward's patients who have Cesarean sections now end up with an infection. An acceptable infection rate would be about 15%. A hospital committee has taken some measures to control the problem, Garite said. But he and several other obstetricians said the ward was so busy, treating more than 500 patients a month in a unit designed for 250, that overworked staff members don't always have time to maintain rigorous hospital standards for cleanliness.

The recently instituted deflection program at UCI Medical Center has engendered heated debates, sometimes degenerating into unsubstantiated accusations and recriminations. As residents in obstetrics and gynecology, we have experienced the consequences of the enormous increase in the volume of deliveries. In a unit built to safely handle 250 deliveries per month, we have over the years seen this number climb steadily to as high as 550 deliveries per month. It has become an all-too-familiar scene to have women laboring and delivering in hallways and on gurneys.

The new technique of DNA fingerprinting, quickly becoming widely used in criminal court cases, can also be used to determine a child's paternity, even before birth, a USC obstetrician reported last week in the journal Obstetrics and Gynecology.

A Panorama City doctor has been suspended from practicing medicine for 30 days for not recognizing medical complications in a pregnant woman whose baby was born dead in a hospital hallway. The Medical Board of California also placed Dr. Lee S. Brilliant on five years probation and ordered him to undergo additional classes in obstetrics and gynecology in connection with the 1988 stillbirth.

The concept of birthing centers--a less expensive alternative to hospital maternity wards--is catching on in Southern California. But no one knows for sure how rapidly, or how well, the centers take care of mothers and babies. That is because there is no state licensing or inspection of the centers, and no agency regularly keeps track of them.

In a blow to Los Angeles County's already overburdened obstetrics system, officials at a South Bay hospital that contracts with the county to handle overflow deliveries announced plans Tuesday to file for Chapter 11 bankruptcy protection while it tries to work out a reorganization plan that would keep it operating. Marina Hills Hospital in Ladera Heights, a 103-bed acute-care facility, had only one patient Tuesday after being filled to capacity early last week.

Palmdale's only hospital, Desert Palms Community, will close its maternity ward in February, leaving just one hospital in the Antelope Valley where women can give birth. Administrators of Desert Palms said this week that obstetric care is not profitable because the 97-bed hospital facility averages only 15 deliveries a month. The hospital, formerly known as Palmdale Hospital Medical Center, will suspend the use of its 10 obstetric beds on Feb.

With a key vote scheduled for today, opposition is building to a proposal by Los Angeles County health officials to close pediatric and obstetric wards at Martin Luther King Jr./Drew Medical Center in an attempt to stabilize the troubled public hospital. A hospital advisory board formed by the county Board of Supervisors is lobbying against the cuts. Two of the five supervisors want to delay the vote on the plan by six weeks.

Several elected officials on Friday condemned a proposal by a Los Angeles County agency to close obstetrics and children's wards at troubled Martin Luther King Jr./Drew Medical Center, vowing at a community meeting that the public hospital would not be downsized without a fight. "This edifice, this center, must go forward.... It's like death by a thousand cuts," U.S. Rep. Diane Watson (D-Los Angeles) told the gathering of more than 100 people.