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Re: Marked variability and non-reassuring fetal heart tracing.From: Andrew Folley (agfolley@hotmail.com)Tue Jun 17 08:27:58 2008
For 40 years we have been using ST analysis as the measure of ischemic changes in the myocardium to determine myocardial hypoxia in adults. This is essentially the same technology. Put baby on a treadmill and see how the myocardium responds to labor. > Date: Mon, 16 Jun 2008 13:11:01 -0500> From: forcep@intercom.net> To: ob-gyn-l@mail.obgyn.net> Subject: Re: Marked variability and non-reassuring fetal heart tracing.> > Let me get this correct: so if we have no scientific basis for FHR > monitoring we then substitute something else which is newer but again > has no studies which> demonstrate any benefits? Joe C> > I guess if the fetal monitor is so great at predicting bad outcomes in > > the fetus then there really is no need for STAN?? On the other hand > > if you are tired of doing csections for "non reassuring" tracings and > > then delivering babies with apgars 9/9 and ApH of 7.3 then maybe we > > should be taking a closer look at the potential benefits of stan > > technology. (and regarding cost: electrode leads $15 and actual > > monitor is $30K although soon to be available at SAMs and best buy for > > $1999 + tax)> >> > ------------------------------------------------------------------------> > Date: Sat, 14 Jun 2008 20:38:48 -0500> > From: rd.braun@gmail.com> > To: ob-gyn-l@ma= --------------------------------------------------------------> > Date: Satil.obgyn.net> > Subject: Re: Marked variability and non-reassuring fetal he= --------------------------------------------------------------> > Date: Satart> > tracing.> >> > easy!!!! C/S with delivery 10 minutes after the variables become> > severe (severe defined as down to 60 and lasting for 60 secs.) I> > believe that definition has been with us for 45-50 years.> >> > Dan> >> > On Sat, Jun 14, 2008 at 4:02 PM, Andrew Folley> > <agfolley@hotmail.com <mailto:agfolley@hotmail.com>> wrote:> >> > Smell this one. G1P0 37 weeks stage one good tracing at 4> > cm. Pt with preeclampsia induciton etc.. develops variables> > at 6 cm they become deep down to 60 and lasting 60 seconds. > > BBV goes down to minimal at 8cm Recurrent lates develop at> > 9cm. What to do???> > I recognize that smell and its not from the mom or the baby.> >> >> > ------------------------------------------------------------il.com <mailto:rd.braun@gmail.com>> >> > To: ob-gyn-l@mail.obgyn.net <mailt= baby.> >> >> > ------------------------------------------------------------o:ob-gyn-l@mail.obgyn.net>> > Subject: Re: Marked variability and non-reass= baby.> >> >> > ------------------------------------------------------------uring fetal> > heart tracing.> >> > Let me see now, Preg >35 weeks Reassuring FHR tracing> > in 1st stage Given that, I can do pretty good just by> > smelling the patient.> >> > Dan> >> > On Fri, Jun 13, 2008 at 9:38 AM, Andrew Folley> > <agfolley@hotmail.com <mailto:agfolley@hotmail.com>> wrote:> >> > STAN has been used routinely in Sweden for over 12> > years with much success in predicting good fetal> > outcomes. It is not indicated for premature> > pregnacies ie before 36 weeks nor in the second> > stage. Also has to be implemented before> > a nonreassuring tracing develops. Essentially STAN is> > looking at the fetus as a baby on a treadmill (labor)> > and looking for signs of myocardial ischemia (ST> > segment changes). agf> >> > > Date: Thu, 12 Jun 2008 13:01:55 -0500> > > From: johnprov@sympatico.ca> > <mailto:johnprov@sympatico.ca>> >> > > To: ob-gyn-l@mail.obgyn.net> > <mailto:ob-gyn-l@mail.obgyn.net>> > > Subject: Re: Marked variability and non-reassuring> > fetal heart tracing.> > >> > > At Thu, 12 Jun 2008, Andrew Folley wrote:> > > >> > > >STAN if it proves to do what it says it can will> > replace any guessing of pH and any guessing as to what> > a questionable or nonreassuring tracing means. agf>> > >> > > I went back and looked at what the makers of STAN> > want you to do before> > > starting, first they want you to start early in the> > first stage, if the> > > FHR tracing is non-reassuring they insist you not> > use STAN. Well give> > > me your hand so I caarch.live.com/cas ----> > Enjoy 5 GB of free, password-protected online storage. Get Windows > > Live SkyDrive.= -------------------------------------------------------------> > Enjoy 5 GB > > <http://www.windowslive.com/skydrive/overview.html?ocid=3DTXT_TAGLM_WL= -------------------------------------------------------------> > Enjoy 5 GB_Refresh_skydrive_062008>> > arncashback
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