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Re: Intermittent auscultation From: Efrain Ramirez MD (eramirez@icepr.com) Thu Feb 18 17:13:23 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Depo and menopause" Previous message: Malcolm Griffiths: "Re: Depo and menopause" In reply to: Luis Sanchez-Ramos: "Re: Intermittent auscultation" Next in thread: Jane Helwig, MD: "Re: Intermittent auscultation" I have seen the "growth" of EFM since its infancy. We all agree on its merits and shortcomings. But today, at least in my hands, I feel uncomfortable doing a delivery without it and I consider myself quiet experienced in EFM's interpretation. It comes to my mind so many cases of "low risks" patients in which without EFM the outcomes would have been disastrous.To put it in another way..I do not disapprove IA, nor I am against it but I do not encourage its use in my patients. At Thu, 18 Feb 1999, Luis Sanchez-Ramos wrote: > >At Thu, 18 Feb 1999, Braun, R. Daniel wrote: > >>>If I recall correctly, the studies expressly excluded anyone who was not >>perfectly normal. Therefore, the results only apply to "LOW RISK" patients.<< > >Apparently your recollection is not correct. Some of the trials >included only low risk subjects while others included those classified >as high risk. Thacker's meta-analysis on the efficacy and safety of >intrapartum EFM (Obstet Gynecol 1995;86:613-20)included RCTs with low >and high risk patients. A review by Cibils (Am J Obstet Gyencol >1996;174:1382-9) states that both modalities apply to low and high risk >patients. >I am a proponent of EFM but only if the person interpreting the fetal >monitor strip understands fetal physiology and pathophysiology and is >experienced in the interpretation of patterns. If not, perhaps IA is >acceptable. Practically every study has shown an increase in cesarean >delivery with EFM. > >-- >Luis Sanchez-Ramos, MD > -- Efrain Ramirez MD FACOG "The things you learn after you know everything are the important ones" Next message: DoctorJoe@aol.com: "Re: Depo and menopause" Previous message: Malcolm Griffiths: "Re: Depo and menopause" In reply to: Luis Sanchez-Ramos: "Re: Intermittent auscultation" Next in thread: Jane Helwig, MD: "Re: Intermittent auscultation"

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