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Re: 'There is no gold standard for decision-to-incision time' ???From: Andrew Folley (agfolley@hotmail.com)Mon Oct 8 17:03:23 2007
You could make the argument this baby has just died as in the past 5 minutes and possibllity of resussitation exists. One could also make the argument that the fetal herart tones being "absent" may be incorrect. ie it is inaccurate and you are simply recording the fetal heart rate in distress of the baby at 90 the same as moms very anxious heart rate andy Date: Sun, 7 Oct 2007 18:38:09 -0500 From: rd.braun@gmail.com To: ob-gyn-l@dns.obgyn.net Subject: Re: 'There is no gold standard for decision-to-incision time' ??? If your indication for the section is fetal distress, certainly. You no longer have that indication. Or do you section people for a dead baby? Dan On 10/7/07, Raymond Stephen <stephen.raymond@dhhs.tas.gov.au> wrote: So if you find there are no fetal heart sounds as the last person arrives, what do you do then? Stand down the team and allow to deliver vaginally? Steve From: ob-gyn-l@obgyn.net [mailto: ob-gyn-l@obgyn.net] On Behalf Of R. Daniel Braun Sent: Sunday, 7 October 2007 12:11 PM To: Multiple recipients of list OB-GYN-L Subject: Re: 'There is no gold standard for decision-to-incision time' ??? Question relating to the case presented. How long from last listening for FHT's and incision? It is easy to stand around in the OR waiting for that last member of the team to arrive and then just make the incision when they get there. One should always know whether or not there is a heart beat before making the incision. IMHO. With a one and 5 minute apgar of "0", I find it hard to believe that there were ht. tones present in the last 3-5 minutes befor the incision. Dan On 10/6/07, Efrain Ramirez <eramirezt@coqui.net> wrote: There is no gold standard for decision-to-incision time Don't accommodate plaintiff's attorneys who have reinvented an intended guideline as a requirement! CONFIDENTIALITY NOTICE AND DISCLAIMERThe information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose.
-- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine
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