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Re: FETAL DISTRESSFrom: HockIsUs@aol.comTue Jun 4 20:57:56 1996
In response to your letter: I totally agree with you that being called to testify does NOT make one an "expert" at whatever it is they are testifying on. Dr. Murray has a PhD, and is the primary consultant to AWHONN on fetal monitoring, and has authored two texts on the subject, as well as serving as author on AWHONN's "Fetal Monitoring Course." But your point is well taken. Several of the ob conferences I have been to in the last several years have alluded to the use of "NRFHT's" instead of "fetal distress." Our hospital has also advised the ob/gyn dept. to use NRFHT terminology. So I agree with you that it is purely a matter of semantics, but just trying to "keep up" with recommendations. The point re: watching lates: Dr. Murray's point was that if you have CONCURRENT signs of fetal health (accels, variability), and non-repetitive lates, that that simply gives you a short amount of time to try and correct the UPI; late decels in the ABSENCE of ANY signs of fetal well-being are indicative of necessitating immediate delivery. Surely we have all seen a stretch of occasional lates on a strip with good variability; most often this is due to maternal supine positioning, and simply altering maternal position will alleviate the lates. I hope this clarifies; I did not mean to imply that you can sit and watch lates for an indeterminate amount of time. I am a certified nurse-midwife employed by a group of ob/gyns at a level III facility. Our group serves as the ones to whom high-risk referrals are made. Lori House-Hewitt, C.N.M., M.S. Adjunct faculty, Univ. of Michigan Practicing in Mid-Michigan
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