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Fetal Monitoring

A professional liability insurer has posted this information on fetal monitoring for doctors.

The opening paragraph:  "Initially, the fetal monitor was developed for the intrapartum period to better evaluate the status of the fetus during labor. Earlier identification of pending acidosis and hypoxia would alert the obstetric team, leading to more timely intervention and thus a significant reduction in the incidence of neonatal morbidity and mortality. Though clinical trials have failed to demonstrate a significant impact on morbidity and mortality, fetal monitoring is now essentially universal."

This is interesting:

"While monitoring can be ambiguous, certain persistent patterns on a tracing require a response on the part of the practitioner. These include but are not limited to:

                    Severe variable decelerations
                    Persistent late decelerations with a nonreactive tracing
                    Persistent fetal tachycardia with a nonreactive tracing
                    Prolonged bradycardia

Failure to execute an intervention or form a plan in these situations may make it difficult to defend against a malpractice allegation. "

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