When a baby begins the labor and delivery process healthy, baby should be born healthy. Proper medical and nursing management of this process is designed to facilitate this process but also to allow removal of the baby from a hostile intrauterine environment if that is necessary to prevent permanent injury to the newborn. Frequently, in cases handled by the firm, we see that the process breaks down because of lack of communication or knowledge deficits in the medical or support staff that result in needless delay in removing baby from the uterus when baby is clearly in trouble. The common enemy here is the development of low blood oxygenation and decreased bloodflow resulting in the blood turning acidic and cell death to vital organ systems such as the brain. Sometimes, such needless delays result in the needless death of the newborn or a severe brain damage or cerebral palsy injury. In this study, the authors show that certain patterns on the fetal heart rate monitor during the last 30-minutes of the birth process are highly correlated with fetal acidemia - a damaging condition resulting from low oxygenation and low blood flow. Repetitive prolonged decelerations of the fetal heart rate conciding with uterine contractions, baseline tachycardia where the fetal heart rate goes abnormally high in baby's attempt to compensate for low blood oxygenation, repetitive variable decelerations where the baby's heart rate decelerates in a certain characteristic pattern, and repetitive late decelerations where the fetal heart rate drops in coincidence with the onset of the uterine contractions were highly correlated with a depressed newborn suffering from fetal acidemia. A new factor suggested, where the total deceleration area associated with fetal heart rate decline is measured, demonstrated a superior predictive ability for acidemia when compared to the other patterns. When one or more of these patterns are seen on teh fetal heart monitor, the medical and support staff are supposed to be thinking "let's get this baby out right away."
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By James Girards, [email protected]
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