Hi Shelley,
I recently attended a advanced fetal assessment course at our tertiary
hospital and all the pros for cord blood gases were presented. CTG's were
discussed with pros and cons such as 80% show some abnormality but 80% of
babies are not sick or acidotic. It was presented as one of certain
diagnostic tools for fetal acidosis and therefore useful for litigation.
You mentioned the results are inaccurate. I'd be very interested in hearing
why they are inaccurate. We don't do them and I don't agree with routinely
doing them so any more information would be helpful.
Thanks
Melissa
----- Original Message -----
From: "michelle gascoigne" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Saturday, October 14, 2006 10:39 PM
Subject: Re: [ozmidwifery] cord blood gases
Naomi
In England we have seen in increase in 'fear' of litigation. Obstetrics in
this country has always taken a huge chunk of the litigation for most
hospitals . We now have in our country CNST (clinical neglegence scheme
for trusts). Trusts are what groups of health care organisations are
called. CNST is an insurance that Trusts pay into so that litigation
claims can be paid when won. The CNST set out standards for trusts and
depending on how well you achieve the standards determines the insurance
premiums, which you can imagine are huge figures. The trouble is that CNST
requirements for the standards to be met are not always sensible or in the
best interests of women. Some standards like (cord blood sampling for ph
post birth) are simply taken to record results in the notes which may
protect against litigation in the future. I have a million issues with
this practice! We had a university supervised professional debate about
this issue in the Trust where I worked when it first became an issue. The
midwives against and the Obs. for. We won the debate but the CNST
requirements meant that we could save the Trust loads of money if we did
them so they were introduced. Some of us still refused to do them. I would
only do them if it was explained in full to the mother and father and they
agreed. I gave it to them warts and all (like the obs openly admit that it
is just to defend them in cases of litigation.). I did not make the
decision the parents did. Needless to say when you tell them how
inaccurate the results are and that neither they nor the baby will benfit
from the results. Many choose not to have it done.
I will search out my references and post them seperately. Our debate was
published in a midwifery mag here!
Shelly
Midwife
----- Original Message -----
From: "Naomi Wilkin" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Friday, October 13, 2006 9:07 AM
Subject: [ozmidwifery] cord blood gases
Hi all,
Just wondering how common it is for cord blood gases to be done in
maternity units. I work in a small metro. hospital with a very busy
maternity unit and our medical 'powers that be' are pushing for them to
be done at every birth. Something we, the midwives, are very, very
reluctant to do.
I was also wondering if anyone knows of any research that may help us to
prevent this from becoming a routine thing.
Thanks
Naomi.
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