Do any of you have to go to the OR and continously fetal monitor fetuses over the age of viability during routine surgical procedures? We have recently been asked to do that. My question is.... if the OB doc isn't rapidly available, what are we going to do with a fetal distress? Any comments on whether you do this, or how you do this will be greatly appreciated. And if you have any policies on this, I would love to hear what they are. Thanks!! Deb
Sep 7, '06
I have been in the OR during surgical procedures on mom when the fetus is over the age of viability. In one case it was a mom 32 weeks along undergoing a bowel resection due to obstructed bowel. Obviously I couldn't monitor the baby during the surgery. But we did so before and after and the OB was the assisting doctor for the surgery. The policy at my last hospital was to have an OB nurse on hand for FHTs before, after and during if possible. I think the rationale for the OB nurse to be there is we are better suited to respond to a fetus in distress. The OB can usually be there quickly if delivery becomes necessary(I hope).
Sep 10, '06
Yes, always before we got FHT's before and after the procedure. Now, a new anesthesiologist wants continous fetal monitoring due to legal risks, he says. But I have to wonder if this is really necessary or even possible sometimes....
Sep 15, '06
Yep, we too are being asked to sit in the OR and continuously monitor fetal heart tones. Seems like some of the new young anesthesiologists are spearheading this change. So during a craniotomy what are we going to do with a big dip? It's a conundrum that I have no answer for. An OB and a perinatologist were not IMMEDIATELY available, so what would a neurosurgeon do if the heart tones were in the sixties?
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