Total Electronic Fetal Monitoring Immersion Seminar

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Total Electronic Fetal Monitoring Immersion Seminar 

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June 27, 2013 - June 28, 2013
AAJ Headquarters
Washington, DC

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Learn the science behind the medicine at AAJ Education’s Total Electronic Fetal Monitoring Immersion Seminar. This advanced seminar will include Dr. Barry Schifrin, Michelle Murray, Ph.D., RNC-OB, Dov Apfel, Kathleen Flynn Peterson, and Chuck Zauzig. The experienced faculty will demonstrate how to read fetal monitoring strips, what they mean to the baby and mother, and when there should be intervention from OB. Attendees will gain a comprehensive understanding of how the science impacts your clients and how to best use fetal monitoring strips in birth injury cases. 

This program is for plaintiffs only and restricted to members of AAJ’s Professional Negligence Section, Birth Trauma Litigation Group (BTLG), and Medical Negligence Information Exchange Group (MNIEG).

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Thursday, June 27, 2013

Registration (Continental Breakfast Available)
8:00 - 9:00 am

Morning Session
9:00 - 12:00 pm  

Welcoming Remarks and Program Objectives

Critical Strategy in EFM Cases
Charles J. Zauzig, III, VA

EFM: Expectations, Problems, and Reality
Dov Apfel, MD

EFM Patterns and Relationships to Labor
Barry S. Schifrin, M.D.
Michelle Murray, Ph.D, RNC-OB
Kathleen Flynn Peterson, MN
      ♦ Periodic Changes
        - Acceleration
        - Deceleration
     ♦ Base Changes
        - Variability
        - Rate
     ♦ Uterine Activity - Normal to Excessive
        - Frequency
        - Duration
             ♦ Amplitude
             ♦ Baseline Tonus
             ♦ Rest Time
      ♦ The Relationship of UC to Progress in Labor
      ♦  Uterine Physiology
          - Definiting Optimal Uterine Activity
          - Effect on Uterine Blood Flow
          - Effect on Cerebral Blood Flow
      ♦ Relationship of Patterns and Progress in Labor
      ♦ Progress in Labor, Descent
      ♦ The Friedman/Zhang Controversy
      ♦ The Conduct of Second Stage Labor
      ♦ Pitfalls
          - Pushing Strategy
          - "Full Dilatation"
         - Malposition
         - Timing and Route of Intervention
      ♦ Issues Relating to the Use of PG and Oxytocin

Lunch (on your own)
12:00 – 1:00 pm  

Afternoon Session
1:00 - 5:30 pm

Algorithms for Management of Category II FHR Patterns
Dov Apfel, MD

Nomenclatures
Barry S. Schifrin, M.D.
Michelle Murray, Ph.D, RNC-OB
   ♦ Categories I-III
   ♦ Parer-5
   ♦ Schifrin-2x2

Challenges of Cross-Examination with Categories
Kathleen Flynn Peterson, MN

Pitfalls in EFM Interpretation
Barry S. Schifrin, M.D.
Michelle Murray, Ph.D., RNC-OB
 ♦ Asking the Wrong Questions
          - Artifact - Double/Half Counting
          - Maternal Insertion
                ♦ Conditions Which Increase Risk of Maternal Tracing
                ♦ Guidelines to Decrease Risk of Maternal Insertion
 ♦ Arrythmia

Causation Block
Dov Apfel, MD
  ♦ Does EFM Have a High False Positive Note?

EFM: Statistics and Relationship
Dov Apfel, MD
Barry S. Schifrin, M.D.
Kathleen Flynn Peterson, MN
  ♦ Cesarean Section Rates
  ♦ Acidosis
  ♦ Perinatal Mortality/Perinatal Morbidity
  ♦ Neurological Handicap

The Encephalopathy Debate
Dov Apfel, MD
Barry S. Schifrin, M.D.
Kathleen Flynn Peterson, MN
  ♦ T.B. 163, Consensus Opinions, NECP
  ♦ The Mechanism and Timing of Fetal Neurological Injury
      - Hypoxic-Ischemic Encephalopathy (HIE)
      - Mechanical/Traumatic Encephalopathy
      - Perinatal Stroke
      - Other—Infection
            ♦ The Prevention of Cerebral Palsy
            ♦  Improving Obstetrical Care

Visual Strategies in EFM Cases
Kathleen Flynn Peterson, MN

5:30 - 6:30 pm  Networking Reception

Friday, June 28, 2013

Continental Breakfast Available
8:00 am - 9:00

Morning Session
9:00 am - 1:00 pm

The Causal Pathway from EFM to Cerebral Palsy
Dov Apfel, MD

Interpreting FHR Patterns - Case Lessons: Fitting the Pieces Together
Barry S. Schifrin, M.D.
Michelle Murray, Ph.D., RNC-OB
Dov Apfel, MD
Kathleen Flynn Peterson, MN
   ♦ Artifact
   ♦ Late Decelerations
   ♦ Variable Decelerations
   ♦ Excessive Uterine Activity
   ♦ Chronic Distress - Preexisting Injury
   ♦ Pitocin Abuse
   ♦ Stroke
   ♦ Variability

Adjourn

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