Can laparoscopic assisted hysterectomy safely replace abdominal hysterectomy

blood sampling (FBS). We are surprised that in this study no mention was made of FBS, the CTG alone being the final arbiter in the decision making process. Once again, this paper illustrates the over-reliance that may be placed on the CTG in the modern management of labour. The best parameters for fetal monitoring in labour remain an issue for debate, but a combination of CTG and FBS would be acceptable to most. Secondly, it is our belief that the study design could not answer the question posed. For example, at the very least, the registrar should have transmitted the same information to two separate consultants. The pronouncement of a decision by a consultant does not render that decision necessarily correct. If a decision could be swung solely on the basis of a CTG, then it is likely that another consultant might have arrived at a different conclusion. Thirdly. the underlying message from this study, albeit a short communication, causes us concern. This kind of paper might be quoted in litigation cases: it will now be possible to enquire whether a consultant made decisions on the further management of labour with access to the CTG. Where this was not the case the decision might well be deemed suboptimal. Maternity units will then be obliged to supply all their consultants with fax machines, a very expensive exercise which we do not believe has been convincingly shown to improve management. Surely such scant resources as are currently available should be used to purchase facilities for FBS, and more energy should be directed to better training of registrars in their interpretation of CTGs, thereby avoiding keeping the spouses of consultants awake at night listening to the interminable buzz of a fax machine.