Medical litigation is on the rise in our country particularly with relation to obstetrics. The day is not far when premiums for malpractice insurance rise parallel to the rise in the compensation offered for these cases. Majority of the cases
seem to be due to the delay in the decision to delivery interval rather than the problems with diagnosis. Although there is poor correlation between FHR patterns and long term outcome a significant association has been noted between the decision to delivery interval and admission to the neonatal intensive care unit for neonatal asphyxia 16. An effort must be made to reduce the decision to delivery interval and restrict it to not more than 30 minutes. It should be the norm to keep the women and her relatives apprised of the situation of the labor at all times and involve them in the decision making. In some cases of fetal distress immediate operative delivery may be the only option to ensure a healthy neonate. Even in these situations intrauterine resuscitation can play a role in enhancing the perinatal outcome. Ultimately, efficient management and a good outcome in cases of fetal distress reflects a strong infrastructure and good coordination between the obstetrician, the nursing staff, the staff in the operation room and the neonatologist.