We appreciate the interest in our article expressed by Drs. Ross and Amaya. We understand that pH level is logarithmic, and we performed the log-transformed analyses as part of our approach. Not surprisingly, there was a significant association between transformed estimates of acid production and length of terminal decelerations by 30-second increments (P<.001), 120 second increments (P=.01), and even brady-cardia (P<.001). However, these transformations are not how clinicians make bedside decisions with electronic fetal heart rate monitoring. Thus, we attempted to present the data in a more clinically useful way. Although the authors site their own work, which certainly has contributed to the literature, it is important to recognize that "truths" discovered in animal models may not hold true in humans.
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