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A telephone consultation system using the Xerox 400 Telecopier has been established to transmit fetal monitor data to a tertiary center from regional hospitals with limited experience in interpreting this data. This report reviews a 4-year experience with this consultative device, discusses both the advantages and disadvantages of such a program, and recommends the establishment of similar services in other tertiary centers. We believe that the establishment of such services can be of diagnostic and therapeutic benefit to inexperienced medical personnel when first confronted with the concept of fetal monitoring. Hopefully, by so doing, hospital use of fetal monitoring will increase.

Transporting the high-risk pregnant woman to a tertiary center prior to labor or delivery, in an attempt to offer more intensive care to the patient and her infant, has gained increasing support from medical communities over the past few years. Because of this concept, tertiary centers need to be actively involved in the organization of these transport systems and to be certain that all members of the perinatal team at the referring as well as the receiving center are kept informed of events. This paper describes how Vanderbilt University Hospital initiated an acitive one-way maternal transport system and how that system is maintained and reviews the first 176 patients treated under that system. Establishing direct lines of communication between the practicing physician and the tertiary center and emphasizing continuing education at all levels seem to be important aspects in the development and maintenance of such a referral system.