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Intrapartum monitoring of high-risk deliveries with ST analysis of the fetal electrocardiogram: an observational study of 6010 deliveries
Acta Obstetricia et Gynecologica Scandinavica, 08/17/2012
Clinical Article
Kessler J et al. – ST analysis (STAN) is a useful tool for identifying of fetuses at risk of intrapartum hypoxia. Despite the restricted use of fetal blood sampling they found a low proportion of cord metabolic acidosis and newborn morbidity.
Methods- Analysis of maternal and neonatal outcomes for all deliveries according to the method of intrapartum monitoring.
- Prevalence of cord metabolic acidosis (pH<7.05, base deficitecf >12 mmol/l).
- Of 23 203 deliveries, 6010 (25.9%) were monitored with STAN.
- Fetal blood sampling was performed in 146 (2.4%) of the 6010 cases.
- During the study period, the prevalence of cord metabolic acidosis and moderate cord acidosis (pH< 7.15) decreased in STAN monitored deliveries from 1.4% to 0.3% (p = 0.01) and from 16.4% to 11.7% (p= 0.001), respectively.
- The prevalence of moderate and severe neonatal encephalopathy was 0.38%.
- In the birth population the proportion of caesarean deliveries decreased from 10.1 to 8.8%.
- The risk of emergency cesarean section after STAN monitoring compared to those monitored with auscultation/ cardiotocography was high (odds ratio 5.4, 95% confidence interval = 4.9–6.1), but remained stable during the study period.