Mölndal, June 2012
In the next issue of Acta Obstetricia et Gynecologica Scandinavica an article will be published in which the Norwegian Society for Gynecology and Obstetrics’ reference group for fetal monitoring questions the Stockholm County Council HTA report that criticized the use of the Stan-method. According to the Norwegian reference group the HTA report mainly suffers from two serious shortcomings;
Firstly, it refers to a subjective choice of evidence for the clinical use of the Stan method. Without giving further explanation, the HTA report chose to disregard some Stan studies and several published clinical studies have been completely ignored.
Secondly, the report does not account for the existence of alternative evidence-based methods for fetal monitoring. As the report claims that the Stan method should not be used clinically it requires a discussion based on scientific evidence whether there are alternative methods. The report makes no mention of the fact that studies have shown a 40% reduction of the alternative monitoring method with fetal scalp blood sampling in combination with CTG if you instead use the Stan-method.
Moreover, according to the article authors, the Stockholm report describes education as a problem associated with the Stan method while in reality the increasing need for training is related to the CTG method and the problems that exist in the interpretation of CTG tracings.
The national guidelines developed by the Norwegian Society for Gynecology and Obstetrics recommend the Stan method for high-risk deliveries and the authors see no reason to revise these guidelines and recommendations.