Dr. Timonen from Turku University Hospital, Finland presented a poster with their experience of ST Analysis at the recent Soc. for Maternal-Fetal Medicine (SMFM) congress in Dallas USA. The rate of metabolic acidosis was reduced with 79% when the first four years of ST Analysis usage were compared to the six following years in patients monitored with CTG+ST. During the same period the number of fetal scalp blood measurements was substantially reduced as well as the rate of total cesarean …

In the European Stan Expert meeting in 2009, the interpretation of a high baseline T/QRS ratio at the start of a registration was discussed since some cases with high baseline T/QRS followed by metabolic acidosis had been encountered.  The baseline T/QRS is the absolute value of the T/QRS ratio at the start of a Stan recording, and is currently only used for comparison with later changes indicating a rise in the T-wave of the fetal ECG.
The objective of this …

The objective of this meta-analysis, which includes five randomised trials (RCT) and 15,352 patients, was to compare the effects of adding ST Analysis to conventional intrapartum CTG. The included RCT’s evaluated singleton term pregnancies in cephalic presentation and the meta-analysis was performed on results for metabolic acidosis, fetal blood sampling, mode of delivery, Apgar score and neonatal care. For three of the studies, published corrected data were used and the meta-analysis could be performed on all data according to the …

The aim of this prospective randomized study was to compare the effectiveness of pulse oximetry and ST Analysis of the fetal ECG, and to determine which method was better at identifying the labour which could continue to deliver a healthy newborn.

One hundred eighty women with a full-term, singleton, cephalic presentation and a CTG tracing with non-reassuring fetal heart rate (NRFHR) were included in the study. The rate of caesarean delivery, indication for operative delivery due to NRFHR and neonatal acid-base status was compared between the groups.

The study showed a significant difference in mode of delivery, in that the rate of caesarean section was 37% lower in the group monitored with ST Analysis. The authors conclude that both methods can prolong labour in situation with NRFHR, but that ST Analysis was more effective in safely avoiding emergency caesarean deliveries, and that this method also provided a more continuous source of information on fetal status throughout labour.

Acta Obstet Gynecol Scand. 2011 Sep;90(9):990-6. doi: 10.1111/j. 1600-0412.2011.01203.x. Epub 2011 Jun 27.
Swedish randomized controlled trial of cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: analysis of data according to standard versus modified intention-to-treat principle.
Amer-Wåhlin I, Kjellmer I, Maršál K, Olofsson P, Rosén KG
Department of Women and Child Health, Karolinska Institute, Stockholm Department of Pediatrics, University of Gothenburg Department of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University Department of Obstetrics and Gynecology, Clinical Sciences Malmö, …

BJOG. 2011 Sep;118(10):1239-1246. doi: 10.1111/j.1471-0528.2011.03027.x. Epub 2011 Jun 14.
Fetal blood sampling in addition to intrapartum ST-analysis of the fetal electrocardiogram: evaluation of the recommendations in the Dutch STAN® trial.
 
Becker J, Westerhuis M, Sterrenburg K, van den Akker E, van Beek E, Bolte A, van Dessel T, Drogtrop A, van Geijn H, Graziosi G, van Lith J, Mol B, Moons K, Nijhuis J, Oei S, Oosterbaan H, Porath M, Rijnders R, Schuitemaker N, Wijnberger L, Willekes C, Visser …

Acta Obstet Gynecol Scand. 2011 Mar 29. doi: 10.1111/j.1600-0412.2011.01138.x. [Epub ahead of print]
Cost-effectiveness of cardiotocography plus ST-analysis of the fetal electrocardiogram compared to cardiotocography only.
 
Vijgen SM, Westerhuis ME, Opmeer BC, Visser GH, Moons KG, Porath MM, Oei GS, Geijn HP, Bolte AC, Willekes C, Nijhuis JG, Beek EV, Graziosi GC, Schuitemaker NW, Lith JM, Akker ES, Drogtrop AP, Dessel HJ, Rijnders RJ, Oosterbaan HP, Mol BW, Kwee A.
Academic Medical Center, Amsterdam, University Medical Center Utrecht, Utrecht, …

The Dutch Randomized Controlled Trial on ST Analysis is published in the June issue of Obstetrics & Gynecology – The Green Journal. The trial is one of the largest ever within obstetrics, and it confirms the results from the previous RCTs with the conclusion that ST Analysis as an adjunct to CTG “…substantially decreases the incidence of (metabolic) acidosis.”
Read the full article
Cardiotocography Plus ST Analysis of Fetal Electrocardiogram Compared With Cardiotocography Only for Intrapartum Monitoring: A Randomized Controlled …

The long-term cost-effectiveness of fetal monitoring during labour: a comparison of cardiotocography complemented with ST analysis versus cardiotocography alone
E Heintz,a T-H Brodtkorb,a N Nelson,b L-A Levinaa.
The purpose of the study was to evaluate the cost-effectiveness of ST analysis compared to that of CTG alone. The authors used a decision model with baseline estimates derived from the literature. The result shows that ST analysis is a cost saving method compared to CTG alone in the long term perspective, including …

Recently, a very large Swedish clinical study was published in the well recognized American Journal of Obstetrics and Gynecology.
For more information, please read the full press release in PDF-format here.