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.”
Large randomized controlled study from Utrecht in the Netherlands confirm the clinical benefits of ST Analysis
This multicenter study included 5681 high risk patients over a period of three years. The purpose of the study was to compare the clinical outcome of the STAN methodology with conventional fetal monitoring, which in the Netherlands include CTG in combination with fetal scalp sampling. The result confirms the results from previous randomized trials and is consistent with observational studies from different parts of the world.
• 30% reduction of metabolic acidosis, defined as pH <7.05 and BDecf >12, in the STAN arm,
• 37% significant reduction of metabolic acidosis, defined as pH <7.05 and BD >12, in the STAN arm
• 48% reduction in fetal scalp sampling in the STAN arm
The results were achieved with the same low percentage of operative deliveries in both groups.
Apgar scores and number of children transferred to neonatal care were also the same in both groups.
There is no consensus on which method to use to calculate the base deficit and metabolic acidosis: in the extracellular fluid or blood. Researchers primarily use the first method but the second is most common in clinical practice (used for automatic calculation in most blood gas analyzers). Both methods showed a reduction of metabolic acidosis when the STAN-methodology was used.
The Dutch study is one of the largest randomized studies ever conducted in obstetrics. It was performed in nine hospitals, three university hospitals and six teaching hospitals. Most of the hospitals had no previous experience with ST Analysis. Before the study started, all staff participated in training courses in the STAN methodology carried out by experienced users from Utrecht University. The study was conducted without any involvement of Neoventa.
Abstract – Westerhuis et al. 2010
