Letter to the Editor accepted in AOGS regarding the latest Meta Analyses:
Belittling of a significant decline in neonatal metabolic acidosis rate achieved by STAN monitoring
Per Olofsson1,2,
DOI: 10.1111/aogs.12861
Abstract:
Blix et al. found in a recent meta-analysis (MA) that intrapartum fetal surveillance with ECG ST analysis (STAN) results in a significant 36% decrease in metabolic acidosis at birth compared to cardiotocography (CTG) alone (1). This demonstrates that STAN monitoring could better than CTG alone protect against hypoxia proceeding to metabolic acidosis. However, by referring to the weak association between metabolic acidosis and “hard endpoints” like death and neurological sequelae, Blix et al. belittle their finding. Approximately 80% of neurological sequelae are not associated with intrapartum events (2) and intrapartum fetal monitoring will then not be protective, but intrapartum hypoxia with metabolic acidosis is causal among the remaining 10-20% of cases (2).
