Are we (mis)guided by current guidelines on intrapartum fetal heart rate monitoring?

Case for a more physiological approach to interpretation
In this interesting paper by Austin Ugwumadu  the general characteristics of the fetal heart rate, the changes in the fetal heart rate pattern that may occur during labour are discussed.
Conclusion:
– An intact fetus with a normal CTG, who is exposed to hypoxia during labour will display a predictable set and sequence of FHR responses.
– With an abnormal CTG the clinician will be able to use the trends in fetal …

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New meta-analysis shows significant reductions in neonatal metabolic acidosis rate and in total operative delivery rate

This second part of the appraisal of RCTs comparing CTG+ST to CTG focus on the five meta-analyses (MAs) published in 2012 and 2013. As discussed in the first part, there are considerable differences in several variables in the five RCTs that make a comparison between the trials, and hence performing adequate meta-analyses, challenging. The type of meta-analyses to use, fixed- or random-effect MA, depends on the heterogeneity of the trials. A random-effect MA as a rule gives a more conservative …

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Differences in RCTs study design and size are likely to impact outcomes

This first article in a series of two, addresses the quality of the five randomized controlled trials(RCTs) comparing CTG+ST vs. CTG (Plymouth trial 1993, Swedish trial 2001, Finnish trial 2006, French trial 2007 and Dutch trial 2010). The following issues are reviewed: power calculation, pre-study training, inclusion criteria, randomization and recruitment pace, intrapartum management protocols, intrapartum interventions, cord blood and early neonatal metabolic acidosis, and neonatal outcomes.
All but the Swedish trial were underpowered for metabolic acidosis, and the majority …

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It is time to introduce ST analysis for fetal monitoring in the labor ward?

After a thorough evaluation of the published data, the authors of this commentary take a definite position in favor of ST analysis in clinical practice. The basis for their standpoint is the solid fundament of experimental data revealing the importance of changes in the ST waveform of the fetal ECG for identification of intrauterine hypoxia. In addition, it is a fact that compared to the alternative of using FBS during labor, ST analysis is less invasive (only needing one perforation …

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Another appreciated CTG Master Class!

We are pleased to report that the CTG Master Class meeting was attended by 50 participants from Sweden, Norway and Denmark. It was the second time Sahlgrenska University Hospital, with the initiator Håkan Norén, arranged the CTG Master Class in collaboration with Neoventa Medical. The CTG Master Class was highly appreciated by obstetricians and midwives, run by the team from St George´s hospital in London with Edwin Chandraharan as a main speaker.
There is a paradigmatic shift in assessment of fetal …

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Fetal scalp blood sampling (FBS) during labour: is it a useful diagnostic test?

St George’s Healthcare NHS Trust, London, UK
Chandraharan E. Fetal scalp blood sampling during labour: is it a useful diagnostic test or a historical test that no longer has a place in modern clinical obstetrics?. BJOG 2014; DOI: 10.1111/1471-0528.12614.

 
Purchase the full paper here

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The ability to identify fetuses at risk of hypoxia with ST Analysis in a high risk population.

The use of ST Analysis as an adjunct to CTG has during the recent years reduced the frequency of vaginal operative deliveries, the necessity of fetal blood sampling and the number of neonates transferred to NICU.

The aim of this prospective observational study was to assess the effect of the time interval from indication of hypoxia to delivery on neonatal outcome.

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White paper: A call to obstetricians caring about perinatal outcome

Over the past few decades, there have been unprecedented increases in healthcare expenditures and rates of caesarean deliveries. Those charged with leadership in healthcare policy and delivery should be aware of the contribution of increasing numbers of caesarean deliveries to the overall cost of healthcare. To halt and reverse this alarming trend, the addition of fetal ECG ST Analysis (the Stan method) to traditional cardiotocography for fetal surveillance in labor can contribute in lowering healthcare costs without jeopardizing the health …

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Neoventa in cooperation with Baby Lifeline

Neoventa Medical is happy to announce the cooperation with Baby Lifeline, UK.  Baby Lifeline is a national organization supporting the care of pregnant women and new born babies all over the UK and worldwide. The aim with the organization is to raise funds to purchase much needed maternity equipment and leading and providing training to the medical and legal professions.
Baby Lifeline was founded in 1981 by Judy Ledger. Judy has personal loss of three premature babies and understands the …

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Meet us at the CNGOF congress in Paris

French College Of Obstetrics And Gynaecology 37th National Congress 2013
Come and meet us at the CNGOF congress
Date: 11-13 December
Venue: CNIT Paris-La Défense
Stand No: 20
 

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