Understanding cardiotocographic patterns associated with intrapartum fetal hypoxia and neurological injury

“If there are more focus on pattern recognition and pathophysiology it all becomes more evident.”
Obstetricians and midwives have been trained to focus on morphological appearances of fetal decelerations rather than to understand the underlying psychological mechanisms, how the fetus compensates and defends itself. In that way original interpretations of fetal heart patterns equated decelerations to fetal distress and mandated operative interventions. Since then consequently operative interventions are undertaken to rescue fetuses that display benign signs of fetal heart rate …

Read more

Poster at ECIC: Assessement of an e-Learning program of FHR monitoring. A randomised study

A French study shows that training in CTG interpretation using an e-learning program improves the performance of obstetrical staff.  A poster of this study was presented at the European Congress on Intrapartum Care (ECIC) in Amsterdam this spring.
 

Read more

Renewed meta-analysis: Further support for ST Analysis

The objective of this meta-analysis was to investigate the additional effect of ST Analysis as an adjunct to electronic fetal monitoring. In order to overcome the shortcomings of conventional meta-analysis that uses aggregated data, the present analysis used individual participant data to allow for a more thorough investigation by taking all information into account, including accounting for missing data.
Only four of the five published randomised controlled trials (RCT) were included in the analysis. The first RCT by Westgate …

Read more

Fetal ECG waveform – helps differentiating maternal from fetal heart rate

The objective of this retrospective study was to investigate the incidence of heart rate accelerations coinciding with contractions during the second stage of labour when monitored either with abdominal ultrasound (external) or scalp electrode (internal).

Read more

Five years of ST Analysis usage in Bergen – a quality improvement study

Data from five years of clinical usage of ST Analysis and Stan at the Labour and Delivery ward at Haukeland University Hospital in Bergen, Norway is reported in this prospective observational study. The study was defined as a project of quality improvement, and included a total of 22,475women selected for vaginal delivery.

Read more

Strict adherence to Stan Guidelines leads to improved outcome

In this sub-analysis of the Dutch randomised trial it is shown that cases with adverse outcome in the index group (CTG+ST analysis) could have been avoided by stricter adherence to Stan guidelines. Improved CTG interpretation and timing of fetal blood sampling could have led to better outcomes in the control group.

Read more

Poster at SMFM: Significantly improved outcomes over 10 years of STAN usage in Turku

Dr. Timonen from Turku University Hospital, Finland presented a poster with their experience of ST Analysis at the recent Society for Maternal- Fetal Medicine (SMFM) congress in Dallas USA. The rate of metabolic acidosis was reduced by 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 …

Read more

No risk associated with high baseline T/QRS ratio

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.

Read more

Meta-Analysis concludes benefits of ST Analysis

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 intention-to-treat principle.

Read more

Effectiveness of pulse oximetry vs ST Analysis

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.

Read more
Page 2 of 3 123

# #