STAN in clinical practice—The outcome of 2 years of regular use in the city of Gothenburg

Norén, Håkan; Blad, Sofia; Carlsson, A.; Flisberg, Anders; Gustavsson, Annika; Lilja, Håkan; Wennergren, Margareta; Hagberg, Henrik

doi:10.1016/j.ajog.2006.01.108

Cited by 60 publications

(49 citation statements)

References 14 publications

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“…This is consistent with previous published rates of neonatal metabolic acidosis seen in association with intrapartum fetal ST analysis used in clinical practice (0.45-2.8%) (Doria et al 2007;Massoud et al 2007;Norén et al 2006). Norén et al (2006) demonstrated that increased use of STAN over time was associated with a reduction in the number of cases with neonatal metabolic acidosis. The authors suggested that this reduction in neonatal metabolic acidosis might be due to increased familiarity with STAN guidelines and the improved response times to ST events.…”

Section: Discussionsupporting

confidence: 92%

“…STAN has been shown to reduce the number of operative deliveries for fetal distress (Kale et al 2008), reduce the need for FBS (Vayssière et al 2007) and also reduce the incidence of neonatal metabolic acidosis in a clinical setting (Norén et al 2006). Intra-partum fetal surveillance with STAN is also acceptable for patients (Parisaei et al 2009) and medical staff (Rault et al 2008).…”

Section: Introductionmentioning

confidence: 97%

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The use of STAN monitoring in the labour ward

Ragupathy

Ismail

Nicoll

2010

Journal of Obstetrics and Gynaecology

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Continuous intrapartum cardiotocography (CTG) augmented by fetal ECG ST segment analysis (STAN) has the potential to reduce the rates of neonatal metabolic acidosis and obstetric interventions. STAN was introduced at Ninewells Hospital, Dundee in October 2007. Data were collected prospectively from all women who received continuous intrapartum CTG and STAN between 1 October 2007 and 31 March 2008. A total of 253 women had continuous CTG and STAN. The median number of ST events was one (range = 1-32). Most (556/719, 77%) ST events were associated with a normal CTG; 46/144 (32%) patients with an ST event required immediate action. Three of the 253 (1.2%) women were delivered based on an ST event with a normal CTG; four (1.5%) had severe neonatal metabolic acidosis and all four cases had intrapartum ST events and were not managed according to STAN guidelines. ST events are common but the majority of ST events require no action. The high incidence of false-positive ST events might have contributed to the failure to act when a significant ST event occurred.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 97%

The use of STAN monitoring in the labour ward

Ragupathy

Ismail

Nicoll

2010

Journal of Obstetrics and Gynaecology

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“…In a series of 411 women monitored with STAN for fetal distress, we showed that the sensitivity of STAN to predict pH b 7.05 at birth is better than it predicting pH b 7.15 (63% and 38%, respectively) [5]. Our findings, like the Swedish results [9][10][11], are encouraging [5] in better screening for more severe acidosis. These recent results were not known when respondents completed the questionnaire in the present study.…”

Section: Discussionsupporting

confidence: 67%

Assessment of STAN S21 fetal heart monitor by medical staff

Rault

Vayssière

Roth

et al. 2008

Intl J Gynecology & Obste

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“…14 BDecf was calculated according to Wiberg et al 11 As part of the introduction of the new STAN methodology for intrapartum fetal surveillance, combining an automatic continuous evaluation of the ST segment of the fetal electrocardiogram (STAN) with conventional fetal heart rate analysis (carditocography [CTG]), a prospective observational study covering the total population of deliveries at term in the city of Gothenburg and surrounding areas was conducted over 2 years (October 2000 to September 2002). 12 Of the 14 687 term deliveries, 78 cases had cord artery metabolic acidosis (group A). Control cases (group B) were identified as the 2 adjacent deliveries monitored with the same technique CTG or CTG and ST analysis in combination, delivered at the same gestational age, of the same gender, having a cord artery pH of .7.10 and in whom there was no need of care in the neonatal ward.…”

Section: Methodsmentioning

confidence: 99%