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Fetal monitoring with computerised ST analysis during labor: a systematic review and meta-analysis.
MedLine Citation:
PMID:  22994593     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Computerised ST analysis of fetal electrocardiography (ECG) combined with cardiotochography (CTG) has been introduced for intrapartum monitoring and is the prevailing method when ST analysis (STAN®) is used. Objectives: To assess the evidence that computerised ST analysis during labor reduces the incidence of fetal metabolic acidosis, hypoxic ischemic encephalopathy, cesarean section, instrumental vaginal delivery or the number of instances where fetal scalp blood sampling is used as compared with CTG only. Search Strategy: Search of PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL and CRD databases. Selection criteria: CTG only compared with CTG + computerised ST analysis. Data collection and analysis: Studies were assessed using pre-designed templates. Meta-analyses of included randomized controlled trials were performed using a random effects model. Main results: Risk ratio for cord metabolic acidosis with STAN® was 0.96 (95% confidence interval (CI) 0.49-1.88). Risk ratio for cesarean sections or instrumental vaginal deliveries for fetal distress was 0.93 (95%CI 0.80-1.08) and for fetal scalp blood sampling 0.55 (95%CI 0.40-0.76). Encephalopathy cases were not assessed due to their low incidence. Conclusions: There is not enough scientific evidence to conclude that computerised ST analysis reduces the incidence of metabolic acidosis. Cesarean sections and instrumental vaginal deliveries due to fetal distress or other indications are the same regardless of method, but STAN® reduces the number of instances where scalp blood sampling is required.
Authors:
Anette Salmelin; Ingela Wiklund; Roger Bottinga; Bengt Brorsson; Gunvor Ekman-Ordeberg; Eva Eneroth Grimfors; Ulf Hanson; May Blom; Elisabeth Persson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-19
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Karolinska Institute, Stockholm Department of Clinical Sciences, Karolinska Institute, Danderyds Hospital, Stockholm Department of Obstetrics and Gynecology, Södertälje Hospital, Södertälje Department of Public Health and Caring Sciences, Uppsala University, Uppsala Department of Women´s and Children´s Health, Division of Obstetrics and Gyneology, Karolinska Institute, Stockholm Department of Obstetrics and Gynecology, Stockholm South General Hospital, Stockholm Department of Womens and Childrens Health, Uppsala University, Uppsala Health Technology Assessment Center, Stockholm County Council, Stockholm Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
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