Document Detail


Intrapartum monitoring of high-risk deliveries with ST analysis of the fetal electrocardiogram: an observational study of 6010 deliveries.
MedLine Citation:
PMID:  22897758     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To evaluate the clinical use of ST analysis (STAN) for intrapartum monitoring of high-risk pregnancies. Design: Prospective observational study. Setting: University hospital, Norway, 2004-2008. Population: Singleton pregnancies with a gestational age above 35(+6) weeks. Methods: Analysis of maternal and neonatal outcomes for all deliveries according to the method of intrapartum monitoring. Main outcome measures: Prevalence of cord metabolic acidosis (pH<7.05, base deficit(ecf) >12 mmol/l). Results: Of 23 203 deliveries, 6010 (25.9%) were monitored with STAN. Fetal blood sampling was performed in 146 (2.4%) of the 6010 cases. During the study period, the prevalence of cord metabolic acidosis and moderate cord acidosis (pH< 7.15) decreased in STAN monitored deliveries from 1.4% to 0.3% (p = 0.01) and from 16.4% to 11.7% (p= 0.001), respectively. The prevalence of moderate and severe neonatal encephalopathy was 0.38%. In the birth population the proportion of caesarean deliveries decreased from 10.1 to 8.8%. The risk of emergency cesarean section after STAN monitoring compared to those monitored with auscultation/ cardiotocography was high (odds ratio 5.4, 95% confidence interval = 4.9-6.1), but remained stable during the study period. Conclusion: STAN is a useful tool for identifying of fetuses at risk of intrapartum hypoxia. Despite the restricted use of fetal blood sampling we found a low proportion of cord metabolic acidosis and newborn morbidity.
Authors:
Jörg Kessler; Dag Moster; Susanne Albrechtsen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-16
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-17     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:
Department of Obstetrics and Gynecology, Haukeland University Hospital Department of Clinical Medicine, University of Bergen Department of Pediatrics, Haukeland University Hospital Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
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