Fetal monitoring with computerized ST analysis during labor : A systematic review and meta-analysis

• Background. Computerized 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. Objective. To assess the evidence that computerized 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. Methods. Search of PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL and CRD databases. Selection criteria. CTG only compared with CTG + computerized 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. 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 computerized 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 which require scalp blood sampling. © 2012 The Authors © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Cardiotochography

fetal electrocardiography

intrapartum monitoring

acid base balance

alkalosis

analysis

analytical equipment

blood sampling

brain disease

carbon dioxide tension

cardiotocography

cesarean section

computerized ST analysis

fetus breathing

fetus distress

fetus electrocardiography

fetus monitoring

high risk pregnancy

human

hypoxic ischemic encephalopathy

incidence

instrumental delivery

labor

meconium

meconium aspiration

meta analysis

metabolic acidosis

newborn hypoxia

pH

priority journal

randomized controlled trial (topic)

respiratory acidosis

review

sensitivity and specificity

ST segment

systematic review

umbilical cord blood

umbilical vein

vaginal delivery

Delivery

Obstetric

Female

Fetal Monitoring

Humans

Pregnancy

Randomized Controlled Trials as Topic

Obstetrik och gynekologi

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)