Clinicians Should Consider ST Analysis for Intrapartum Monitoring

According to new research, ST analysis for intrapartum monitoring can be a helpful tool that reduces operative deliveries and the need for additional fetal blood sampling. The results were published in a recent issue of Obstetrics & Gynecology.

Dr. Jeroen H. Becker, from the departments of obstetrics and gynecology at University Medical Center Utrecht, the Netherlands, and colleagues conducted a meta-analysis of randomized controlled trials that compared ST-waveform analysis and conventional cardiotocography for intrapartum fetal monitoring of singleton pregnancies in cephalic presentation beyond 34 weeks gestation. Based on inclusion criteria, Becker et al. identified 5 trials for analysis, which included a total of 15,352 patients.

Becker and colleagues noted that ST analysis, in comparison with conventional cardiotocography, proved useful and effective, significantly reducing the number of other interventions used. Specifically, the researchers noted that ST analysis significantly reduced the incidence of additional fetal blood sampling (relative risk=0.59), operative vaginal deliveries (relative risk=0.88), and total operative deliveries (relative risk=0.94). However, Becker and colleagues found a nonsignificant reduction in metabolic acidosis (relative risk=0.72).

The authors cautioned about making sweeping changes and said further research is warranted. They explained, “Because we found no clear evidence of neonatal benefit so far, cost-effectiveness analyses can provide the clinician with additional argumentation on whether ST analysis should be used in everyday clinical practice.”

“Future studies on long-term behavioral and neurological outcomes will hopefully provide some information about long-term cost-effectiveness and can guide the clinicians’ decision on whether fetal ST analysis can add quality during labor in everyday clinical practice,” they added.

References:

Reference:
Becker JH, Bax L, Amer-Wahlin I, et al. ST analysis of the fetal electrocardiogram in intrapartum fetal monitoring: a meta-analysis. Obstet Gynecol. 2012;119(1):145-54.