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

Acta Obstetricia et Gynecologica Scandinavica

Volumn 92, Issue 1, 2013, Pages 28-39

  Salmelin, Anette ^a   Wiklund, Ingela ^b   Bottinga, Roger ^c   Brorsson, Bengt ^d   Ekman Ordeberg, Gunvor ^a   Grimfors, Eva Eneroth ^e   Hanson, Ulf ^f   Blom, May ^g   Persson, Elisabeth ^a,g  

^a KAROLINSKA INSTITUTE   (Sweden)

^b DANDERYD HOSPITAL   (Sweden)

^c Södertälje Hospital   (Sweden)

^d UPPSALA UNIVERSITY   (Sweden)

^e STOCKHOLM SÖDER HOSPITAL   (Sweden)

^f UPPSALA UNIVERSITY   (Sweden)

^g STOCKHOLM COUNTY COUNCIL   (Sweden)

Author keywords

Cardiotochography; fetal electrocardiography; intrapartum monitoring

Indexed keywords

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;

CARDIOTOCOGRAPHY; DELIVERY, OBSTETRIC; FEMALE; FETAL MONITORING; HUMANS; PREGNANCY; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 84872341940     PISSN: 00016349     EISSN: 16000412     Source Type: Journal    
DOI: 10.1111/aogs.12009     Document Type: Review

References (45)

1. Verklan MT,. The chilling details: hypoxic-ischemic encephalopathy. J Perinatal Neonatal Nurs. 2009; 23: 59-68.
2. Freeman JM,. Beware: the misuse of technology and the law of unintended consequences. Neurotherapeutics. 2007; 4: 549-54.
3. Blix E, Oian P,. Labor admission test: an assessment of the test's value as screening for fetal distress in labor. Acta Obstet Gynecol Scand. 2001; 80: 738-43.
4. Alfirevic Z, Devane D, Gyte GML,. Continuous cardiotocography (CTG) as a form of electronical fetal monitoring (EFM) for fetal assessment during labor. Cochrane database of systematic reviews. 2006;Issue 3.Art. no. CD006066.
5. The Swedish Council on Technology Assessment in Health Care (SBU). ST-analys i kombination med CTG (STAN) för fosterövervakning under förlossning. Stockholm. 2006; SBU alert-rapport nr 2006-4.
6. Westergate J, Harris M, Curnow JS, Green KR,. Randomized trial of cardiotocography alone with ST-waveform analysis for intrapartum monitoring. Lancet. 1992; 340: 194-8.
7. Neilson JP,. Fetal electrocardiogram (ECG) for fetal monitoring during labor. Cochrane database of systematic reviews. 2006;Issue 3,updated 2011. Art.no: CD000116.
8. Neoventa Medical AB. Stan Clinical Guidelines. http://www.neoventa.se/ Articles/Products/Training-tools/ClinicalGuidelines.html, 2010
9. Essin DJ,. The application of the extracellular base excess to children. Biochem Med. 1984; 32: 67-78.
10. Review Manager (RevMan) [Computer program]. Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
11. [Nyren O], Assessment templates. Attachment 1, in 'Blödande magsår: en systematisk litteraturöversikt'. Stockholm: Swedish Council on Technology Assessment in Health Care (SBU). 2011; 313-33.
12. Westergate J, Harris M, Curnow JS, Greem KR,. Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring in 2400 cases. Am J Obstet Gynecol. 1993; 169: 1151-60.
13. Finnish Office for Health Care Technology Assessment. STAN -follow up during labor (Project record). Helsinki: (FinOHTA), 2007.
14. Amer-Wåhlin I, Bördahl P, Eikeland T, Hellsten C, Noren H, Sörnes T, et al,. ST-analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study. J Matern Fetal Neonatal Med. 2002; 12: 260-6.
15. Dervaitis K, et al,. ST segment analysis of the fetal electrocardiogram plus electronic fetal heart rate monitoring in labor and its relationship to umbilical cord arterial blood gases. Am J Obstet Gynecol. 2004; 191: 879-84.
16. Devoe L, Ross M, Wilde C, Beal M, Lysikewicz A, Maier J,. United States Multicenter Clinical Usage Study of the STAN 21 Electronic Fetal Monitoring System. Am J Obstet Gynecol. 2006; 195: 729-34.
17. Doret M, Massoud M, Constans A, Gaucherand P,. Use of peripartum ST analysis of fetal electrocardiogram without blood sampling: a large prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2011; doi: 10.1016/j.ejogrb2010. 12.042.
18. Doria VA, Papageorghiou AT, Gustafsson A, Ugwumadu A, Farrer K, Arulkumaran S,. Review of the first 1502 cases of ECG-ST waveform analysis during labor in a teaching hospital. Br J Obstet Gynaecol. 2007; 114: 1202-7.
19. Kale A, Chong Y-S, Biswas A,. Effect of availability of fetal ECG monitoring on operative deliveries. Acta Obstet Gynecol Scand. 2008; 87: 1189-93.
20. Kwee A, van der Hoorn-van den Beld CW, Veerman J, Dekkers AHS, Visser GHA, et al,. STAN S21 fetal heart monitor for fetal surveillance during labor: an observational study in 637 patients. J Matern Fetal Neonatal Med. 2004; 15: 400-7.
21. Luttkus AK, Norén H, Stupin JH, Blad S, Arulkumaran S, Erkkola R, et al,. Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to CTG. A multi-center, observational study. J Perinat Med. 2004; 32: 486-94.
22. Amer-Wåhlin I, Ingemarsson I, Marsal K, Herbst A,. Fetal heart rate patterns and ECG ST segment changes preceding metabolic acidaemia at birth. Br J Obstet Gynaecol. 2005; 112: 160-5.
23. Heintz E, et al,. The long-term cost-effectiveness of fetal monitoring during labor: a comparison of cardiotocography complemented with ST analysis versus cardiotocography alone. Br J Obstet Gynaecol. 2008; 115: 1676-87.
24. Massoud M, Giannesi A, Amabile N, Manevy M, Geron G, Gaucherand P,. Fetal electrocardiotocography in labor and neonatal outcome: An observational study in 1889 patients in the French center of Edouard Herriot, Lyon. J Matern Fetal Neonatal Med. 2007; 20: 819-24.
25. Luzietti R, Erkkola R, Hasbargen U, Mattson LA, Thoulon JM, Rosen KG,. European Community multi-center Trial "Fetal ECG Analysis during Labor". ST plus CTG analysis. J Perinat Med. 1999; 27: 431-40.
26. Norén H, Amer-Wåhlin I, Hagberg H, Herbst A, Kjellmer I, Marsal K, et al,. Fetal electrocardiography in labor and neonatal outcome: data from the Swedish randomized controlled trial on intrapartum fetal monitoring. Am J Obstet Gynecol. 2003; 188: 183-92.
27. Norén H, Luttkus AK, Stupin JH, Blad S, Arulkumaran S, Erkkola R, et al,. Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to cardiotocography to predict fetal acidosis in labor-a multi-center, case controlled study. J Perinat Med. 2007; 35: 408-14.
28. Palmgren Colov N,. Undervisningsbehov over tid ved implementering af en ny fosterovervåknings-teknologi. Videnskab Praksis. 2007; 169: 3294-7.
29. Ross MG, Devoe LD, Rosén KG,. ST-segment analysis of the fetal electrocardiogram improves fetal heart rate tracing interpretation and clinical decision making. J Matern Fetal Neonatal Med. 2004; 15: 181-5.
30. Rzepka R, Torbé A, Kwiatkowski S, Blogowski W, Czajka R,. Clinical outcomes of high-risk labors monitored using fetal electrocardiography. Ann Acad Med Singapore. 2010; 39: 27-32.
31. Welin AK, Norén H, Odeback A, Andersson M, Andersson G, Rosén KG,. STAN, a clinical audit: the outcome of 2 years of regular use in the city of Varberg, Sweden. Acta Obstet Gynecol Scand. 2007; 86: 827-32.
32. Amer-Wåhlin I, Hellsten C, Norén H, Hagberg H, Herbst A, Kjellmer I, et al,. Cardiotocography only versus cardiotocography plus ST-analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Lancet. 2001; 358: 534-8.
33. Amer-Wåhlin I, Kjellmer I, Maršál K, Olofsson P, Rosén KG,. Swedish randomized controlled trial of cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: analysis of data according to standard versus modified intention-to-treat principle. Acta Obstet Gynecol Scand. 2011; 90: 990-6.
34. Westerhuis MEMH, Visser GHA, Moons KGM, van Beek E, Benders MJ, Bijvoet SM, et al,. Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial. Obstet Gynecol. 2010; 115: 1173-80.
35. Westerhuis MEMH, Visser GHA, Moons KGM, Zuithoff NPA, Mol BWJ, Kwee A,. Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial/Letter to the editor + Corrections. Obstet Gynecol. 2011; 117: 406-7, 412.
36. Ojala K, Vääräsmäki M, Mäkikallio K, Valkama M, Tekay A,. A comparison of intrapartum automated fetal electrocardiography and conventional cardiotocography-a randomised controlled study. Br J Obstet Gynaecol. 2006; 113: 419-23.
37. Vayssière C, David E, Meyer N, Haberstich R, Sebahoun V, Roth E, et al,. A French randomized controlled trial of ST-segment analysis in a population with abnormal cardiotocograms during labor. Am J Obstet Gynecol. 2007; 197: e1-6.
38. Norén H, Blad S, Carlsson A, Flisberg A, Gustavsson A, Lilja H, et al,. STAN in clinical practice-the outcome of 2 years of regular use in the city of Gothenburg. Am J Obstet Gynecol. 2006; 195: 7-15.
39. Melin M, Bonnevier A, Cardell M, Hogan L, Herbst A,. Changes in the ST-interval segment of the fetal electrocardiogram in relation to acid-base status at birth. Br J Obstet Gynaecol. 2008; 115: 1669-75.
40. Schroll JB, Moustgaard R, Gøtzsche PC,. Dealing with substantial heterogeneity in Cochrane reviews. Cross-sectional study. BMC Medical Research Methodology. 2011; 11: 22. http://www.biomedcentral.com/1471-2288/11/22.
41. http://www.vardsamordning.sll.se/Global/Vardsamordning/Dokument/Tema/HTA/ Publ%20HTA-rapporter/STAN%20HTA%20report%202011-3.pdf.
42. Wiberg N, Källén K, Herbst A, Olofsson P,. Relation between umbilical cord blood pH, base deficit, lactate, 5-minute Apgar score and development of hypoxic ischemic encephalopathy. Acta Obstet Gynecol Scand. 2010; 89: 1263-9.
43. Jonsson M, Nordén-Lindeberg S, Östlund I, Hanson U,. Metabolic acidosis at birth and suboptimal care-illustration of the gap between knowledge and clinical practice. Br J Obstet Gynaecol. 2009; 116: 1453-60.
44. Malin GI, Morris RK, Shan KS,. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. Br Med J. 2010; 340c1471. doi: 10.1136/bmjc1471.
45. Becker JH, Bax L, Amer-Wåhlin I, Ojala K, Vayssière C, Westerhuis ME, et al,. ST analysis of the fetal electrogardiogram in intrapartum fetal monotoring. Obstet Gynecol. 2012; 119: 145-54.