Open AccessScientific and clinical evidence for the use of fetal ECG ST segment analysis (STAN)
Author(s) -
Steer Philip J.,
Hvidman Lone Egly
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12369
Subject(s) - medicine , cardiotocography , fetus , fetal heart rate , scalp , fetal monitoring , fetal distress , obstetrics , acidosis , st segment , amniotic fluid , pregnancy , heart rate , cardiology , surgery , blood pressure , genetics , myocardial infarction , biology
Abstract Fetal electrocardiogram waveform analysis has been studied for many decades, but it is only in the last 20 years that computerization has made real‐time analysis practical for clinical use. Changes in the ST segment have been shown to correlate with fetal condition, in particular with acid–base status. Meta‐analysis of randomized trials (five in total, four using the computerized system) has shown that use of computerized ST segment analysis ( STAN ) reduces the need for fetal blood sampling by about 40%. However, although there are trends to lower rates of low Apgar scores and acidosis, the differences are not statistically significant. There is no effect on cesarean section rates. Disadvantages include the need for amniotic membranes to be ruptured so that a fetal scalp electrode can be applied, and the need for STAN values to be interpreted in conjunction with detailed fetal heart rate pattern analysis.