The use of STAN monitoring in the labour ward

Ragupathy, Kalpana; Ismail, Farzanah; Nicoll, Antony

doi:10.3109/01443615.2010.482218

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Many cohort and observational studies have been published that have sought to investigate the longterm effects of using STAN monitoring. Due to the increasing and ubiquitous use of this new technology and the improved training of health care personnel, there has been a remarkable reduction in the incidence of neonatal metabolic acidosis (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). STAN is a system that studies the level of central fetal oxygenation (e.g., myocardium) of the fetus, and (46).…”

Section: Determination Of Acid-base Balance On Umbilical Cord Bloodmentioning

confidence: 99%

Integrative Techniques of Cardiotocography

Felis S

2023

AJMCRR

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ST-analysis of the fetal electrocardiogram (ECG) (STAN (®)) combined with cardiotocography (CTG) for intrapartum fetal monitoring has been developed following many years of animal research. Changes in the ST-segment of the fetal ECG correlated with fetal hypoxia occurring during labor. In 1993 the first randomized controlled trial (RCT), comparing CTG with CTG + ST-analysis was published. STAN (®) was introduced for daily practice in 2000. To date, six RCTs have been performed, out of which five have been published. Furthermore, there are six published meta-analyses. The meta-analyses showed that CTG + ST-analysis reduced the risks of vaginal operative delivery by about 10% and fetal blood sampling by 40%. There are conflicting results regarding the effect on metabolic acidosis, much because of controversies about which RCTs should be included in a meta-analysis, and because of differences in methodology, execution and quality of the meta-analyses. Several cohort studies have been published, some showing significant decrease of metabolic acidosis after the introduction of STanalysis. In this review, we discuss not only the scientific evidence from the RCTs and meta-analyses, but also the limitations of these studies. In conclusion, ST-analysis is effective in reducing operative vaginal deliveries and fetal blood sampling but the effect on neonatal metabolic acidosis is still under debate. Further research is needed to determine the place of ST-analysis in the labor ward for daily practice.

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Section: Determination Of Acid-base Balance On Umbilical Cord Bloodmentioning

confidence: 99%

Integrative Techniques of Cardiotocography

Felis S

2023

AJMCRR

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“…In 2010, Ragupathy et al. commented that “the high incidence of false‐positive STAN events may have contributed to the failure to act when a significant ST event occurred” . In 2011, Doret et al.…”

Section: Introductionmentioning

confidence: 99%

Scientific and clinical evidence for the use of fetal ECG ST segment analysis (STAN)

Steer

Hvidman

2014

Acta Obstet Gynecol Scand

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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. Metaanalysis 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.

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“…Additional information about the fetal well being can be obtained by analyzing the morphology of the fECG signal, which was recently introduced in clinical practice for fetal monitoring. Its clinical relevance was demonstrated by a series of clinical studies [3], randomized controlled trials [4–8] and prospective observational studies [9–18], which prove that clinical fetal monitoring based on both fHR and fECG morphology analysis, especially the ST waveform analysis, leads to the reduction in the number of operative vaginal deliveries, smaller rate of metabolic acidosis at birth, less blood samples performed during labor, and fetal morbidity reduction.…”

Section: Introductionmentioning

confidence: 99%

Fetal ECG Extraction from Abdominal Signals: A Review on Suppression of Fundamental Power Line Interference Component and Its Harmonics

Ţarălungă

Ungureanu

Gussi

et al. 2014

Computational and Mathematical Methods in Medicine

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Interference of power line (PLI) (fundamental frequency and its harmonics) is usually present in biopotential measurements. Despite all countermeasures, the PLI still corrupts physiological signals, for example, electromyograms (EMG), electroencephalograms (EEG), and electrocardiograms (ECG). When analyzing the fetal ECG (fECG) recorded on the maternal abdomen, the PLI represents a particular strong noise component, being sometimes 10 times greater than the fECG signal, and thus impairing the extraction of any useful information regarding the fetal health state. Many signal processing methods for cancelling the PLI from biopotentials are available in the literature. In this review study, six different principles are analyzed and discussed, and their performance is evaluated on simulated data (three different scenarios), based on five quantitative performance indices.

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The use of STAN monitoring in the labour ward

Cited by 7 publications

References 17 publications

Integrative Techniques of Cardiotocography

Integrative Techniques of Cardiotocography

Scientific and clinical evidence for the use of fetal ECG ST segment analysis (STAN)

Fetal ECG Extraction from Abdominal Signals: A Review on Suppression of Fundamental Power Line Interference Component and Its Harmonics

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