High usage of CTG+ST Analysis results in a reduced rate of metabolic acidosis

This prospective clinical study investigated the improvements in quality-of-care after the introduction of ST Analysis in a Swedish district hospital. Data was collected during seven years and almost 13,000 deliveries were included in a detailed analysis. The number of deliveries increased by 47% during the time period, and during the same period the usage of CTG + ST Analysis increased from 26 to 69%. The rate of cord gas sampling also increased and was 96.3% in 2007.

The cord metabolic acidosis rate in the total population of term deliveries in active labour was reduced from 0.72 to 0.06%, signifying a 91.7% decrease. There was no significant change in the rate of operative deliveries.

The authors write that in their view frequent monitoring with CTG + ST is required to enable accurate identification of risk situations, because most cases with metabolic acidosis have no known risk factors. They recognize that the established custom of high usage of scalp electrode, the availability of one Stan ST monitor in every delivery room together with the structured and continuous staff support providing regular feedback have been essential in achieving the results. In conclusion the authors state that the data indicate a paradigm shift in the outcome of labour and delivery related to a high rate of CTG + ST usage and the application of a structured CTG analysis.

 

 

Abstract – Norén and Carlsson 2010

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