The Stan Method results in reduced metabolic acidosis at birth

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In a prospective clinical study conducted over 7 years, 12,832 term pregnancies were analysed. Cord blood metabolic acidosis and neonatal outcome were main outcome measures.

  • The rate of using Stan increased from 26 to 69%
  • The rate of cord metabolic acidosis was reduced from 0.72 to 0.06%
  • The 91.7% improvement was associated with a significantly better quality of care (interpretation of tracings and timely action)

Norén & Carlsson Am J Obstet Gynecol  2010.

Zero rate of cases with risk of permanent brain injury

 

The Stan Method was first implemented in the L&D ward in Akershus hospital in 2001.  In 2007 the department was fully equipped with one Stan in each of the eight labor room.

In 2008 the hospital reported:

  • 4200 deliveries
  • Eight children diagnosed as “birth asfyxia” (0.19%)
  • No children with HIE grad II and III and pH<7.0, indicating risk of brain injury

The report concludes that the reduction has continued since the introduction of the Stan Method in the hospital.

Sørnes 2008, Yearly report from Akershus Norway

The Stan Method is cost-effective

Two cost-effectiveness (CE) studies of the use of ST Analysis as a compliment to EFM alone during labor have reached the same result, namely that ST Analysis is a cost-effective method.

Both studies came to similar results:

  • EFM + ST Analysis is the cost-effective method both in a long- and a shorter time perspective
  • The Stan Method means less risk of injured babies at a lower cost
  • Additional costs for ST Analysis are very limited compared to total cost of labor
  • The initial cost of implementing Stan is an investment that will pay off
  • The cost of saving one baby from risk of injury is less than 25% of the annual cost of caring for a child with CP

Heintz et al (BJOG 2008)1 calculated the life-long CE based on the Cochrane Meta analysis. Vijgen et al (Acta Obstet Gynecol Scand 2011)2 performed the CE study alongside the Dutch RCT with a short, health-care provider perspective.

1Heintz et al. The long-term cost-effectiveness of fetal monitoring during labour: a comparison of cardiotocography complemented with ST analysis versus cardiotocography alone. BJOG. 2008;115:1676–1687.

2 Vijgen et al. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only. Acta Obstet Gynecol Scand. 2011;90:772–8.

 

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