• Jörg Kessler, Dag Moster, and Susanne Albrechtsen.
• Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway. jorg.kessler@kk.uib.no
• Acta Obstet Gynecol Scand. 2013 Jan 1; 92 (1): 75-84.

ObjectiveTo evaluate the clinical use of ST analysis (STAN) for intrapartum monitoring of high-risk pregnancies.DesignProspective observational study.SettingUniversity hospital, Norway, 2004-2008.PopulationSingleton pregnancies with a gestational age above 35(+6) weeks.MethodsAnalysis of maternal and neonatal outcomes for all deliveries according to the method of intrapartum monitoring.Main Outcome MeasuresPrevalence of cord metabolic acidosis (pH < 7.05, extracellular fluid base deficit (extracellular fluid) >12 mmol/L).ResultsOf 23 203 deliveries, 6010 (25.9%) were monitored with STAN. Fetal blood sampling was performed in 146 (2.4%) of the 6010 cases. During the study period, the prevalence of cord metabolic acidosis and moderate cord acidosis (pH < 7.15) decreased in STAN-monitored deliveries from 1.4 to 0.3% (p = 0.01) and from 16.4 to 11.7% (p = 0.001), respectively. The prevalence of moderate and severe neonatal encephalopathy was 0.38%. In the birth population, the proportion of cesarean deliveries decreased from 10.1 to 8.8%. The risk of emergency cesarean section after STAN monitoring compared with those monitored with auscultation/cardiotocography was high (odds ratio 5.4, 95% confidence interval = 4.9-6.1) but remained stable during the study period.ConclusionsST analysis is a useful tool for identification of fetuses at risk of intrapartum hypoxia. Despite the restricted use of fetal blood sampling, we found a low proportion of cord metabolic acidosis and newborn morbidity.© 2013 The Authors © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

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