• K Ojala, M Vääräsmäki, K Mäkikallio, M Valkama, and A Tekay.
• Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulu, Finland. kati.ojala@oulu.fi
• BJOG. 2006 Apr 1;113(4):419-23.

ObjectiveTo examine whether intrapartum monitoring by means of automatic ST analysis (STAN) of fetal electrocardiography could reduce the rate of neonatal acidemia and the rate of operative intervention during labour, compared with monitoring by means of cardiotocography (CTG).DesignRandomised controlled trial.SettingLabour ward in tertiary-level university hospital.SampleA total of 1483 women in active labour with singleton term fetus in cephalic presentation.MethodsWomen were randomly assigned to be monitored either by STAN or by CTG. Fetal blood sampling (FBS) was optional in both groups.Main Outcome MeasuresNeonatal acidemia (umbilical artery pH <7.10), neonatal metabolic acidosis (umbilical artery pH <7.05 and base excess <-12 mmol/l) and operative interventions: caesarean section rate, vacuum outlet (VO) rate and FBS rate.ResultsThere were no statistically significant differences between the STAN group and CTG group in the incidence of neonatal acidemia (5.8 versus 4.7%) or metabolic acidosis (1.7 versus 0.7%). The caesarean section rate (6.4 versus 4.7%) and the VO rate (9.5 versus 10.7%) were also similar in the STAN and CTG groups. The incidence of FBS was lower (P < 0.001) in the STAN group (7.0%) than in the CTG group (15.6%).ConclusionsIntrapartum fetal monitoring by means of automatic STAN did not improve the neonatal outcome or decrease the caesarean section rate. However, the need for FBS during labour was lower in the STAN group.

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