• Sushma Potti and Vincenzo Berghella.
• Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. sushmapotti@gmail.com
• Am J Perinatol. 2012 Sep 1;29(8):657-64.

ObjectiveTo estimate the effectiveness of intrapartum ST waveform analysis (STAN) versus cardiotocography (CTG) alone in prevention of metabolic acidosis.Study DesignMeta-analysis of randomized trials comparing intrapartum fetal monitoring utilizing STAN with CTG versus CTG alone. Primary outcome was neonatal metabolic acidosis, defined as umbilical arterial pH <7.05 and base deficit >12 mmol/L.ResultsFive randomized trials including 15,303 singletons, vertex, term, or near-term pregnancies met inclusion criteria and were analyzed. Compared with CTG alone, STAN with CTG was associated with similar incidences of metabolic acidosis (0.81% versus 1.12%, relative risk [RR] 0.80; 95% confidence interval [CI] 0.44 to 1.47), perinatal death, neonatal encephalopathy, Apgar score <7 at 5 minutes, admission to neonatal intensive care unit, and cesarean delivery. Operative vaginal delivery (OVD) was lower in the STAN with CTG compared with CTG alone (13.56% versus 15.20%; RR 0.89; 95% CI 0.83 to 0.97).ConclusionThere is no difference in perinatal outcomes between STAN with CTG compared with CTG alone, except for lower rate of OVD.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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