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Intrapartum fetal monitoring by ST analysis at University Hospital of Wales: usage and outcome
  1. H Faisel,
  2. P Amin
  1. Cardiff and Vale NHS Trust, Cardiff, UK

Abstract

Objective Review usage and outcome of cases where STAN fetal monitoring was used at University Hospital of Wales over 6 months (June–November 2009).

Background STAN monitoring was introduced in our unit in 2006. Local guideline for its usage is available. Training in its usage is regularly conducted in the unit.

Methods Paper files were hand searched for all cases where STAN monitoring was used during the study period. SPSS used for analysis.

Results STAN monitoring used in 43 cases (2% of deliveries). 77% were primip. STAN monitoring was used in high risk cases as post date induction of labour (44% of cases), medical problem (14%), intrauterine growth restriction (2%), cardiotocograph abnormalities (44%). Other indications were prolonged rupture of membranes, previous Caesarean section (CS), thick meconeum.

Outcome 33% had spontaneous vaginal delivery, 35% had instrumental delivery and 32% delivered by CS. 29% of these CS was for fetal distress and 71% for failure to progress. The background CS rate in the unit is 22%.

There was one case of metabolic acidosis; delivery occurred within 30 min of significant STAN event.

Three cases admitted to SCBU (special care baby unit): one for fetal academia and low Apgar score (discharged after 1 day), one for thick meconeum aspiration (discharged after 3 days) and last one for congenital anomaly. None required follow up.

Conclusion STAN usage in the unit was appropriate. Larger cohort is required to assess reduction of intervention and fetal academia.

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