Cardiotocography combined with ST analysis versus cardiotocography combined with fetal blood sampling in deliveries with abnormal CTG: a randomized trial
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Cardiotocography combined with ST analysis versus cardiotocography combined with fetal blood sampling in deliveries with abnormal CTG: a randomized trial. / Victor, Simon Foged; Bach, Diana Bøttcher Brøndum; Hvelplund, Anna Carolina; Nickelsen, Carsten; Lyndrup, Jens; Wilken-Jensen, Charlotte; Scharff, Lise Jul; Weber, Tom; Secher, Niels Jørgen; Krebs, Lone.
In: Archives of Gynecology and Obstetrics, Vol. 307, No. 6, 2023, p. 1771–1780.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Cardiotocography combined with ST analysis versus cardiotocography combined with fetal blood sampling in deliveries with abnormal CTG: a randomized trial
AU - Victor, Simon Foged
AU - Bach, Diana Bøttcher Brøndum
AU - Hvelplund, Anna Carolina
AU - Nickelsen, Carsten
AU - Lyndrup, Jens
AU - Wilken-Jensen, Charlotte
AU - Scharff, Lise Jul
AU - Weber, Tom
AU - Secher, Niels Jørgen
AU - Krebs, Lone
PY - 2023
Y1 - 2023
N2 - MethodsWe performed a two-center randomized trial. 1013 women with term fetuses in cephalic presentation entered the trial. If a CTG showed intermediate or pathological abnormalities, they were offered fetal blood sampling (FBS) and inclusion if the pH value was above 7.25. They were randomized to either CTG + FBS or CTG + STAN. The primary outcome was neonatal metabolic acidosis, defined as umbilical cord arterial blood pH below 7.05, and base excess equal to or below −10. The secondary outcomes included operative vaginal delivery for fetal distress.ResultsThe rate of metabolic acidosis was 0.8% in the CTG + FBS group and 1.5% in women in the CTG + STAN (P = 0.338). More women in the CTG + STAN group delivered by operative vaginal delivery (25.6% vs 33.5%, P = 0.006). Significantly fewer women in the CTG + STAN group had three to five (28.8% vs 11.0%, P = < 0.001) and six to ten fetal blood samples taken (3.4% vs 0.4%, P = < 0.001).ConclusionCTG + STAN did not reduce the incidence of neonatal metabolic acidosis compared to CTG + FBS. CTG + STAN was, however, associated with an increased risk of operative vaginal delivery and a reduced use of FBS. If STAN is used for fetal surveillance, we recommend that it is combined with other methods, such as FBS, for confirmation of the need for operative delivery.
AB - MethodsWe performed a two-center randomized trial. 1013 women with term fetuses in cephalic presentation entered the trial. If a CTG showed intermediate or pathological abnormalities, they were offered fetal blood sampling (FBS) and inclusion if the pH value was above 7.25. They were randomized to either CTG + FBS or CTG + STAN. The primary outcome was neonatal metabolic acidosis, defined as umbilical cord arterial blood pH below 7.05, and base excess equal to or below −10. The secondary outcomes included operative vaginal delivery for fetal distress.ResultsThe rate of metabolic acidosis was 0.8% in the CTG + FBS group and 1.5% in women in the CTG + STAN (P = 0.338). More women in the CTG + STAN group delivered by operative vaginal delivery (25.6% vs 33.5%, P = 0.006). Significantly fewer women in the CTG + STAN group had three to five (28.8% vs 11.0%, P = < 0.001) and six to ten fetal blood samples taken (3.4% vs 0.4%, P = < 0.001).ConclusionCTG + STAN did not reduce the incidence of neonatal metabolic acidosis compared to CTG + FBS. CTG + STAN was, however, associated with an increased risk of operative vaginal delivery and a reduced use of FBS. If STAN is used for fetal surveillance, we recommend that it is combined with other methods, such as FBS, for confirmation of the need for operative delivery.
U2 - 10.1007/s00404-022-06649-3
DO - 10.1007/s00404-022-06649-3
M3 - Journal article
C2 - 35701639
VL - 307
SP - 1771
EP - 1780
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
SN - 0932-0067
IS - 6
ER -
ID: 310638892