STAN in clinical practice--the outcome of 2 years of regular use in the city of Gothenburg

Am J Obstet Gynecol. 2006 Jul;195(1):7-15. doi: 10.1016/j.ajog.2006.01.108. Epub 2006 Apr 27.


Objective: The purpose of this study was to monitor the introduction of the STAN-methodology (Noventa Medical, Moelndal, Sweden).

Study design: This was a prospective observational study covering the total population of deliveries at term during 2 years. Four thousand eight hundred and thirty out of 14,687 term pregnancies were monitored using the STAN S 21 fetal heart monitor and the associated clinical guidelines. Cord artery metabolic acidosis, neonatal outcome, and rates of operative deliveries for fetal distress were assessed.

Results: The annual rate of STAN usage increased from 28.1% to 37.7% and was associated with a significant reduction in metabolic acidosis rate in the total population from 0.76% to 0.44% (P < .05). The compliance with the clinical guidelines increased in cases requiring intervention. The rates for moderate/severe hypoxic neonatal encephalopathy were consistently low, 0.55 and 0.68 per 1000 deliveries, respectively, and corresponding to previous findings. The rate of operative delivery did not change during the 2 years in the total population.

Conclusion: Increasing STAN usage provided consistent improvements in fetal outcome equalling those noted in the Swedish randomized controlled trial (RCT) without increasing operative interventions for fetal distress.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis / epidemiology
  • Acidosis / prevention & control
  • Apgar Score
  • Electrocardiography
  • Female
  • Fetal Distress / epidemiology
  • Fetal Distress / therapy
  • Fetal Monitoring / methods*
  • Fetal Monitoring / standards
  • Guideline Adherence
  • Heart Rate, Fetal
  • Humans
  • Incidence
  • Labor, Induced / statistics & numerical data
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Outcome*
  • Signal Processing, Computer-Assisted*
  • Sweden