Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Am J Perinatol. 2012 Sep;29(8):657-64. doi: 10.1055/s-0032-1314886. Epub 2012 May 25.
To estimate the effectiveness of intrapartum ST waveform analysis (STAN) versus cardiotocography (CTG) alone in prevention of metabolic acidosis.
Meta-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.
Five 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).
There is no difference in perinatal outcomes between STAN with CTG compared with CTG alone, except for lower rate of OVD.
评估产时 ST 波分析（STAN）与单独使用胎心监护图（CTG）在预防代谢性酸中毒方面的效果。
比较产时利用 STAN 与 CTG 联合监测与单独使用 CTG 对胎儿进行监测的随机试验的荟萃分析。主要结局为新生儿代谢性酸中毒，定义为脐动脉 pH 值<7.05 和碱剩余>12mmol/L。
符合纳入标准并进行分析的有 5 项随机试验，共纳入 15303 例单胎、头位、足月或近足月妊娠。与单独使用 CTG 相比，STAN 联合 CTG 发生代谢性酸中毒的发生率相似（0.81%与 1.12%，相对风险 [RR] 0.80；95%置信区间 [CI] 0.44 至 1.47）、围产儿死亡、新生儿脑病、5 分钟时 Apgar 评分<7、新生儿重症监护病房入院和剖宫产。与单独使用 CTG 相比，STAN 联合 CTG 行阴道助产（OVD）的比例较低（13.56%与 15.20%；RR 0.89；95% CI 0.83 至 0.97）。
与单独使用 CTG 相比，STAN 联合 CTG 对围产儿结局没有影响，除了 OVD 发生率较低。
