General Obstetrics and GynecologyFetal electrocardiography in labor and neonatal outcome: Data from the Swedish randomized controlled trial on intrapartum fetal monitoring☆,☆☆
Section snippets
Background study
The Swedish RCT was conducted during 18 months at three labor wards in southern Sweden.8 Women in active labor with singleton fetuses in cephalic presentation at >36 completed gestational weeks were included in the study after a decision to apply a fetal scalp electrode for continuous internal cardiotocographic recording. At power-on, the computer of the fetal heart monitor (STAN S21, Neoventa Medical, Göteborg, Sweden) randomly allocated the parturients to either monitoring with cardiotocogram
Results
One fetus died intrapartum, and 350 newborn infants (7.0% of all trial cases) were admitted to the SCBU. Of all 420 ODFD, 103 infants (24.5%) entered the SCBU. The corresponding figure for operative deliveries for failure to progress was 67 of 534 (12.5%). Of the 4012 babies who were delivered spontaneously vaginally, 180 babies (4.5 %) were admitted to the SCBU; the indications were neonatal distress (n = 8 babies), hypoglycemia (n = 14 babies), respiratory distress (n = 46 babies), clinical
Comment
The aim of intrapartum fetal monitoring is to identify fetuses for whom intervention is necessary to avoid adverse outcome. The Swedish RCT showed that combined monitoring with cardiotocogram and analysis of the ST waveform of the fetal electrocardiogram reduced the risk of fetuses being exposed to significant hypoxia that leads to metabolic acidosis at birth.8
Low et al13 have concluded that the incidence of metabolic acidosis is 2% of total births at term, with an incidence of neonatal
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Supported by European Union Innovation grant No. IPS-1999-00029, Neoventa Medical, Gothenburg and the Knowledge Foundation, Stockholm, Sweden, and by Grants to Researchers in Public Health Service from the Swedish Government.
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Reprint requests: K. G. Rosén, MD, PhD, Neoventa Medical, Lilla Bommen 1, SE 411 04 Goteborg, Sweden. E-mail: [email protected]