No significant benefit found for adjunctive use of intrapartum fetal ECG ST-segment analysis
THURSDAY, Aug. 13, 2015 (HealthDay News) — Use of ST-segment analysis in fetal heart-rate monitoring is not associated with reduced composite neonatal outcomes, according to a study published in the Aug. 13 issue of the New England Journal of Medicine.
Michael A. Belfort, M.B., B.Ch., from the University of Utah Health Sciences Center in Salt Lake City, and colleagues performed a multicenter trial involving women with a singleton fetus who were randomized to “open” (5,532 women) or “masked” (5,576 women) monitoring with fetal ST-segment analysis. The masked system functioned as a normal fetal heart-rate monitor, while the open system displayed additional information for use on detection of uncertain fetal heart-rate patterns.
The researchers found that the primary outcome of a composite of intrapartum fetal death, neonatal death, an Apgar score of 3 or less at 5 minutes, neonatal seizure, an umbilical-artery blood pH of 7.05 or less with a base deficit of 12 mmol or more, intubation for ventilation at delivery, or neonatal encephalopathy occurred in 0.9 percent of fetuses or neonates in the open group and 0.7 percent in the masked group (relative risk, 1.31; 95 percent confidence interval, 0.87 to 1.98; P = 0.20).
“This large and closely monitored randomized, controlled trial showed no significant benefit of the adjunctive use of ST-segment analysis in reducing a composite of neonatal outcomes or in reducing cesarean or operative vaginal deliveries,” the authors write.
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