title: STAN in clinical practice--the outcome of 2 years of regular use in the city of Gothenburg.
abstract: OBJECTIVE
  The purpose of this study was to monitor the introduction of the STAN-methodology (Noventa Medical, Moelndal, Sweden).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Perinatal Center, Sahlgrenska University Hospital, Gothenburg, Sweden. hakan.noren@vgregion.se
authors.forename: Håkan
authors.initials: H
authors.lastname: Norén
authors.forename: Sofia
authors.initials: S
authors.lastname: Blad
authors.forename: Ann
authors.initials: A
authors.lastname: Carlsson
authors.forename: Anders
authors.initials: A
authors.lastname: Flisberg
authors.forename: Annika
authors.initials: A
authors.lastname: Gustavsson
authors.forename: Håkan
authors.initials: H
authors.lastname: Lilja
authors.forename: Margareta
authors.initials: M
authors.lastname: Wennergren
authors.forename: Henrik
authors.initials: H
authors.lastname: Hagberg
mesh_terms: D000138:Acidosis / Q000453:epidemiology / Q000517:prevention & control; D001034:Apgar Score; D004562:Electrocardiography; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000628:therapy; D005323:Fetal Monitoring / Q000379:methods* / Q000592:standards; D019983:Guideline Adherence; D006340:Heart Rate, Fetal; D006801:Humans; D015994:Incidence; D007751:Labor, Induced / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D012815:Signal Processing, Computer-Assisted; D013548:Sweden