STAN, a clinical audit: the outcome of 2 years of regular use in the city of Varberg, Sweden.
OBJECTIVE
To monitor and analyze (audit) the introduction of the STAN methodology in a district hospital.


METHODS
Retrospective study covering the total population of deliveries at term during 2004 and 2005.


METHODS
1,875 out of 3,193 term pregnancies (59%) were monitored using the STAN fetal heart monitor (Neoventa Medical, Moelndal, Sweden) and the associated clinical guidelines. Cord metabolic acidosis, neonatal outcome, and rates of operative deliveries for fetal distress were recorded.


RESULTS
The overall cesarean section rate was significantly reduced in the STAN group. Emergency (crash) cesarean sections were significantly reduced from 1.51% to 0.27% in the cardiotocography- and STAN-monitored groups, respectively (OR 0.18, 95% CI 0.07-0.49). When cesarean section was performed only because of non-reassuring cardiotocography, cord acid base was significantly higher, 7.26 versus 7.19 (p<0.01), as compared to when STAN guidelines were followed. Total population rates for operative deliveries for fetal distress and cesarean section rates were 6.7% and 3.5% respectively. The corresponding metabolic acidosis rate was 0.5%.


CONCLUSIONS
High STAN usage in a busy labor ward setting provided an outcome equaling that noted previously in a larger academic unit, demonstrating the safe implementation of the STAN methodology in a nonacademic unit.
Welin
Anna-Karin
AK
Department of Obstetrics and Gynaecology, Varberg Hospital, Varberg, Sweden. anna-karin.welin@telia.com
Norén
Håkan
H
Odeback
Anders
A
Andersson
Mona
M
Andersson
Gunnel
G
Rosén
K G
KG
D001034:Apgar Score; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000295:instrumentation / Q000379:methods*; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008485:Medical Audit; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013548:Sweden