title: STAN, a clinical audit: the outcome of 2 years of regular use in the city of Varberg, Sweden.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Varberg Hospital, Varberg, Sweden. anna-karin.welin@telia.com
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Welin
authors.forename: Håkan
authors.initials: H
authors.lastname: Norén
authors.forename: Anders
authors.initials: A
authors.lastname: Odeback
authors.forename: Mona
authors.initials: M
authors.lastname: Andersson
authors.forename: Gunnel
authors.initials: G
authors.lastname: Andersson
authors.forename: K G
authors.initials: KG
authors.lastname: Rosén
mesh_terms: 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