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Comparison of effect of CTG + STan with CTG alone on emergency Cesarean section rate: STan Australian Randomized controlled Trial (START).
Kuah, S; Simpson, B; Salter, A; Matthews, G; Louise, J; Bednarz, J; Chandraharan, E; Symonds, I; McPhee, A; Mol, B W; Turnbull, D; Wilkinson, C.
Afiliación
  • Kuah S; Women's and Children's Hospital, North Adelaide, SA, Australia.
  • Simpson B; Women's and Children's Hospital, North Adelaide, SA, Australia.
  • Salter A; Women's and Children's Health, Adelaide Medical School, University of Adelaide, North Adelaide, SA, Australia.
  • Matthews G; School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
  • Louise J; Women's and Children's Hospital, North Adelaide, SA, Australia.
  • Bednarz J; Women's and Children's Hospital, Faculty of Health and Medical Sciences, University of Adelaide, North Adelaide, SA, Australia.
  • Chandraharan E; School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
  • Symonds I; South Australian Health and Medical Research Institute, SAHMRI Women and Kids, North Adelaide, SA, Australia.
  • McPhee A; Global Academy of Medical Education and Training Ltd, London, UK.
  • Mol BW; Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
  • Turnbull D; South Australian Health and Medical Research Institute, SAHMRI Women and Kids, North Adelaide, SA, Australia.
  • Wilkinson C; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
Ultrasound Obstet Gynecol ; 62(4): 462-470, 2023 10.
Article en En | MEDLINE | ID: mdl-37289946
OBJECTIVE: To investigate whether use of ST analysis of the fetal electrocardiogram (STan) as an adjunct to continuous cardiotocography (CTG) reduces the rate of emergency Cesarean section (EmCS) compared with CTG alone. METHODS: This was a randomized controlled trial of patients with a singleton fetus in cephalic presentation at ≥ 36 weeks' gestation, requiring continuous electronic fetal monitoring during labor at a tertiary maternity hospital in Adelaide, Australia, between January 2018 and July 2021. Participants were randomized to undergo CTG + STan or CTG alone. The calculated sample size was 1818 participants. The primary outcome was EmCS. Secondary outcomes included metabolic acidosis, a composite adverse perinatal outcome, and other maternal and neonatal morbidity and safety outcomes. RESULTS: The present study enrolled 970 women, of whom 967 were included in the primary analysis. EmCS occurred in 107/482 (22.2%) deliveries in the CTG + STan arm and in 107/485 (22.1%) in the CTG arm (adjusted relative risk, 1.02 (95% CI, 0.81-1.27); P = 0.89). There was no difference in the rate of adverse maternal or neonatal outcomes between arms. CONCLUSIONS: The addition of STan as an adjunct to continuous CTG did not reduce the EmCS rate. The smaller-than-anticipated sample size meant that this study was underpowered to detect absolute differences of ≤ 5% and, therefore, this negative finding could be due to a Type-2 error. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabajo de Parto / Cardiotocografía Tipo de estudio: Clinical_trials / Etiology_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Oceania Idioma: En Revista: Ultrasound Obstet Gynecol Asunto de la revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabajo de Parto / Cardiotocografía Tipo de estudio: Clinical_trials / Etiology_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Oceania Idioma: En Revista: Ultrasound Obstet Gynecol Asunto de la revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido