Fetal surveillance during delivery : a population-based comparison of STAN versus fetal scalp blood lactate as adjunct analyses during cardiotocography monitoring
Magnus Borgan Berge
Bok · Engelsk · 2025 · Doktoravhandlinger
Tekstet på: Engelsk, Bokmål
| Omfang | 1 bind (varierende paginering) : figurer
|
|---|---|
| Opplysninger | Delvis opptrykk av artikler. - Avhandling (Ph.D) - Universitetet i Oslo, 2025. - Forlagets beskrivelse: "High-risk deliveries are monitored using continuous cardiotocography (CTG). Due to CTG’s low specificity, adjunctive methods are often employed. The two most commonly used adjunctive techniques in modern obstetrics are fetal scalp blood lactate measurement and ST-analysis (STAN). Elevated fetal scalp lactate levels typically prompt expedited delivery, however, the impact of delivery delays in these cases had not been thoroughly investigated. Although several studies have examined fetal scalp lactate and STAN individually, their diagnostic performance had not previously been compared directly. Moreover, the optimal cutoff value for fetal scalp lactate had only been assessed in a small observational study, leaving current recommendations somewhat uncertain. The aim of this thesis was to address these gaps in knowledge regarding fetal monitoring. We conducted a prospective observational study including 10,000 women. Our results demonstrated an increased risk of adverse neonatal outcomes when the interval from sampling to delivery exceeded 20 minutes in operative deliveries indicated by a high scalp lactate value. Furthermore, STAN exhibited higher sensitivity for detecting moderate acidemia but lower specificity for all examined outcomes compared to fetal scalp lactate. Finally, we validated the previously recommended scalp lactate cutoff of 5.2 mmol/L. Overall, the thesis contributes to filling existing knowledge gaps in fetal monitoring. These findings enhance the evidence base supporting current recommendations and may ultimately improve care for women in labor and their neonates."
|
| Emner | |
| Sjanger | |
| ISBN | 9788234807268
|