Fetal Monitoring That Reduces Brain Damage

Monitoring ST segment activity along with standard fetal heart rate during labor appears to reduce the number of babies born with hypoxic brain damage as well as unnecessary cesarean sections (C-sections).

Heart-rate monitoring alone can provide a horribly false sense of security, according to researchers at the Medical College of Georgia (Augusta, USA), the lead site for a study of a new system that combines heart monitoring with ST segment monitoring. Called STAN S21, the fetal heart monitor system was developed by Neoventa Medical (Molndal, Sweden) and is now being tested in a trial of some 800 labors. Prior studies during 8,000 labors in the United Kingdom and Sweden found a 50% reduction in babies born with abnormal blood gases, a 20% reduction in unnecessary C-sections, and no hypoxic brain damage in babies monitored with the new system.

"This is really the first practical breakthrough in moving the field of monitoring to the next level, that is helping the precision of the tool and helping people who use it to make better clinical decisions,” explained principal investigator Dr. Lawrence D. Devoe, professor and chair of the department of obstetrics and gynecology at the Medical College of Georgia.

The studies of the device are not randomized. With parental consent, the device is being used in pregnancies at least 36 weeks along, with the baby pointed head first and where there is enough concern to place an electrode on the head rather than monitor heart rate via the mother's abdomen. Dr. Devoe classifies these labors at the "higher end of risk.”

"What we are looking at here is translatability of a system that has already been tested and proven in other countries,” he added.