Evidence map›Paper›PMID 37289946›Full record

Trial reportUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2023

Comparison of effect of CTG + STan with CTG alone on emergency Cesarean section rate: STan Australian Randomized controlled Trial (START).

S Kuah, B Simpson, A Salter, G Matthews, J Louise, J Bednarz, E Chandraharan, I Symonds, A McPhee, B W Mol and 2 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 3 countries.

S KuahWomen's and Children's Hospital, North Adelaide, SA, Australia.
B SimpsonWomen's and Children's Hospital, North Adelaide, SA, Australia.ORCID 0000-0001-7750-4168
A SalterSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
G MatthewsWomen's and Children's Hospital, North Adelaide, SA, Australia.
J LouiseWomen's and Children's Hospital, Faculty of Health and Medical Sciences, University of Adelaide, North Adelaide, SA, Australia.
J BednarzSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
E ChandraharanGlobal Academy of Medical Education and Training Ltd, London, UK.
I SymondsAdelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
A McPheeSouth Australian Health and Medical Research Institute, SAHMRI Women and Kids, North Adelaide, SA, Australia.
B W MolDepartment of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.ORCID 0000-0001-8337-550X
D TurnbullSchool of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
C WilkinsonWomen's and Children's Hospital, North Adelaide, SA, Australia.
Women's and Children's Hospital · AUThe University of Adelaide · AUSouth Australian Health and Medical Research Institute · AUAcademy of Medical Royal Colleges · GBUniversity of Aberdeen · GB

Funding

National Health and Medical Research Council 1129648
6 · The paper itself

Abstract

objectiveTo 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.

methodsThis 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.

resultsThe 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.

conclusionsThe 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.

Indexed as

CardiotocographyLabor, ObstetricAustraliaCesarean SectionElectrocardiographyFemaleFetal MonitoringHumansInfant, NewbornParturitionPregnancycardiotocographyCesarean sectionCTGfetal ECGfetal electrocardiographyintrapartum fetal monitoringrandomized controlled trialRCTSTanST analysis

Identifiers

PMID37289946
PMCPMC10946943
OpenAlexW4379792160

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.