Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only.
Acta Obstet Gynecol Scand
; 90(7): 772-8, 2011 Jul.
Article
em En
| MEDLINE
| ID: mdl-21446929
ABSTRACT
OBJECTIVE:
To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only.DESIGN:
Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG.SETTING:
Obstetric departments of three academic and six general hospitals in The Netherlands. Population. Laboring women with a singleton high-risk pregnancy, a fetus in cephalic presentation, a gestational age >36 weeks and an indication for internal electronic fetal monitoring.METHODS:
A trial-based cost-effectiveness analysis was performed from a health-care provider perspective. MAIN OUTCOMEMEASURES:
Primary health outcome was the incidence of metabolic acidosis measured in the umbilical artery. Direct medical costs were estimated from start of labor to childbirth. Cost-effectiveness was expressed as costs to prevent one case of metabolic acidosis.RESULTS:
The incidence of metabolic acidosis was 0.7% in the ST-analysis group and 1.0% in the CTG-only group (relative risk 0.70; 95% confidence interval 0.38-1.28). Per delivery, the mean costs per patient of CTG plus ST analysis (n= 2 827) were 1,345 vs. 1,316 for CTG only (n= 2 840), with a mean difference of 29 (95% confidence interval -9 to 77) until childbirth. The incremental costs of ST analysis to prevent one case of metabolic acidosis were 9 667.CONCLUSIONS:
The additional costs of monitoring by ST analysis of the fetal ECG are very limited when compared with monitoring by CTG only and very low compared with the total costs of delivery.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Resultado da Gravidez
/
Cardiotocografia
/
Custos de Cuidados de Saúde
/
Gravidez de Alto Risco
/
Eletrocardiografia
/
Monitorização Fetal
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Acta Obstet Gynecol Scand
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Holanda