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The long-term cost-effectiveness of fetal monitoring during labour: a comparison of cardiotocography complemented with ST analysis versus cardiotocography alone
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
2008 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 115, 1676-1687 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To assess the cost-effectivness of the use of cardiotocography (CTG) complemented with fetal electrocardiography and ST analysis compared with the use of CTG alone in term deliveries when a decision has been made to use fetal monitoring with a scarlp electrode. Design: A cost-effectiveness analysis based on a probabilistic decision model incorporating relevant strategies and lifelong outcomes. Setting: Maternity wards in Sweden. Population: Women with term fetuses after a clinical decision had been made to apply a fetal scalp electrode for internal CTG. Methods: A decision model was used to compare the costs and effects of two different treatment strategies. Baseline estimates were derived from the literature. Discounted costs and quality-adjusted life years (QALYs) were simulated over a lifetime horizon using a probabilistic model. Main outcome measures: QALYs, incremental costs, and cost per QALY gained expressed as incremental cost-effectiveness ratio (ICER). Results: The analysis found an incremental effect of 0.005 QALYs for ST analysis compared with CTG; the ST analysis strategy was also moreover associated with a -56 decrease in costs, thus dominating the CTG strategy. The probability that ST analysis is cost-effective in comparison with CTG is high, irrespective of the willingness-to-pay value for a QALY. Conclusions: Compared with CTG alone, ST analysis is cost-effective when used in term high-risk deliveries in which there is a need for internal fetal monitoring.

Place, publisher, year, edition, pages
2008. Vol. 115, 1676-1687 p.
Keyword [en]
Cardiotocography, cerebral palsy, cost-effectiveness, fetal monitoring, ST analysis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-44507DOI: 10.1111/j.1471-0528.2008.01935.xLocal ID: 76910OAI: oai:DiVA.org:liu-44507DiVA: diva2:265369
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-01-31

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Heintz, EmelieBrodtkorb, Thor-HenrikNelson, NinaLevin, Lars-Åke

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Heintz, EmelieBrodtkorb, Thor-HenrikNelson, NinaLevin, Lars-Åke
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Health Technology Assessment and Health EconomicsFaculty of Health SciencesPediatricsDepartment of Paediatrics in Linköping
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British Journal of Obstetrics and Gynecology
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