Vol 92, No 12 (2021)
Research paper
Published online: 2021-04-21

open access

Page views 7829
Article views/downloads 907
Get Citation

Connect on Social Media

Connect on Social Media

The relevance of Short-Term Variation (STV) value measured within 1 hour before delivery in predicting adverse neonatal outcome

Gabriela Wilczynska1, Magdalena Kolak1, Magdalena Plonka1, Agata Staron1, Daniel Lipka1, Malgorzata Radon-Pokracka1, Hubert Huras1
Pubmed: 33914335
Ginekol Pol 2021;92(12):878-883.


Objectives: Computer CTG analysis (cCTG) included short-term variation (STV) is one of the methods of monitoring fetal condition during delivery. The aim of our study was to define appropriability of STV measured within 1 hour before delivery in prediction of neonatal outcomes.
Material and methods: The retrospective study included 1014 pregnant women, who gave birth in the Department of Obstetrics and Perinatology. Participants were divided into two groups: group 1 — term pregnancies (37–41 weeks) and group 2 — preterm pregnancies (lower than 37 weeks). In each of them, two subgroups have been separated: control (STV ≥ 3 ms) and study group (STV < 3 ms).
Results: In both groups 1 and 2, there were no statistically significant differences related to Apgar scores in 1st, 3rd and 5th minute between group with STV < 3 ms and group with STV > 3 ms Moreover, for 37–41 weeks the sensitivity, specificity, positive predictive value and negative predictive value were: 22.7%, 83.9%, 3.3% and 97.8% and for lower than 37: 45.7%, 65.4%, 47.1%, 64.2% in 1st minute after delivery. In group 1 the area under curve (AUC) measurements were 0.45 (95% CI: 0.32–0.58) for 1st minute and 0.55 (95% CI: 0.35–0.74) for 5th minute and in group 2: 0.58 (95% CI: 0.45–0.71) for 1st minute and 0.57 (95% CI: 0.42–0.72) for 5th minute.
Conclusions: High specificity and negative predictive value of STV indicates a good Apgar score of newborns in term pregnancies. Analysis of STV in preterm pregnancy is not clear. Fetal well-being in preterm pregnancy should include STV and other non-invasive and invasive tools.

Article available in PDF format

View PDF Download PDF file


  1. Wretler S, Holzmann M, Graner S, et al. Fetal heart rate monitoring of short term variation (STV): a methodological observational study. BMC Pregnancy Childbirth. 2016; 16: 55.
  2. Galazios G, Tripsianis G, Tsikouras P, et al. Fetal distress evaluation using and analyzing the variables of antepartum computerized cardiotocography. Arch Gynecol Obstet. 2010; 281(2): 229–233.
  3. WHO recommendations on intervention to improve preterm birth outcomes . https://apps.who.int/iris/bitstream/handle/10665/183037/?sequence=1.
  4. Leeflang MMG. Systematic reviews and meta-analyses of diagnostic test accuracy. Clin Microbiol Infect. 2014; 20(2): 105–113.
  5. Hoo ZH, Candlish J, Teare D. What is an ROC curve? Emerg Med J. 2017; 34(6): 357–359.
  6. Cnattingius S, Norman M, Granath F, et al. Apgar Score Components at 5 Minutes: Risks and Prediction of Neonatal Mortality. Paediatr Perinat Epidemiol. 2017; 31(4): 328–337.
  7. Simon R. Sensitivity, Specificity, PPV, and NPV for Predictive Biomarkers. J Natl Cancer Inst. 2015; 107(8).
  8. Bandos AI, Guo B, Gur D. Estimating the Area Under ROC Curve When the Fitted Binormal Curves Demonstrate Improper Shape. Acad Radiol. 2017; 24(2): 209–219.
  9. Pinas A, Chandraharan E. Continuous cardiotocography during labour: Analysis, classification and management. Best Pract Res Clin Obstet Gynaecol. 2016; 30: 33–47.
  10. Leszczynska-Gorzelak B, Poniedzialek-Czajkowska E, Oleszczuk J. Intrapartum cardiotocography and fetal pulse oximetry in assessing fetal hypoxia. Int J Gynaecol Obstet. 2002; 76(1): 9–14.
  11. Gyllencreutz E, Lu Ke, Lindecrantz K, et al. Validation of a computerized algorithm to quantify fetal heart rate deceleration area. Acta Obstet Gynecol Scand. 2018; 97(9): 1137–1147.
  12. Giuliano N, Annunziata ML, Esposito FG, et al. Computerised analysis of antepartum foetal heart parameters: New reference ranges. J Obstet Gynaecol. 2017; 37(3): 296–304.
  13. Mullins E, Lees C, Brocklehurst P. Is continuous electronic fetal monitoring useful for all women in labour? BMJ. 2017; 359: j5423.
  14. Wolf H, Gordijn SJ, Onland W, et al. Computerized fetal heart rate analysis in early preterm fetal growth restriction. Ultrasound in Obstetrics & Gynecology. 2020; 56(1): 51–60.
  15. Verdurmen KMJ, Warmerdam GJJ, Lempersz C, et al. The influence of betamethasone on fetal heart rate variability, obtained by non-invasive fetal electrocardiogram recordings. Early Hum Dev. 2018; 119: 8–14.