Interpretation
Although no significant evidence of a reduction in maternal costs has been demonstrated, consistent indications of reduced neonatal costs associated with babies requiring less complex levels of care in the Stan+CTG arm suggest that this technology warrants further Australian and international research. As more data become available, it will be important to undertake meta-analyses, ideally including individual patient data, as well as updating existing reviews. These reviews will result in a stronger evidence base that should subsequently be used to formulate information for women about their options for fetal monitoring so that they can make informed decisions wherever practical. In the interim, given our previous findings of similarity in the main outcome (EmCS) and consistent patterns of cost reduction, we suggest that the addition of STan to CTG has the potential to be cost effective.