This study was undertaken to determi ne the ability of intrapartum electronic fetal heart rate monitoring(EFM)plus fetal electrocardiogram(ECG)ST segment automated ANalysis(STAN,Neoventa Medical,Gteborg,S weden)monitoring to predict metabolic acidemia(defined as an umbilical cord artery pH <7.15and base deficit≥12mmol /L)at birth.Women with singleton,termpregnancies who had a clinical indic ation for internal EFM with a fetal scalp electrode were included in the study.Attending physicians were blinded t o the ST analysis in-formation,only using available EFM as per current clinical practice.After delivery,2trained observers blinded to neonatal outcome and ST analysis inf ormation performed visual classification of the EFM tra cing in 10-minute e-pochs according to FIGO guidelines.ST events automati-cally detected by the STAN S21monito r(Neoventa Medi-cal)were combined with the visual EFM cla ssification as per STAN clinical guidelines(Neoventa Medical).When applying STAN clinical guidelines f rom a sample of 143women,our data indicated a sensitiv ity of 43%,speci-ficity of 74%,negative predictive v alue of 96%,and a positive predictive value of 8%for metabolic acidemia at birth.Poor ECG quality,despite goo d EFM tracings(ECG signal loss),occurred 11%of the tracing time.The STAN clinical guidelines have a p oor positive predic-tive value and a sensitivity of less t han 50%for metabolic acidemia at birth. This study was undertaken to determine the ability of intrapartum electronic fetal heart rate monitoring (EFM) plus fetal electrocardiogram (ECG) ST segment automated ANalysis (STAN, Neoventa Medical, Gteborg, S weden) monitoring to predict metabolic acidemia (defined as an umbilical cord artery pH <7.15 and base deficit ≧ 12 mmol / L) at birth. Women with singleton, termpregnancies who had a clinical indiction for internal EFM with a fetal scalp electrode were included in the study. Anding physicians were blinded to the ST analysis in-formation, only using available EFM as per current clinical practice. After delivery, 2trained observers blinded to neonatal outcome and ST analysis inf ormation performed visual classification of the EFM traing in 10-minute e-pochs according to FIGO guidelines. ST events automati-cally detected by the STAN S21monito r (Neoventa Medi-cal) were combined with the visual EFM cla ssification as per STAN clinical guidelines (Neoventa Medical) .When applying STAN clinical guidelines f rom a sample of 143 women, our data shows a sensitivity of 43%, speci-ficity of 74%, negative predictive vlue of 96%, and a positive predictive value of 8% for metabolic acidemia at birth .Poor ECG quality , 11% of the tracing time. The STAN clinical guidelines have ap oor positive predictive value and a sensitivity of less t han 50% for metabolic acidemia at birth.