Interobserver variation in the assessment of fetal heart rate recordings

Electronic fetal heart rate monitoring (EFM) has not fulfilled its expectations. To improve its validity various attempts were made to standardize terminology and assessment of fetal heart rate (FHR) recordings. In a multinational study, 21 experienced obstetricians were asked to segment and classif...

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Bibliographic Details
Published inEuropean journal of obstetrics & gynecology and reproductive biology Vol. 52; no. 1; pp. 21 - 28
Main Authors Donker, Dick K., van Geijn, Herman P., Hasman, Arie
Format Journal Article
LanguageEnglish
Published Shannon Elsevier Ireland Ltd 01.11.1993
Elsevier
Subjects
Biological and medical sciences
Cardiotocography
Electronic fetal monitoring
Female
Fetal heart rate
Fetal Monitoring - standards
Fetal Monitoring - statistics & numerical data
Gynecology. Andrology. Obstetrics
Heart Rate, Fetal
Humans
Interobserver agreement
Kappa statistic
Management. Prenatal diagnosis
Medical sciences
Observer Variation
Pregnancy
Pregnancy. Fetus. Placenta
Validity
Electronic fetal monitoring
Validity
Cardiotocography
Fetal heart rate
Interobserver agreement
Kappa statistic
Pregnancy
Heart rate
Surveillance
Observer
Variations
Fetus
Hemodynamics
Interpretation
Monitoring
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Summary:Electronic fetal heart rate monitoring (EFM) has not fulfilled its expectations. To improve its validity various attempts were made to standardize terminology and assessment of fetal heart rate (FHR) recordings. In a multinational study, 21 experienced obstetricians were asked to segment and classify FHR patterns, recorded in 13 obstetric cases. In addition, the referees were asked to give their interpretation of the FHR pattern, to assess the fetal condition and to propose obstetric management. The kappa statistic showed fair agreement among the obstetricians for the classification of accelerations, baseline segments and decelerations. Poor agreement was found when the referees had to classify baseline variability or the type of deceleration. Also, the clinical assessment of fetal condition and proposals for obstetric management showed poor agreement among the referees. We conclude there is still a lack of unequivocal terminology and definitions in the assessment of FHR recordings.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0301-2115
1872-7654
DOI:10.1016/0028-2243(93)90220-7