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- W2008525063 abstract "Recently, the 2008 NICHD Workshop Report on Electronic Fetal Monitoring, proposed a “Three-Tier Fetal Heart Rate (FHR) Interpretation System”. However, no data regarding the relative frequency (prevalence) of these three FHR categories during labor or its clinical use were presented. In addition, it is well known that significant interobserver variability exists in the interpretation of FHR patterns. Therefore, the aims of this study were to: 1) establish the relative frequency (prevalence) of the three FHR categories during labor; and 2) examine the interobserver variability utilizing this new FHR classification system. We included singleton pregnancies >34 weeks' gestation who had an umbilical artery cord pH performed during a four-month period at our institution (n=102). We categorized the fetal heart rate pattern during the last 60 minutes prior to delivery according to the NICHD three-tier system. Three separate Obstetricians at different levels of training (MFM Attending, Fellow, and Chief Resident) independently categorized the FHR patterns using the NICHD criteria. A Kappa coefficient was calculated to assess the interobserver variability of category classification. A Kappa of 0.81-0.99 is considered almost perfect agreement, 0.61-0.80 substantial agreement, 0.41-0.60 moderate agreement, 0.21-0.40 fair agreement, and 0.01-0.20 is slight agreement. The median gestational age at delivery was 39 2/7 weeks (34 – 41 2/7). Seventeen tracings (17%) were determined to be category I tracings, eighty (79%) category II, and four (4%) category III. One tracing could not be categorized. The calculated Kappa coefficient among the three observers was 0.50 indicating “moderate” agreement in interpretation. The overwhelming majority of the tracings (79%) were category II. There is moderate agreement in the interpretation of fetal heart rate categories using the NICHD “Three-Tier Fetal Heart Rate Interpretation System”. The clinical value (predictive ability) of this new classification should determined by future studies." @default.
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- W2008525063 date "2009-12-01" @default.
- W2008525063 modified "2023-10-03" @default.
- W2008525063 title "666: The NICHD's Three-Tier Fetal Heart Rate Interpretation System: what is the interobserver variability?" @default.
- W2008525063 doi "https://doi.org/10.1016/j.ajog.2009.10.531" @default.
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