Document Detail

Assessment of the concordance among 2-tier, 3-tier, and 5-tier fetal heart rate classification systems.
MedLine Citation:
PMID:  22071068     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In 2008, a National Institute of Child Health and Human Development/Society for Maternal-Fetal Medicine-sponsored workshop on electronic fetal monitoring recommended a new fetal heart tracing interpretation system. Comparison of this 3-tier system with other systems is lacking. Our purpose was to determine the relationships between fetal heart rate categories for the 3 existing systems.
METHODS: Three Maternal-Fetal Medicine specialists reviewed 120 fetal heart rates. All tracings were from term, singleton pregnancies with known umbilical artery pH. The fetal heart rates were classified by a 2-tier, 3-tier, and 5-tier system.
RESULTS: Each Maternal-Fetal Medicine examiner reviewed 120 fetal heart rate segments. When compared with the 2-tier system, 0%, 54%, and 100% tracings in categories 1, 2, and 3 were "nonreassuring." There was strong concordance between category 1 and "green" as well as category 3 and "red" tracings.
CONCLUSION: The 3-tier and 5-tier systems were similar in fetal heart rate interpretations for tracings that were either very normal or very abnormal. Whether one system is superior to the others in predicting fetal acidemia remains unknown.
Cynthia Gyamfi Bannerman; William A Grobman; Leah Antoniewicz; Maria Hutchinson; Sean Blackwell
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-24
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  205     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-11-10     Completed Date:  2012-02-02     Revised Date:  2013-08-09    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  288.e1-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
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MeSH Terms
Cardiotocography / methods*
Heart Rate, Fetal / physiology*
Labor, Obstetric
National Institute of Child Health and Human Development (U.S.)
Retrospective Studies
United States

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