| Intrapartum nonreassuring fetal heart rate tracing and prediction of adverse outcomes: interobserver variability. | |
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MedLine Citation:
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PMID: 18667185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We determined interobserver variability in the classification of fetal heart rate (FHR) tracing with periodic deceleration as being reassuring or nonreassuring and in the ability to predict emergency cesarean delivery (ECD) or umbilical arterial pH < 7.00. STUDY DESIGN: Five clinicians reviewed 100 FHR tracings 1 hour before abnormalities and, if applicable, the hour before delivery. We calculated weighted Kappa coefficients (WKC) to assess interobserver variability and likelihood ratio of FHR tracing to identify ECD and low pH. RESULTS: Among 100 parturients, 46% of the women had ECD, and 2% of the women had low pH. The WKC for the classification of the FHR tracing as reassuring or nonreassuring in early labor was -0.12 and before delivery was 0.15. The WKC for ECD was 0.26 and for low pH was 0.21. The likelihood ratio for these 2 outcomes was < 2.0. CONCLUSION: There was poor agreement among the clinicians who classified FHR as reassuring vs nonreassuring; they could not identify which parturient would have ECD or a newborn infant with low pH. |
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Authors:
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Suneet P Chauhan; Chad K Klauser; Thomas C Woodring; Maureen Sanderson; Everett F Magann; John C Morrison |
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Publication Detail:
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Type: Journal Article Date: 2008-07-30 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 199 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-16 Completed Date: 2009-01-22 Revised Date: 2009-06-01 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 623.e1-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Aurora Health Care, West Allis, WI, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Apgar Score Cesarean Section / methods* Cohort Studies Emergency Treatment / methods Female Fetal Distress / diagnosis* Fetal Monitoring / methods* Heart Rate, Fetal / physiology* Humans Hydrogen-Ion Concentration Infant, Newborn Labor Stage, Second Labor, Obstetric Male Observer Variation Predictive Value of Tests Pregnancy Pregnancy Outcome* Risk Assessment Sensitivity and Specificity Time Factors Trial of Labor Young Adult |
| Comments/Corrections | |
Comment In:
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Am J Obstet Gynecol. 2009 Jun;200(6):e8
[PMID:
19286149
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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