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How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study
Birth: Issues in Perinatal Care ( IF 2.8 ) Pub Date : 2024-08-21 , DOI: 10.1111/birt.12858
Christina Hernandez Engelhart 1, 2 , Sophie Vanbelle 3 , Pål Øian 4 , Aase Serine Devold Pay 2, 5 , Anne Kaasen 2 , Ellen Blix 2
Affiliation  

BackgroundWe aimed to examine the inter‐reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks. This is the first interrater reliability and agreement study on intermittent auscultation (IA) to our knowledge.MethodsThe participant population consisted of 154 women in labor, from a mixed‐risk population and admitted to hospital for intrapartum care. The rater population were 16 midwives from various maternity care settings in Norway. A total of 154 soundtracks were recorded with a handheld Doppler device, and the 16 raters assessed 1‐min soundtracks once, through an online survey (Nettskjema). They assessed the baseline, FHR increase or decrease, and the FHR classification. The primary outcome, baseline, was measured with intraclass correlation coefficient (ICC). The secondary outcomes were measured with kappa and proportion of agreement.ResultsThe interrater reliability for the baseline (bpm) was ICC(A,1) 0.74 (95% CI 0.69–0.78). On average, an absolute difference of 7.9 bpm (95% CI 7.3–8.5 bpm) was observed between pairs of raters.ConclusionOur results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.

中文翻译:


通过产时间歇听诊评估胎心率基线的效果如何?评估者间的可靠性和一致性研究



背景我们的目的是检查助产士在使用手持多普勒评估胎心率(FHR)时的相互可靠性和一致性。主要目的是衡量胎心率基线(基线)的可靠性和一致性(以每分钟心跳数 (bpm) 表示)。第二个目标是测量相对于基线的波动(定义为增加和减少)以及胎心率音轨的分类(正常或异常)。据我们所知,这是第一个关于间歇性听诊 (IA) 的受试者间可靠性和一致性研究。 方法 参与者包括 154 名临产妇女,来自混合风险人群,并入院接受产时护理。评估者是来自挪威不同产妇护理机构的 16 名助产士。使用手持多普勒设备总共录制了 154 首配乐,16 位评分者通过在线调查 (Nettskjema) 对 1 分钟的配乐进行了一次评估。他们评估了基线、胎心率增加或减少以及胎心率分类。主要结果(基线)通过组内相关系数(ICC)进行测量。次要结果用 kappa 和一致性比例来衡量。结果基线 (bpm) 的受试者间可靠性为 ICC(A,1) 0.74 (95% CI 0.69–0.78)。平均而言,在评估者对之间观察到 7.9 bpm (95% CI 7.3–8.5 bpm) 的绝对差异。结论我们的结果表明,使用手持多普勒评估基线时,可靠性和一致性处于可接受的水平。
更新日期:2024-08-21
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