The impact that intense ‘fetal-physiology’ training has on inter-observer agreement in interpreting intrapartum cardiotocograph traces in comparison to the classical ‘pattern-recognition’ approach: a prospective observational study

  1. Henares, Juan de Dios Gutierrez 1
  2. Gomez, David Diaz 1
  3. Chandraharan, Edwin 2
  1. 1 St George’s University Hospitals NHS Foundation Trust
    info

    St George’s University Hospitals NHS Foundation Trust

    Londres, Reino Unido

    ROR https://ror.org/039zedc16

  2. 2 Tianjin Central Hospital of Obstetrics and Gynecology
Aldizkaria:
Authorea

Argitalpen urtea: 2020

Mota: Artikulua

DOI: 10.22541/AU.159007742.29125414 GOOGLE SCHOLAR lock_openSarbide irekia editor

Laburpena

To explore the level of agreement as well as the contribution of human-factors on CTG interpretationin a hospital where a high intense, ‘fetal physiology-based’ training on CTG-interpretation was implemented by a dedicatedCTG-Team. Design: Prospective observational study Setting: Tertiary Hospital, UK Population: A total of 25 midwives and 7doctors ([?]10% of staff) Method: interpretation of 5 anonymised colour-printed copies of 5 different CTGs using a questionnaire(160 CTG interpretations) using local CTG-guidelines (pattern-recognition approach) and Types of hypoxia (fetal-physiology).Results: Interpretation of CTG by type of hypoxia compared against CTG-guidelines presented better Proportion of concordance(PC=76.1% vs 61.2%, P=0.006) and slightly better reliability (K= 0.37 (0.35–0.39) vs 0.33 (0.32–0.36)). Doctors rely mostin fetal-physiology than midwives who rely most in guidelines. Overall, 68% of the staff felt confident or very confident inCTG interpretation. In general, Self-reported confidence on CTG interpretation and fetal-physiology knowledge increased withthe level of seniority. Conclusions: ‘Fetal-physiology-based’ training increases level of self-reported confidence and level offetal-physiology knowledge leading to better inter-observer agreement and reliability in CTG interpretation especially whenconsidering type of hypoxia in CTG-classification. Funding: JG collected the data as part of a Self-funded university MScprogram. A secondary analysis of the data was performed to elaborate this manuscript. There is no source of funding todeclare by the rest of co-authors in this paper. Keywords: Fetal-physiology, Cardiotocography Interpretation, Intrapartum fetalmonitoring, Inter-observer agreement.

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