How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study

IF 2.8 3区医学 Q1 NURSING

Birth-Issues in Perinatal Care Pub Date : 2024-08-20 DOI:10.1111/birt.12858

Christina Hernandez Engelhart MMid, Sophie Vanbelle PhD, Pål Øian MD, PhD, Aase Serine Devold Pay PhD, Anne Kaasen PhD, Ellen Blix PhD

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Abstract

Background

We 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.

Methods

The 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.

Results

The 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.

Conclusion

Our results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.

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产前间歇听诊对胎儿心率基线的评估效果如何？研究人员间的可靠性和一致性。

背景：我们旨在研究助产士使用手持多普勒评估胎儿心率（FHR）时的相互可靠性和一致性。主要目的是测量以每分钟心跳数（bpm）为单位的胎儿心率基线（基线）的可靠性和一致性。次要目的是测量基线的波动（定义为增加和减少）以及 FHR 声带的分类（正常或异常）。据我们所知，这是第一项关于间歇性听诊（IA）的交互可靠性和一致性研究：参与者包括 154 名产妇，她们来自混合风险人群，入院接受产前护理。测评者为来自挪威不同产科护理机构的16名助产士。16名评分者通过在线调查（Nettskjema）对1分钟的音轨进行了一次评估。他们对基线、FHR 增减和 FHR 分级进行评估。主要结果（基线）采用类内相关系数（ICC）进行测量。次要结果用卡帕和一致比例进行测量：基线（bpm）的评分者间可靠性为 ICC(A,1) 0.74 (95% CI 0.69-0.78)。平均而言，两组评分者之间的绝对差异为 7.9 bpm (95% CI 7.3-8.5 bpm)：我们的结果表明，使用手持式多普勒评估基线的可靠性和一致性达到了可接受的水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth-Issues in Perinatal Care 医学-妇产科学

CiteScore

4.10

自引率

4.00%

发文量

审稿时长

>12 weeks

期刊介绍： Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.