Inter‐ and intraobserver agreement of antenatal cardiotocography assessments by maternity care professionals: A prospective study

Neppelenbroek, Elise M.; van der Heijden, Olivier W. H.; de Vet, Henrica C. W.; de Groot, Amanda J. J.; Daemers, Darie O. A.; de Jonge, Ank; Verhoeven, Corine J. M.

Abstract

Objective: In the Netherlands, antenatal cardiotocography (aCTG) to assess fetal well‐being is performed in obstetrician‐led care. An innovative initiative was started to evaluate whether aCTG for specific indications—reduced fetal movements, external cephalic version, or postdate pregnancy—is feasible in non‐obstetrician‐led care settings by independent primary care midwives. Quality assessment is essential when reorganizing and shifting tasks and responsibilities. Therefore, we aimed to assess the inter‐ and intraobserver agreement for aCTG assessments between and within four professional groups involved in Dutch maternity care regarding the overall classification and assessment of the various components of aCTG. Method: This was a prospective study among 47 Dutch primary care midwives, hospital‐based midwives, residents, and obstetricians. Ten aCTG traces were assessed twice at a 1 month interval. To ensure a representative sample, we used two different sets of 10 aCTG traces each. We calculated the degree of agreement using the proportions of agreement. Results: The proportions of agreement for interobserver agreement on the classification of aCTG between and within the four professional groups varied from 0.82 to 0.94. The proportions of agreement for each professional group were slightly higher for intraobserver (0.86–0.94) than for interobserver agreement. For the various aCTG components, the proportions of agreement for interobserver agreement varied from 0.64 (presence of contractions) to 0.98 (baseline heart frequency). Conclusion: The proportion of agreement levels between and within the maternity care professionals in the classification of aCTG traces among healthy women were comparable. This means that these professional groups are equally well able to classify aCTGs in healthy pregnant women.

• Journal Article Type: Article
• Acceptance Date: Mar 12, 2024
• Online Publication Date: Mar 22, 2024
• Publication Date: Mar 22, 2024
• Deposit Date: Jun 7, 2024
• Publicly Available Date: Jun 10, 2024
• Journal: International Journal of Gynecology & Obstetrics
• Print ISSN: 0020-7292
• Electronic ISSN: 1879-3479
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1002/ijgo.15497
• Keywords: antenatal cardiotocography, interobserver agreement, midwife‐led care, intraobserver agreement, low‐risk pregnancy
• Public URL: https://nottingham-repository.worktribe.com/output/33011925
• Publisher URL: https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.15497