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Can Med Assoc J. 1982 August 1; 127(3): 214–216.
PMCID: PMC1861923

The reproducibility of intrapartum cardiotocogram assessments.


Five obstetrician-gynecologists experienced in fetal monitoring assessed 150 intrapartum cardiotocograms obtained with an external transducer. There were three successive blind readings, the first two without any clinical data apart from gestational age. The reviewers indicated whether the tracings showed definite, possible or no abnormalities. The interpretations given by each reviewer for any one tracing were fairly consistent, but they varied markedly from one reviewer to another. The proportion of tracings interpreted as normal ranged from 39% to 74%, and the proportion assessed as abnormal ranged from 3% to 43%. All five observers agreed on the interpretation of 29% of the tracings. Inter-reviewer reproducibility scarcely changed when clinical data were provided. These findings emphasize the need to evaluate all methods of fetal monitoring before they become widespread.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Zuspan FP, Quilligan EJ, Iams JD, van Geijn HP. Predictors of intrapartum fetal distress: the role of electronic fetal monitoring. Report of the National Institute of Child Health and Human Development Consensus Development Task Force. Am J Obstet Gynecol. 1979 Oct 1;135(3):287–291. [PubMed]
  • Renou P, Chang A, Anderson I, Wood C. Controlled trial of fetal intensive care. Am J Obstet Gynecol. 1976 Oct 15;126(4):470–476. [PubMed]
  • Kelso IM, Parsons RJ, Lawrence GF, Arora SS, Edmonds DK, Cooke ID. An assessment of continuous fetal heart rate monitoring in labor. A randomized trial. Am J Obstet Gynecol. 1978 Jul 1;131(5):526–532. [PubMed]
  • Trimbos JB, Keirse MJ. Observer variability in assessment of antepartum cardiotocograms. Br J Obstet Gynaecol. 1978 Dec;85(12):900–906. [PubMed]
  • Peck TM. Physicians' subjectivity in evaluating oxytocin challenge tests. Obstet Gynecol. 1980 Jul;56(1):13–16. [PubMed]

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