Access to computerised analysis of intrapartum cardiotocographs improves clinicians' prediction of newborn umbilical artery blood pH

BJOG : an International Journal of Obstetrics and Gynaecology
A CostaJ Bernardes


To evaluate the impact of access to computerised cardiotocograph (CTG) analysis on reproducibility and accuracy of clinicians' predictions of umbilical artery blood pH (UAB pH) and 5-minute Apgar score. Prospective evaluation of pre-recorded cases. A tertiary-care university hospital. From databases of intrapartum CTGs acquired in singleton term pregnancies, 204 tracings with low signal loss and short time interval to delivery were consecutively selected. Tracings were randomly assigned to computer analysis by the Omniview-SisPorto 3.5 system (study group n = 104) or to no analysis (control group n = 100). Three experienced clinicians evaluated all tracing printouts independently and were asked to predict the newborns' UAB pH and 5-minute Apgar scores from them. Interobserver agreement (measured by the intraclass correlation coefficient [ICC]) and accuracy in prediction of neonatal outcomes with 95% CI. Agreement on prediction of UAB pH was significantly higher in the study group (ICC = 0.70; 95% CI 0.61-0.77) than in the control group (ICC = 0.43; 95% CI 0.21-0.60), and a trend towards better agreement was also seen in estimation of 5-minute Apgar scores (ICC = 0.55; 95% CI 0.38-0.68 versus ICC = 0.43; 95% CI 0.25-0.57). Obser...Continue Reading


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Jan 18, 2012·Current Opinion in Obstetrics & Gynecology·Susana Santo, D Ayres-de-Campos
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Related Concepts

Apgar Score
Clinical Skill
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