Assessment of the concordance among 2-tier, 3-tier, and 5-tier fetal heart rate classification systems

American Journal of Obstetrics and Gynecology
Cynthia Gyamfi BannermanSean C Blackwell

Abstract

In 2008, a National Institute of Child Health and Human Development/Society for Maternal-Fetal Medicine-sponsored workshop on electronic fetal monitoring recommended a new fetal heart tracing interpretation system. Comparison of this 3-tier system with other systems is lacking. Our purpose was to determine the relationships between fetal heart rate categories for the 3 existing systems. Three Maternal-Fetal Medicine specialists reviewed 120 fetal heart rates. All tracings were from term, singleton pregnancies with known umbilical artery pH. The fetal heart rates were classified by a 2-tier, 3-tier, and 5-tier system. Each Maternal-Fetal Medicine examiner reviewed 120 fetal heart rate segments. When compared with the 2-tier system, 0%, 54%, and 100% tracings in categories 1, 2, and 3 were "nonreassuring." There was strong concordance between category 1 and "green" as well as category 3 and "red" tracings. The 3-tier and 5-tier systems were similar in fetal heart rate interpretations for tracings that were either very normal or very abnormal. Whether one system is superior to the others in predicting fetal acidemia remains unknown.

References

Jul 10, 2007·American Journal of Obstetrics and Gynecology·Julian T Parer, Tomoaki Ikeda
Aug 1, 2008·American Journal of Obstetrics and Gynecology·Suneet P ChauhanJohn C Morrison
Oct 23, 2010·Obstetrics and Gynecology·American College of Obstetricians and Gynecologists

Citations

Nov 19, 2011·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Tekoa L King, Julian T Parer
Jan 17, 2012·American Journal of Obstetrics and Gynecology·Jaclyn ColettaCynthia Gyamfi-Bannerman
Nov 8, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Sabina Martí GamboaSergio Castán Mateo
Jun 11, 2017·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Ninlapa PruksanusakChusana Petpichetchian
May 11, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Shoichi MagawaTomoaki Ikeda
May 7, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Shoichi MagawaTomoaki Ikeda
Oct 9, 2012·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Mariarosaria Di TommasoFrancesca Rizzello
Jan 11, 2020·Obstetrics and Gynecology·William W Andrews, Alan Thevenet N Tita

Related Concepts

Heart Rate, Fetal
Labor (Childbirth)
Retrospective Studies
Cardiotocogram
National Institute of Child Health and Human Development (U.S.)
Classification
Fetal Heart
Structure of Umbilical Artery
Evaluation
Fetal Acidosis

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