SynthesisActa obstetricia et gynecologica Scandinavica2023
Reliability and agreement in intrapartum fetal heart rate monitoring interpretation: A systematic review.
Synthesis in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Reliability and agreement in intrapartum fetal heart rate monitoring interpretation: A systematic review.Acta obstetricia et gynecologica Scandinavica · 2023Pooled it
- Large-scale analysis of interobserver agreement and reliability in cardiotocography interpretation during labor using an online tool.BMC pregnancy and childbirth · 2024Trial
- Fetal heart rate patterns associated with acidemia at fetal blood sampling during labor-An observational study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Utility of Admission and Intrapartum Cardiotocography for Predicting Umbilical Artery pH Status at Birth: A Retrospective Cohort Study in Iran.Health science reports · 2026Article
- Review
- Interobserver agreement among midwives in cardiotocography interpretation using the 2015 FIGO guidelines for intrapartum fetal monitoring: A retrospective study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Observational
- Article
- Randomised study of human machine collaboration for cardiotocography interpretation during labour.NPJ digital medicine · 2026Article
- Assessing signal loss, accuracy, and acceptability of an ambulatory fetal electrocardiography with cardiotocography in the antepartum and intrapartum phases.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Long-term neurological health of the term offspring born via cesarean section for non-reassuring fetal monitoring.Archives of gynecology and obstetrics · 2026Article
- Interpretable machine learning model for predicting low birth weight in singleton pregnancies: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Measuring Agreement in Diagnostics: A Practical Guide for Researchers.Statistics in medicine · 2025Article
- Article
- Advancements in Fetal Heart Rate Monitoring: A Report on Opportunities and Strategic Initiatives for Better Intrapartum Care.BJOG : an international journal of obstetrics and gynaecology · 2025Review
- Intermittent auscultation fetal monitoring practice in different UK birth settings: a cross-sectional survey.BMC pregnancy and childbirth · 2025Article
- Article
- Review
- Comparison and verification of detection accuracy for late deceleration with and without uterine contractions signals using convolutional neural networks.Frontiers in physiology · 2025Article
- A comprehensive guide to study the agreement and reliability of multi-observer ordinal data.BMC medical research methodology · 2024Article
- Methodological quality in reliability/agreement studies.Acta obstetricia et gynecologica Scandinavica · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionFetal heart rate (FHR) monitoring is routine in intrapartum care worldwide and one of the most common obstetrical procedures. Intrapartum FHR monitoring helps assess fetal wellbeing and interpretation of the FHR help form decisions for clinical management and intervention. It relies on the observers' subjective assessments, with variation in interpretations leading to variations in intrapartum care. The purpose of this systematic review was to summarize and evaluate extant inter- and intrarater reliability research on the human interpretation of intrapartum FHR monitoring. MATERIAL AND
methodsWe searched for the terms "fetal heart rate monitoring," "interpretation agreement" and related concepts on Embase, Medline, Maternity and Infant Care Database and CINAHL. The last search was made on January 31, 2022. The protocol for the study was prospectively registered in PROSPERO (CRD42021260937). Studies that assess inter- and intrarater reliability and agreement of health professionals' intrapartum FHR monitoring were included and studies including other assessment of fetal wellbeing excluded. We extracted data in reviewer pairs using quality appraisal tool for studies of diagnostic reliability (QAREL) forms. The data retrieved from the studies are presented as narrative synthesis and in additional tables.
resultsForty-nine articles concerning continuous FHR monitoring were included in the study. For interrater reliability and agreement, in total 577 raters assessed 6315 CTG tracings. There was considerable heterogeneity in quality and measures across the included articles. We found higher reliability and agreement for the basic FHR features than for overall classification and higher agreement for intrarater reliability and agreement than for their interrater counterparts.
conclusionsThere is great variation in reliability and agreement measures for continuous intrapartum FHR monitoring, implying that intrapartum CTG should be used with caution for clinical decision making given its questionable reliability. We found few high-quality studies and noted methodological concerns in the studies. We recommend a more standardized approach to future reliability studies on FHR monitoring.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.