ReviewPloS one2025
Factors contributing to visual intrapartum cardiotocograph interpretation variation among healthcare professionals: An integrative review.
Review in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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Who cites it
4 citing papers in PubMed.
- 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
- Antepartum Computerized Cardiotocography in High-Risk Pregnancies: Comparative Analysis of Fetal Heart Rate Parameters in Hypertensive Disorders of Pregnancy, Diabetes and Intrahepatic Cholestasis.Journal of clinical medicine · 2026Article
- Article
- Case Report: Ultrasound "whirlpool sign" in fetal intestinal malrotation and torsion: a case-based approach to early diagnosis and intervention.Frontiers in pediatrics · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The reliability of cardiotocographs as diagnostic tools for fetal well-being is hampered by interpretational variations among healthcare professionals, contributing to high rates of cesarean sections and instrumental deliveries. While adjunct technologies may be used to confirm cases of fetal distress, those in resource constrained areas continue to rely on visual cardiotocograph interpretation to come up with the diagnosis of fetal hypoxia. This study investigated the factors contributing to variations in the visual interpretation of intrapartum cardiotocograph among healthcare professionals in the absence of adjunctive technologies. In this integrative literature review, we conducted a literature search of the following electronic databases: EBScohost, PubMed, Web of Science, and Scopus. The following search terms and Boolean operators were used: (Intrapartum OR Labor OR Labour OR Childbirth OR Birth OR Delivery) AND (Cardiotocography OR CTG OR "Electronic Fetal Monitoring" OR EFM) AND (Interpretation OR Analysis) AND (Variations OR Differences) AND ("Healthcare Workers" OR Nurses OR "Medical Workers" OR "Healthcare Professionals" OR Midwives OR Obstetricians). After removal of duplicates, a total of 1481 articles and titles were screened, 60 full-text articles were examined to verify whether they addressed the scope of the literature review. Nine articles addressed the factors contributing to variations in the visual interpretation of intrapartum cardiotocographs among healthcare professionals. The quality of the studies was appraised using the Quality Appraisal Tool for Studies of Diagnostic Reliability. Thematic analysis identified the following themes: 1) Interpretational variations in cardiotocograph characteristics among health professionals, and 2) factors leading to increased interpretational variation among healthcare professionals. Our results highlight the need for increased cardiotocograph training to improve consistency among health professionals, especially for suspicious and pathological traces, which often lead to cesarean section.
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