Affiliation:
1. Norwegian Research Centre for Women's Health Oslo University Hospital Oslo Norway
2. Faculty of Health Sciences Oslo Metropolitan University Oslo Norway
3. Department of Methodology and Statistics Maastricht University Maastricht The Netherlands
4. Department of Gynaecology and Obstetrics University Hospital of North Norway Tromsø Norway
5. Department of Gynaecology and Obstetrics, Bærum Hospital Vestre Viken Hospital Trust Bærum Norway
Abstract
AbstractBackgroundWe aimed to examine the inter‐reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks. This is the first interrater reliability and agreement study on intermittent auscultation (IA) to our knowledge.MethodsThe participant population consisted of 154 women in labor, from a mixed‐risk population and admitted to hospital for intrapartum care. The rater population were 16 midwives from various maternity care settings in Norway. A total of 154 soundtracks were recorded with a handheld Doppler device, and the 16 raters assessed 1‐min soundtracks once, through an online survey (Nettskjema). They assessed the baseline, FHR increase or decrease, and the FHR classification. The primary outcome, baseline, was measured with intraclass correlation coefficient (ICC). The secondary outcomes were measured with kappa and proportion of agreement.ResultsThe interrater reliability for the baseline (bpm) was ICC(A,1) 0.74 (95% CI 0.69–0.78). On average, an absolute difference of 7.9 bpm (95% CI 7.3–8.5 bpm) was observed between pairs of raters.ConclusionOur results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.