Archives of Gynecology and Obstetrics

, Volume 296, Issue 5, pp 897–905 | Cite as

Estimation of neonatal outcome artery pH value according to CTG interpretation of the last 60 min before delivery: a retrospective study. Can the outcome pH value be predicted?

  • S. Kundu
  • E. Kuehnle
  • C. Schippert
  • J. von Ehr
  • P. Hillemanns
  • Ismini Staboulidou
Maternal-Fetal Medicine
First Online:
Received:
Accepted:

Abstract

Purpose

The aim of this study was to analyze whether the umbilical artery pH value can be estimated throughout CTG assessment 60 min prior to delivery and if the estimated umbilical artery pH value correlates with the actual one. This includes analysis of correlation between CTG trace classification and actual umbilical artery pH value. Intra-and interobserver agreement and the impact of professional experience on visual analysis of fetal heart rate tracing were evaluated.

Methods

This was a retrospective study. 300 CTG records of the last 60 min before delivery were picked randomly from the computer database with the following inclusion criteria; singleton pregnancy >37 weeks, no fetal anomalies, vaginal delivery either spontaneous or instrumental-assisted. Five obstetricians and two midwives of different professional experience classified 300 CTG traces according to the FIGO criteria and estimated the postnatal umbilical artery pH.

Results

The results showed a significant difference (p < 0.05) in estimated and actual pH value, independent of professional experience. Analysis and correlation of CTG assessment and actual umbilical artery pH value showed significantly (p < 0.05) diverging results. Intra- and interobserver variability was high. Intraobserver variability was significantly higher for the resident (p = 0.001). No significant differences were detected regarding interobserver variability.

Conclusion

An estimation of the pH value and consequently of neonatal outcome on the basis of a present CTG seems to be difficult. Therefore, not only CTG training but also clinical experience and the collaboration and consultation within the whole team is important.

Keywords

Intraobserver variability Interobserver variability FIGO classification Cardiotococardiography Neonatal outcome measures Umbilical artery pH value 
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Notes

Acknowledgements

We would like to thank Prof. Sibbertsen and Dr. Betram, Institute of Statistics of the Leibniz-University of Hanover, for the statistical analysis.

Author contributions

SK and IS conceived the study design, prepared the study protocol with input of PH. IS was in charge of overall project coordination and data management. SK, IS and EK interpreted the data and prepared the first draft of the manuscript. EK, CS, JvE, SK and IS have been examiners in the study. All authors contributed to interpretation of the results, provided input to all stages of the article and revised the manuscript for intellectual content. All authors approved the manuscript for publication.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of Hanover Medical School on 29th of January 2015 (no: 2572-2015).

Funding

There was no funding.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Gynecology and ObstetricsHanover Medical SchoolHanoverGermany

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