



@article {2257,
	title = {Access to computerised analysis of intrapartum cardiotocographs improves clinicians{\textquoteright} prediction of newborn umbilical artery blood pH},
	journal = {BJOG: An International Journal of Obstetrics and GynaecologyBJOG Int. J. Obstet. Gynaecol.},
	volume = {117},
	year = {2010},
	note = {Cited By (since 1996): 3Export Date: 21 November 2012Source: ScopusCODEN: BIOGFdoi: 10.1111/j.1471-0528.2010.02645.xPubMed ID: 20618316Language of Original Document: EnglishCorrespondence Address: Costa, A.; Departamento de Ginecologia e Obstetr{\'\i}cia, Faculdade de Medicina da Universidade Do Porto, Alameda Hernani Monteiro, 4200-319 Porto, Portugal; email: cosantonia@gmail.comReferences: Ayres-De-Campos, D., Bernardes, J., Costa-Pereira, A., Pereira-Leite, L., Inconsistencies in classification by experts of cardiotocograms and subsequent clinical decision (1999) Br J Obstet Gynaecol, 106, pp. 1307-10;Donker, D.K., Van Geijn, H.P., Hasman, A., Interobserver variation in the assessment of fetal heart rate recordings (1993) Eur J Obstet Gynecol Reprod Biol, 52, pp. 21-8; 
Paneth, N., Bommarito, M., Stricker, J., Electronic fetal monitoring and later outcome (1993) Clin Invest Med, 16, pp. 159-65; 
Bernardes, J., Moura, C., Marques-De-S{\'a}, J.P., Pereira-Leite, L., The Porto system for automated cardiotocographic signal analysis (1991) J Perinat Med, 19, pp. 61-5; 
Ayres-De-Campos, D., Sousa, P., Costa, A., Bernardes, J., Omniview-SisPorto {\textregistered} 3.5 - A central fetal monitoring station with online alerts based on computerized cardiotocogram+ST event analysis (2008) J Perinat Med, 36, pp. 260-4; 
Costa, A., Ayres-De-Campos, D., Costa, F., Santos, C., Bernardes, J., Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals (2009) Am J Obstet Gynecol, 201, pp. 464e1-6. , Jun 17. [Epub ahead of print]; 
Westerhuis, M., Van Horen, E., Kwee, A., Van Dertweel, I., Visser, G., Moons, K., Inter- and intra-observer agreement of intrapartum ST analysis of the fetal electrocardiogram in women monitored by STAN (2009) BJOG, 116, pp. 545-51; 
Ayres-De-Campos, D., Bernardes, J., Marsalb, K., Nickelsen, C., Makarainend, L., Banfield, P., Can the reproducibility of fetal heart rate baseline estimation be improved? (2004) Eur J Obstet Gynecol Reprod Biol, 112, pp. 49-54; 
Huch, A., Huch, C., Rooth, G., Guidelines for blood sampling and measurement of pH and blood gas values in Obstetrics (1994) Eur J Obstet Gynecol Reprod Biol, 54, pp. 165-75; 
Umbilical artery blood acid-base analysis (1996) Int J Gynecol Obstet, 52, pp. 305-10. , ACOG technical bulletin; 
Westgate, J., Garibaldi, J.M., Greene, K.R., Umbilical cord blood gas analysis at delivery: A time for quality data (1994) Br J Obstet Gynaecol, 101, pp. 1054-63; 
Costa-Santos, C., Costa Pereira, A., Bernardes, J., Agreement studies in obstetrics and gynaecology: Inappropriateness, controversies and consequences (2005) BJOG, 112, pp. 667-9; 
Bland, J.M., Altman, D.G., Agreement between methods of measurement with multiple observations per individual (2007) J Biopharm Stat, 17, pp. 571-82; 
Chauhan, S.P., Klauser, C.K., Woodring, T.C., Sanderson, M., Magann, E.F., Morrison, J.C., Intrapartum nonreassuring fetal heart rate tracing and prediction of adverse outcomes: Interobserver variability (2008) Am J Obstet Gynecol, 199, pp. 623e1-e5; 
Nielsen, P.V., Stigsby, B., Nickelsen, C., Nim, J., The value of computer assessment compared with visual assessment (1988) Acta Obstet Gynecol Scand, 67, pp. 461-464
},
	month = {2010///},
	pages = {1288 - 1293},
	abstract = {Objective To evaluate the impact of access to computerised cardiotocograph (CTG) analysis on reproducibility and accuracy of clinicians{\textquoteright} predictions of umbilical artery blood pH (UAB pH) and 5-minute Apgar score. Design Prospective evaluation of pre-recorded cases. Setting A tertiary-care university hospital. Population From databases of intrapartum CTGs acquired in singleton term pregnancies, 204 tracings with low signal loss and short time interval to delivery were consecutively selected. Methods Tracings were randomly assigned to computer analysis by the Omniview-SisPorto 3.5                        {\textregistered} system (study group n = 104) or to no analysis (control group n = 100). Three experienced clinicians evaluated all tracing printouts independently and were asked to predict the newborns{\textquoteright} UAB pH and 5-minute Apgar scores from them. Main outcome measures Interobserver agreement (measured by the intraclass correlation coefficient [ICC]) and accuracy in prediction of neonatal outcomes with 95\% CI. Results Agreement on prediction of UAB pH was significantly higher in the study group (ICC = 0.70; 95\% CI 0.61-0.77) than in the control group (ICC = 0.43; 95\% CI 0.21-0.60), and a trend towards better agreement was also seen in estimation of 5-minute Apgar scores (ICC = 0.55; 95\% CI 0.38-0.68 versus ICC = 0.43; 95\% CI 0.25-0.57). Observers predicted UAB pH values correctly within a 0.10 margin in 70\% of cases in the study group (95\% CI 0.61-0.79) versus 46\% in the control group (95\% CI 0.35-0.56). They predicted 5-minute Apgar scores within a margin of one in 81\% of cases in the study group (95\% CI 0.73-0.88) and in 70\% of cases in the control group (95\% CI 0.61-0.79). Conclusions Prediction of UAB pH is more reproducible and accurate when clinicians have access to computerised analysis of CTGs. {\textcopyright} RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.
},
	keywords = {access to information, Apgar score, arterial pH, article, Cardiotocography, clinical competence, computer analysis, computerised analysis, controlled study, delivery, Diagnosis, Computer-Assisted, diagnostic accuracy, Female, Fetal Blood, Fetal heart rate, Fetal monitoring, Gestational Age, human, Humans, Hydrogen-Ion Concentration, Infant, Newborn, male, neonatal acidaemia, Neonatology, newborn, observer variation, outcome assessment, prediction, Pregnancy, priority journal, Prospective Studies, prospective study, reproducibility, Umbilical Arteries, umbilical artery, university hospital},
	isbn = {14700328 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-77955794381\&partnerID=40\&md5=49e6cf80fa55cf7009fcb9ccec497ab2},
	author = {Costa, A. and Santos, C. and Ayres-de-Campos, D. and Costa, C. and Bernardes, J.}
}
