[Validity of cardiotocography in the detection of umbilical cord complications].
OBJECTIVE
The purpose of this study was to investigate the validity of cardiotocography for the detection of cord complications.


METHODS
A low-risk population of 4196 cases was selected in which cord complications have been recognized in 34.3%. Cases with cord complications and controls were paired by parity, gestational age, maternal age and mode of delivery. 25 pairs were randomly selected. 50 tracings were presented twice to 4 obstetricians in a double-blind manner. As parameters for the determination of the validity of fetal monitoring the reliability, positive (ppv) and negative predictive value (npv), sensitivity and specificity were used. Inter- and intra-observer variability were also examined.


RESULTS
Reliability 52%, ppv 52%, npv 52%, sensitivity 46%, specificity 58%. Interobserver variability: All 4 obstetricians agreed in 47 of 100 evaluations. The level of agreement was higher in the controls (63%) than in the cord complication group (56%). The intraobserver variability was 25%.


CONCLUSIONS
Cardiotocography is not useful for the detection of cord complications. The range of possibilities has not been exploited yet, even for the evaluation of the fetal state.
Frauenklinik und Poliklinik, Universität Rostock.
C
C
Troeger
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V
Briese
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H
Müller
D015148:Cardiotocography; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003251:Constriction, Pathologic / Q000150:complications / Q000175:diagnosis; D004311:Double-Blind Method; D005260:Female; D005316:Fetal Distress / Q000209:etiology*; D006340:Heart Rate, Fetal; D006439:Hemodynamics; D006554:Hernia, Umbilical / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D008297:Male; D015997:Neonatal Screening; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012680:Sensitivity and Specificity; D014470:Umbilical Cord / Q000098:blood supply*
Zur Validität der Kardiotokographie bei Nabelschnurkomplikationen.