[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.
Troeger
C
C
Frauenklinik und Poliklinik, Universität Rostock.
Briese
V
V
Müller
H
H
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.