[Evaluation of the reproducibility of Doppler ultrasonographic measurements in obstetrics].
BACKGROUND
Are obstetric doppler ultrasonographic measurements of the fetal and maternal flow parameters reproducible?


METHODS
For internal quality management, doppler ultrasonographic measurements were performed on 81 patients (random screening sample) with an Acuson Sequoia Ultrasound at the Universitätsfrauenklinik Marburg. Successively two experienced investigators measured the umbilical artery, medial cerebral artery, and the uterine arteries. The correlation between the measurements of the two investigators was presented in a spread chart. In order to exclude systematic differences between the measurements, linear regression was analyzed and the distance to the abscissa was calculated. A relative divergence of more than 20% was determined as a non corresponding measurement.


RESULTS
The distance of the linear regression to the abscissa was calculated for the four vessels: umbilical artery 0.4 (95% CI; 0.124 - 0.486), medial cerebral artery 0.9 (95% CI; 0.534 - 1.264), right uterine artery 0.2 (95% CI; 0.124 - 0.305), and left uterine artery 0.2 (95% CI; 0.121 - 0.317). Concerning the four arteries, a divergence of more than 20% between the two investigators was found: umbilical artery 16%, medial cerebral artery 42%, right uterine artery 28%, and left uterine artery 37%.


CONCLUSIONS
Because the interobserver variability was surprisingly high and acceptable correlation could be stated only for the umbilical artery, internal quality standards are essential. Routine use of different devices should be made after careful consideration only, especially if clinical decisions are to be based on them.
Hellmeyer
L
L
Klinik für Geburtshilfe und Perinatalmedizin der Philipps-Universität Marburg.
Sierra
F
F
Heller
G
G
Tekesin
I
I
Kühnert
M
M
Schmidt
S
S
D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D005260:Female; D005333:Fetus / Q000098:blood supply*; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D015588:Observer Variation; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011786:Quality Control; D012016:Reference Values; D012044:Regression Analysis; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler / Q000592:standards / Q000706:statistics & numerical data*; D016216:Ultrasonography, Prenatal / Q000592:standards / Q000706:statistics & numerical data*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D014599:Uterus / Q000098:blood supply*