title: Reproducibility of placental maturity grade classification using a dynamic ultrasonography.
abstract: OBJECTIVE
  To evaluate the agreement between ultrasonographers in classifying placental maturity grade using examination videos.
  
  
  METHODS
  A prospective, cross-sectional study was conducted using 25 videos of ultrasonographic examinations of single, healthy pregnancies ≥ 34 + 0 weeks. The Grannum (grades 0, I, II and III) and Julio (grades 0, 1, 2A, 2B and 3) classifications were used for placental maturity grade. The videos were evaluated on two occasions by 10 experienced ultrasonographers. Intra- and inter-observer agreements were evaluated using the Kappa (k) coefficient of agreement.
  
  
  RESULTS
  According to the Grannum classification, the inter-observer agreement coefficients were good for grades III and 0 (k = 0.69 and 0.738, respectively) and moderate for grades I and II (k = 0.401 and 0.593, respectively) placentas. According to the Julio classification, the inter-observer agreement coefficients were good for grades 0 and 3 (k = 0.738 and 0.651, respectively), moderate for grades 1 and 2A (0.401 and 0.413, respectively) and poor for grade 2B (k = 0.161). Intra-observer coefficients for the Grannum and Julio classifications ranged from 0.567 to 0.890 and from 0.446 to 0.790, respectively.
  
  
  CONCLUSIONS
  Placental maturity grading using the Grannum and Julio classifications demonstrated moderate/good intra- and inter-observer agreements on examination videos evaluation.
authors.affiliation: a Department of Obstetrics and Gynecology , Federal University of Paraná (UFPR) , Curitiba , PR , Brazil and.
authors.forename: Ricardo Ditzel
authors.initials: RD
authors.lastname: Delle Donne
authors.affiliation: b Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo, SP , Brazil.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: b Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo, SP , Brazil.
authors.forename: Liliam Cristine
authors.initials: LC
authors.lastname: Rolo
authors.affiliation: a Department of Obstetrics and Gynecology , Federal University of Paraná (UFPR) , Curitiba , PR , Brazil and.
authors.forename: Rafael Frederico
authors.initials: RF
authors.lastname: Bruns
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015588:Observer Variation; D010920:Placenta / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000502:physiology*; D010929:Placentation / Q000502:physiology*; D011247:Pregnancy; D015203:Reproducibility of Results; D012107:Research Design; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data
keywords: Grannum classification; placenta; reproducibility of results; ultrasonography