title: [Does the paper speed in fetal heart monitoring during labour influence the variability in the interpretation by professionals?]
abstract: OBJECTIVE
  Assessing inter- and intra- observer agreement in the reading of fetal heart rate (FHR) between two different paper speeds (1 and 2cm/min) using FIGO classification.
  
  
  METHODS
  Single-centre experimental study consisting in reading 60minutes FHR tracings by six readers (3 midwives and 3 obstetricians) during 1cm and 2cm/min sessions within a period of three weeks. The reading guideline was based on FIGO classification. Inter- and intra-observer agreement was assessed thanks to Kappa coefficient (K) and percentage of agreement (PA) using the classification of FHR tracings drawn up by readers.
  
  
  RESULTS
  Intra-observer agreement reached 60% between the two paper speeds, and PA ranged from 48 to 67%. Inter-observer agreement was poor to moderate (K=0.42 for 1cm/min sessions and K=0.38 for 2cm/min sessions). Inter-observer agreement was significantly higher for normal tracings (PA ranged from 55.2% for 2cm/min sessions to 57.4% for 1cm/min sessions). The preterminal category had the lowest concordance rates (PA=19% for 1cm/min sessions and 20, 7% for 2cm/min sessions).
  
  
  CONCLUSIONS
  This study did not highlight significant differences in intra- and inter-observer variability between the two FHR paper speeds. The 1cm/min paper speed, which is commonly used in France, is more economical and gives a better bedside overview of FHR. Therefore, it should be recommended.
authors: École de SF de Nancy, 10, rue du Dr-Heydenreich, CS 74213, 54042 Nancy cedex, France. Electronic address: lemoine.helene@orange.fr.
authors: H
authors: H
authors: Lemoine
authors: Inserm, unité UMR 1027, faculté de médecine, université Toulouse III, 37, allées J.-Guesde, 31062 Toulouse cedex 9, France.
authors: V
authors: V
authors: Ehlinger
authors: Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue Grande-Bretagne, 31059 Toulouse cedex 9, France; Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France.
authors: M
authors: M
authors: Groussolles
authors: Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France; Unité de soutien méthodologique à la recherche, CHU de Toulouse, 31059 Toulouse, France.
authors: C
authors: C
authors: Arnaud
authors: Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue Grande-Bretagne, 31059 Toulouse cedex 9, France; Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France.
authors: C
authors: C
authors: Vayssière
mesh_terms: D000328:Adult; D015148:Cardiotocography / Q000295:instrumentation / Q000592:standards*; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D008880:Midwifery / Q000592:standards*; D009774:Obstetrics / Q000295:instrumentation / Q000592:standards*; D010820:Physicians / Q000592:standards*; D011247:Pregnancy
keywords: FHR; Paper speed; RCF; Variability; Variabilité; Vitesse de déroulement