Interobserver agreement in intrapartum estimation of fetal head station

International Journal of Gynecology & Obstetrics - Tập 101 - Trang 285-289 - 2008
Eckhart Buchmann1, Elena Libhaber2
1Department of Obstetrics and Gynecology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
2Department of Cardiology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa

Tóm tắt

AbstractObjectiveTo determine interobserver agreement in estimation of fetal head station during labor, and the determinants of agreement.MethodsA prospective study of fetal head station in 508 women in term labor. Vaginal examination of station was performed by a researcher at the same time as clinicians performed routine intrapartum assessments of the participants. Station 0 was considered to represent engagement.ResultsStation could be estimated by both the researcher and clinicians in 446 women (88%). The kappa statistic for agreement was 0.23 (95% confidence interval, 0.17–0.29). There was agreement in 166 cases (37%) and disagreement by 1 cm in 208 (47%) cases. Agreement was best (50%) when the researcher assessed the head at station minus 1. Multiple regression analysis showed that agreement was not influenced by level of experience of the attending clinicians, nor by obstetric factors.ConclusionEstimation of station as a method of determining the level of the fetal head in labor appears imprecise and poorly reproducible.

Tài liệu tham khảo

Philpott R.H., 1982, The recognition of cephalopelvic disproportion, Clin Obstet Gynaecol, 9, 609, 10.1016/S0306-3356(21)00534-3 2002, Guidelines for Perinatal Care Cunningham F.G., 2005, Williams Obstetrics, 409 Friedman E.A., 1978, Clinical evaluation and management, 37 Crichton D., 1974, A reliable method of establishing the level of the fetal head in obstetrics, S Afr Med J, 48, 784 10.1016/S0029-7844(98)00451-7 10.1002/uog.102 10.1016/j.ajog.2004.09.028 10.1111/j.1471-0528.2007.01386.x Department of Health, 2002, A manual for clinics, community health centres and district hospitals Cilliers J.B.F., 2003, Obstetrics in southern Africa, 74 10.1136/bmj.4.5890.451 10.1111/j.1479-828X.1993.tb02381.x Buchmann EJ. Head descent moulding and other intrapartum clinical findings in the prediction of cephalopelvic disproportion [PhD thesis]. Johannesburg: University of the Witwatersrand; 2007. 10.1002/uog.1765 10.1002/uog.3848
Thông tin
Thông tin xuất bản

International Journal of Gynecology & Obstetrics

Tập 101

285-289

Thông tin tác giả