Fetal Heart Rate Classification Proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology: Reproducibility and Clinical Usefulness
Aim: Intrapartum management guidelines based on fetal heart rate classification comprising a 5-tier system (Levels 1-5) was proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology (JSOG). This study aimed to assess the reproducibility and clinical usefulness of this...
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| Veröffentlicht in: | Journal of Nippon Medical School 2012, Vol.79(1), pp.60-68 |
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| creator | Hayashi, Masako Nakai, Akihito Sekiguchi, Atsuko Takeshita, Toshiyuki |
| description | Aim: Intrapartum management guidelines based on fetal heart rate classification comprising a 5-tier system (Levels 1-5) was proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology (JSOG). This study aimed to assess the reproducibility and clinical usefulness of this classification. Methods: For assessing intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracing, 2 obstetricians reviewed 247 fetal heart rate tracings using the JSOG classification (Level 1, normal; Level 2, benign variant; Level 3, mild variant; Level 4, moderate variant; and Level 5, severe variant) and a subjective 3-tier classification (normal, equivocal, and ominous). In a separate series, we investigated whether the JSOG classification is related to early neonatal outcome and the delivery mode in 96 deliveries. Results: Weighted kappa coefficients of intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracings based on the JSOG classification were 0.73 to 0.77 and 0.70, respectively. In the subjective classification, these values were 0.69 to 0.72 and 0.59. There was a progressive increase in the rate of instrumental or cesarean deliveries across the 5 levels of the JSOG classification (P |
| doi_str_mv | 10.1272/jnms.79.60 |
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This study aimed to assess the reproducibility and clinical usefulness of this classification. Methods: For assessing intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracing, 2 obstetricians reviewed 247 fetal heart rate tracings using the JSOG classification (Level 1, normal; Level 2, benign variant; Level 3, mild variant; Level 4, moderate variant; and Level 5, severe variant) and a subjective 3-tier classification (normal, equivocal, and ominous). In a separate series, we investigated whether the JSOG classification is related to early neonatal outcome and the delivery mode in 96 deliveries. Results: Weighted kappa coefficients of intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracings based on the JSOG classification were 0.73 to 0.77 and 0.70, respectively. In the subjective classification, these values were 0.69 to 0.72 and 0.59. There was a progressive increase in the rate of instrumental or cesarean deliveries across the 5 levels of the JSOG classification (P<0.001). Although, level 5 of the JSOG classification had a lower Apgar score and umbilical artery pH than did the other 4 levels (p<0.05), there were no significant differences among the other levels in regard to early neonatal outcome. Conclusions: This study demonstrated that both intraobserver reproducibility and interobserver reproducibility of the JSOG classification for interpreting FHR tracings were clinically acceptable. The results also suggest that the intervention according to the JSOG classification is useful for avoiding worsening early neonatal outcomes.</description><identifier>ISSN: 1345-4676</identifier><identifier>EISSN: 1347-3409</identifier><identifier>DOI: 10.1272/jnms.79.60</identifier><identifier>PMID: 22398791</identifier><language>eng</language><publisher>Japan: The Medical Association of Nippon Medical School</publisher><subject>Adult ; Blood Chemical Analysis ; cardiotocography ; classification ; early neonatal outcome ; Female ; fetal heart rate ; guideline ; Gynecology ; Heart Rate, Fetal - physiology ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Japan ; Observer Variation ; Obstetrics ; Perinatology ; Pregnancy ; Pregnancy Outcome ; Reproducibility of Results ; Societies, Medical ; Umbilical Arteries - metabolism</subject><ispartof>Journal of Nippon Medical School, 2012, Vol.79(1), pp.60-68</ispartof><rights>2012 by the Medical Association of Nippon Medical School</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c633t-6a92ce35df8a627f7bb6fc9538be57c33df188e9863db5cd156ebb58c80b9bda3</citedby><cites>FETCH-LOGICAL-c633t-6a92ce35df8a627f7bb6fc9538be57c33df188e9863db5cd156ebb58c80b9bda3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22398791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hayashi, Masako</creatorcontrib><creatorcontrib>Nakai, Akihito</creatorcontrib><creatorcontrib>Sekiguchi, Atsuko</creatorcontrib><creatorcontrib>Takeshita, Toshiyuki</creatorcontrib><creatorcontrib>Nippon Medical School</creatorcontrib><creatorcontrib>Division of Reproductive Medicine</creatorcontrib><creatorcontrib>Graduate School of Medicine</creatorcontrib><creatorcontrib>Perinatology and Gynecologic Oncology</creatorcontrib><title>Fetal Heart Rate Classification Proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology: Reproducibility and Clinical Usefulness</title><title>Journal of Nippon Medical School</title><addtitle>J Nippon Med Sch</addtitle><description>Aim: Intrapartum management guidelines based on fetal heart rate classification comprising a 5-tier system (Levels 1-5) was proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology (JSOG). This study aimed to assess the reproducibility and clinical usefulness of this classification. Methods: For assessing intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracing, 2 obstetricians reviewed 247 fetal heart rate tracings using the JSOG classification (Level 1, normal; Level 2, benign variant; Level 3, mild variant; Level 4, moderate variant; and Level 5, severe variant) and a subjective 3-tier classification (normal, equivocal, and ominous). In a separate series, we investigated whether the JSOG classification is related to early neonatal outcome and the delivery mode in 96 deliveries. Results: Weighted kappa coefficients of intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracings based on the JSOG classification were 0.73 to 0.77 and 0.70, respectively. In the subjective classification, these values were 0.69 to 0.72 and 0.59. There was a progressive increase in the rate of instrumental or cesarean deliveries across the 5 levels of the JSOG classification (P<0.001). Although, level 5 of the JSOG classification had a lower Apgar score and umbilical artery pH than did the other 4 levels (p<0.05), there were no significant differences among the other levels in regard to early neonatal outcome. Conclusions: This study demonstrated that both intraobserver reproducibility and interobserver reproducibility of the JSOG classification for interpreting FHR tracings were clinically acceptable. The results also suggest that the intervention according to the JSOG classification is useful for avoiding worsening early neonatal outcomes.</description><subject>Adult</subject><subject>Blood Chemical Analysis</subject><subject>cardiotocography</subject><subject>classification</subject><subject>early neonatal outcome</subject><subject>Female</subject><subject>fetal heart rate</subject><subject>guideline</subject><subject>Gynecology</subject><subject>Heart Rate, Fetal - physiology</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Infant, Newborn</subject><subject>Japan</subject><subject>Observer Variation</subject><subject>Obstetrics</subject><subject>Perinatology</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Reproducibility of Results</subject><subject>Societies, Medical</subject><subject>Umbilical Arteries - metabolism</subject><issn>1345-4676</issn><issn>1347-3409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9UcFuGyEQXVWtmtTtpR9QcatUyS4sXlh6qSqrcVpFSpQ2ZwTsbILFggusqv2c_GlYO_GBGcR782aGV1UfCV6Rmtdfd35IKy5WDL-qzgld8yVdY_H6cG-Wa8bZWfUupR3GlDYNe1ud1TUVLRfkvHq8gKwcugQVM7pVGdDGqZRsb43KNnh0E8M-JOiQnlB-AHQD0XqVgwv3E9qEYbA5A6DQH9Dfaq88-hOMhTzNj9c6ZcjRmoSU79B28mAOtd_QLexj6EZjtXW2sGd846wvnR26S9CPzkNK76s3vXIJPjznRXV38fPv5nJ5db39tflxtTSM0rxkStQGaNP1rWI177nWrDeioa2GhhtKu560LYiW0U43piMNA62b1rRYC90puqg-H3XLVP9GSFkONhlwTnkIY5Ki5qwtYV2YX45ME0NKEXq5j3ZQcZIEy9kROTsiuZAMF_KnZ9lRD9CdqC8WFML2SCjovHrw5Q9A7sIYfdlXmv9kF2a9GpNaYswFJnMqh-E5tIStSVM2XVTfj0q7lNU9nFoVa61xcJqKHEOpfkHMg4oSPH0C7oC5NA</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Hayashi, Masako</creator><creator>Nakai, Akihito</creator><creator>Sekiguchi, Atsuko</creator><creator>Takeshita, Toshiyuki</creator><general>The Medical Association of Nippon Medical School</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Fetal Heart Rate Classification Proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology: Reproducibility and Clinical Usefulness</title><author>Hayashi, Masako ; Nakai, Akihito ; Sekiguchi, Atsuko ; Takeshita, Toshiyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c633t-6a92ce35df8a627f7bb6fc9538be57c33df188e9863db5cd156ebb58c80b9bda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Blood Chemical Analysis</topic><topic>cardiotocography</topic><topic>classification</topic><topic>early neonatal outcome</topic><topic>Female</topic><topic>fetal heart rate</topic><topic>guideline</topic><topic>Gynecology</topic><topic>Heart Rate, Fetal - physiology</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Infant, Newborn</topic><topic>Japan</topic><topic>Observer Variation</topic><topic>Obstetrics</topic><topic>Perinatology</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Reproducibility of Results</topic><topic>Societies, Medical</topic><topic>Umbilical Arteries - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hayashi, Masako</creatorcontrib><creatorcontrib>Nakai, Akihito</creatorcontrib><creatorcontrib>Sekiguchi, Atsuko</creatorcontrib><creatorcontrib>Takeshita, Toshiyuki</creatorcontrib><creatorcontrib>Nippon Medical School</creatorcontrib><creatorcontrib>Division of Reproductive Medicine</creatorcontrib><creatorcontrib>Graduate School of Medicine</creatorcontrib><creatorcontrib>Perinatology and Gynecologic Oncology</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of Nippon Medical School</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hayashi, Masako</au><au>Nakai, Akihito</au><au>Sekiguchi, Atsuko</au><au>Takeshita, Toshiyuki</au><aucorp>Nippon Medical School</aucorp><aucorp>Division of Reproductive Medicine</aucorp><aucorp>Graduate School of Medicine</aucorp><aucorp>Perinatology and Gynecologic Oncology</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fetal Heart Rate Classification Proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology: Reproducibility and Clinical Usefulness</atitle><jtitle>Journal of Nippon Medical School</jtitle><addtitle>J Nippon Med Sch</addtitle><date>2012</date><risdate>2012</risdate><volume>79</volume><issue>1</issue><spage>60</spage><epage>68</epage><pages>60-68</pages><issn>1345-4676</issn><eissn>1347-3409</eissn><abstract>Aim: Intrapartum management guidelines based on fetal heart rate classification comprising a 5-tier system (Levels 1-5) was proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology (JSOG). This study aimed to assess the reproducibility and clinical usefulness of this classification. Methods: For assessing intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracing, 2 obstetricians reviewed 247 fetal heart rate tracings using the JSOG classification (Level 1, normal; Level 2, benign variant; Level 3, mild variant; Level 4, moderate variant; and Level 5, severe variant) and a subjective 3-tier classification (normal, equivocal, and ominous). In a separate series, we investigated whether the JSOG classification is related to early neonatal outcome and the delivery mode in 96 deliveries. Results: Weighted kappa coefficients of intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracings based on the JSOG classification were 0.73 to 0.77 and 0.70, respectively. In the subjective classification, these values were 0.69 to 0.72 and 0.59. There was a progressive increase in the rate of instrumental or cesarean deliveries across the 5 levels of the JSOG classification (P<0.001). Although, level 5 of the JSOG classification had a lower Apgar score and umbilical artery pH than did the other 4 levels (p<0.05), there were no significant differences among the other levels in regard to early neonatal outcome. Conclusions: This study demonstrated that both intraobserver reproducibility and interobserver reproducibility of the JSOG classification for interpreting FHR tracings were clinically acceptable. The results also suggest that the intervention according to the JSOG classification is useful for avoiding worsening early neonatal outcomes.</abstract><cop>Japan</cop><pub>The Medical Association of Nippon Medical School</pub><pmid>22398791</pmid><doi>10.1272/jnms.79.60</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of Nippon Medical School, 2012, Vol.79(1), pp.60-68 |
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| language | eng |
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| source | MEDLINE; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese |
| subjects | Adult Blood Chemical Analysis cardiotocography classification early neonatal outcome Female fetal heart rate guideline Gynecology Heart Rate, Fetal - physiology Humans Hydrogen-Ion Concentration Infant, Newborn Japan Observer Variation Obstetrics Perinatology Pregnancy Pregnancy Outcome Reproducibility of Results Societies, Medical Umbilical Arteries - metabolism |
| title | Fetal Heart Rate Classification Proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology: Reproducibility and Clinical Usefulness |
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