Comparison of a Novel Computerized Analysis Program and Visual Interpretation of Cardiotocography

Objective: To compare a novel computerized analysis program with visual cardiotocography (CTG) interpretation results. Methods: Sixty-two intrapartum CTG tracings with 20- to 30-minute sections were independently interpreted using a novel computerized analysis program, as well as the visual interpretations of eight obstetricians, to evaluate the baseline fetal heart rate (FHR), baseline FHR variability, number of accelerations, number/type of decelerations, uterine contraction (UC) frequency, and the National Institute of Child Health and Human Development (NICHD) 3-Tier FHR classification system. Results: There was no significant difference in interobserver variation after adding the components of computerized analysis to results from the obstetricians' visual interpretations, with excellent agreement for the baseline FHR (ICC 0.91), the number of accelerations (ICC 0.85), UC frequency (ICC 0.97), and NICHD category I (kappa statistic 0.91); good agreement for baseline variability (kappa statistic 0.68), the numbers of early decelerations (ICC 0.78) and late decelerations (ICC 0.67), category II (kappa statistic 0.78), and overall categories (kappa statistic 0.80); and moderate agreement for the number of variable decelerations (ICC 0.60), and category III (kappa statistic 0.50). Conclusions: This computerized analysis program is not inferior to visual interpretation, may improve interobserver variations, and could play a vital role in prenatal telemedicine.