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Updated: Aug 29, 2026
In utero Measurement of Heart Rate in Mouse by Noninvasive M-mode Echocardiography
Published on: November 22, 2013
Can the reproducibility of fetal heart rate baseline estimation be improved?
Diogo Ayres-de-Campos1, João Bernardes, Karel Marsal
1Department of Obstetrics and Gynaecology, Faculdade de Medicina do Porto, 4200 Porto, Portugal. sisporto@med.up.pt
Insights
A new objective definition for fetal heart rate (FHR) baseline estimation significantly improves reproducibility when clinicians receive prior training. This method shows higher agreement compared to FIGO guidelines, enhancing clinical accuracy.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Monitoring
Background:
- Accurate fetal heart rate (FHR) baseline estimation is crucial for assessing fetal well-being.
- Existing guidelines, such as those from the International Federation of Gynecology and Obstetrics (FIGO), may have limitations in reproducibility.
- Objective and detailed definitions are needed to standardize FHR baseline interpretation.
Purpose of the Study:
- To evaluate the reproducibility of a novel, objective FHR baseline estimation definition.
- To compare the reproducibility of the new definition against the current FIGO guidelines' definition.
- To assess the impact of prior training on the reproducibility of the proposed FHR baseline definition.
Main Methods:
- Analysis of 300 FHR tracings (150 antepartum high-risk, 150 intrapartum).
- Nine experienced clinicians were divided into three groups: using the new definition without training, using the new definition with training, and using the FIGO guidelines' definition.
- Reproducibility was assessed using kappa statistic, proportion of agreement, and intra-class correlation coefficient.
Main Results:
- The group using the proposed FHR baseline definition with prior training demonstrated significantly higher agreement.
- This trained group also showed a trend towards higher agreement compared to the group using the FIGO guidelines' definition.
- The proposed definition, when accompanied by training, yielded substantially more reproducible FHR baseline estimations.
Conclusions:
- The objective FHR baseline definition presented in this study offers highly reproducible estimations.
- Prior training in the use of this new definition is key to achieving its maximum reproducibility.
- This improved reproducibility has the potential to enhance the reliability of fetal monitoring and clinical decision-making.
Objective:
To evaluate the reproducibility of fetal heart rate (FHR) baseline estimation according to an objective and detailed definition presented in this article, by comparison with the FIGO guidelines' definition.
Study Design:
Three hundred consecutively acquired FHR tracings, 150 from antepartum high-risk pregnancies and 150 from unselected intrapartum cases, were presented to nine experienced clinicians included in three different groups, for an estimation of the FHR baseline. The first group consisted of clinicians using the proposed definition, without previous training in its use. The second group consisted of clinicians using the proposed definition, where a previous training session was promoted. The third group consisted of clinicians using the FIGO guidelines' definition. Agreement in baseline estimation was evaluated using the kappa statistic, the proportions of agreement and the intra-class correlation coefficient.
Results:
Using the baseline definition proposed in this article, agreement was significantly higher in the group with prior training in its use. This group also showed a trend towards a higher agreement than the one using the FIGO guidelines.
Conclusion:
The FHR baseline definition proposed in this article provides an extremely reproducible estimation when associated with prior training in its use.
