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通过使用当前的FIGO和基于生理学的指导方针,助产士对产后心脏图解的观察者间协议

Serena Neri¹, Ruben Ramirez Zegarra², Marialuigia Dininno¹

¹Midwifery School, Department of Medicine and Surgery, University of Parma, Parma, Italy.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|November 13, 2024

概括

对于产后心电图 (CTG) 的解释,助产士的协议很差,而2015年的FIGO指南显示出比基于生理学的指南更好的结果. 高级助产士通过使用FIGO指南达成初步协议.

科学领域:

产科和妇科产科和妇科
胎儿监测胎儿监测胎儿监测
临床决策临床决策

背景情况:

产后心脏图谱 (CTG) 对于在分娩期间对胎儿健康状况的评估至关重要.
在CTG解读中观察者间的协议影响临床实践和患者的结果.
现有的指导方针,包括2015年FIGO和基于生理学的方法,旨在标准化解释.

研究的目的:

为了评估分娩中CTG痕迹的分娩助产士之间的观察者间协议.
为了比较2015年FIGO和基于生理学的CTG指南之间的协议水平.
评估临床经验 (高级与初级助产士) 对协议的影响.

主要方法:

从操作分娩中对100个产后CTG痕迹进行了回顾性观察性研究.
五名助产士 (高级/初级) 独立地使用两套指南对CTG痕迹进行了分类.
使用Krippendorff的α统计来衡量观察者之间的一致性.

主要成果:

对于2015年FIGO (alpha=0.632) 和基于生理学 (alpha=0.359) 的指南,观察者间的总体共识是"不可接受的".
高级助产士与2015年FIGO指南显示"暂时可接受的协议" (alpha=0.724).
初级助产士表现出"不可接受的"同意这两套指导方针.

结论:

助产士对产期内CTG的解释显示了总体上不可接受的观察者间协议.
2015年FIGO指南提供了比基于生理学的指南更好的协议.
临床经验,特别是在使用FIGO指南的高级助产士中,改善了协议.

关键词:

在FIGO指导方针中.观察者之间的协议.产妇内心心电图 (Cardiotocography) 是一个产妇内心电图.助产士助产士助产士基于生理学的指导方针.

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