[Validity of cardiotocography in the detection of umbilical cord complications]

Zentralbl Gynakol. 1999;121(5):233-8.
[Article in German]


Objective: The purpose of this study was to investigate the validity of cardiotocography for the detection of cord complications.

Material and methods: A low-risk population of 4196 cases was selected in which cord complications have been recognized in 34.3%. Cases with cord complications and controls were paired by parity, gestational age, maternal age and mode of delivery. 25 pairs were randomly selected. 50 tracings were presented twice to 4 obstetricians in a double-blind manner. As parameters for the determination of the validity of fetal monitoring the reliability, positive (ppv) and negative predictive value (npv), sensitivity and specificity were used. Inter- and intra-observer variability were also examined.

Results: Reliability 52%, ppv 52%, npv 52%, sensitivity 46%, specificity 58%. Interobserver variability: All 4 obstetricians agreed in 47 of 100 evaluations. The level of agreement was higher in the controls (63%) than in the cord complication group (56%). The intraobserver variability was 25%.

Conclusions: Cardiotocography is not useful for the detection of cord complications. The range of possibilities has not been exploited yet, even for the evaluation of the fetal state.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Cardiotocography*
  • Cardiovascular Diseases / diagnosis*
  • Constriction, Pathologic / complications
  • Constriction, Pathologic / diagnosis
  • Double-Blind Method
  • Female
  • Fetal Distress / etiology*
  • Heart Rate, Fetal
  • Hemodynamics
  • Hernia, Umbilical / complications
  • Hernia, Umbilical / diagnosis
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis*
  • Male
  • Neonatal Screening
  • Observer Variation
  • Pilot Projects
  • Predictive Value of Tests
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Sensitivity and Specificity
  • Umbilical Cord / blood supply*