Single versus pairwise interpretation of cardiotochography, a comparative study from six Swedish delivery units

•The proportion of correctly individually classified CTG's was 75% and the proportion of correctly pairwise classified CTG's was 80% (difference 5%, p = 0.12).•The baseline was high, 75% (95% CI: 72%–79%) individually correct classifications. This finding indicates a high standard of agreement in CTG classification in our study population, which was large and unselected, including both large and small delivery units.•Differences in proportion of correctly classified CTG recordings between the delivery units were observed, indicating a potential area of improvement in CTG interpretation.

Objective:The aim of the study was to evaluate whether interpreting CTG pairwise brings about a higher level of correctly classified CTG recordings in a non-selected population of midwives and physicians.Study design:A comparative study.Setting:Five delivery units in Stockholm and one delivery unit in Uppsala, with 1589, 3740, 3908, 4539, 6438, and 7331 deliveries in 2011, respectively.Subjects:536 midwives and physicians classified one randomly selected CTG recording individually followed by a pairwise classification. The pairs consisted of two midwives (119 pairs) or one midwife and one physician (149 pairs), a total of 268 pairs.Main outcome measure:The proportion of individually correctly classified CTG recordings versus the proportion of pairwise correctly classified CTG recordings.Results:The proportion of individually correctly classified CTG's was 75% and the proportion of pairwise correctly classified CTG's was 80% (difference 5%, p = 0.12).Conclusions:There was no statistically significant difference when CTG's were classified pairwise compared to individual classifications. The proportion of individually correctly classified CTG's was high (75%). There were differences in the proportion of correctly classified CTG recordings between the delivery units, indicating potential areas of improvement.