Physicians' subjectivity in evaluating oxytocin challenge tests
Peck, T.M.
Obstetrics and Gynecology 56(1): 13-16
1980
ISSN/ISBN: 0029-7844 PMID: 7383479 Document Number: 161865
Five physicians subspecializing in maternal-fetal medicine individually evaluated 50 oxytocin challenge tests (OCT), of which 33 were originally read as positive. There was considerable disagreement among the study physicians (SP) such that 2 SP would agree, on the average, only 52% of the time on any one OCT. The SP were also asked to evaluate fetal heart rate (FHR) reactivity patterns, if present. Again, there was great disagreement. When the majority (3 of 5 or more) of SP agreed on the OCT result and/or reactivity, there was reasonable correlation with human neonatal outcome, indicating the validity of the physiologic premise of the test. Presence or absence of FHR accelerations with fetal motion, regardless of the OCT reading, correlated extremely well with eventual neonatal outcome. The most significant variable in antepartum FHR monitoring is the FHR acceleration pattern.