Objective In the Netherlands, antenatal cardiotocography (aCTG) is performed in obstetrician-led care to assess fetal well-being. An innovation project was initiated to evaluate whether aCTG is feasible in non-obstetrician-led care settings. Healthy women received aCTG in midwife-led care if indicated for specific indications. Quality assessment is essential when shifting tasks and responsibilities. Therefore, we aimed to assess the interobserver and intraobserver agreement for aCTG assessments among four professional groups regarding the overall classification and the assessment of the various components of the CTG. Design Prospective study. Sample 47 Dutch primary care midwives, hospital-based midwives, residents, and obstetricians. Methods Ten aCTG traces were assessed twice at a one month interval on baseline heart frequency, accelerations, decelerations, variability and contractions, and overall classification. We used two sets of ten aCTG traces to ensure sufficient variation. Main Outcome Measure Proportion of agreement. Results The proportions of agreement for interobserver agreement on classification of aCTG among the professional groups varied from 0.82 to 0.94, indicating excellent agreement. The proportions of agreement for primary care midwives, hospital-based midwives and obstetricians were slightly higher for intraobserver (0.86 to 0.94) than for interobserver agreement. For various CTG components, the proportions of agreement for interobserver agreement varied from 0.64 (presence of contractions) to 0.98 (baseline heart frequency), indicating good to excellent agreement. Conclusion Excellent agreement for the overall classification and good to excellent agreement for the various components were found in the assessments of aCTG in healthy women, both between and within the different professional groups.
