Reproducibility of placental maturity grade classification using a dynamic ultrasonography

Abstract

Objective: To evaluate the agreement between ultrasonographers in classifying placental maturity grade using examination videos.

Methods: A prospective, cross-sectional study was conducted using 25 videos of ultrasonographic examinations of single, healthy pregnancies ≥ 34 + 0 weeks. The Grannum (grades 0, I, II and III) and Julio (grades 0, 1, 2A, 2B and 3) classifications were used for placental maturity grade. The videos were evaluated on two occasions by 10 experienced ultrasonographers. Intra- and inter-observer agreements were evaluated using the Kappa (k) coefficient of agreement.

Results: According to the Grannum classification, the inter-observer agreement coefficients were good for grades III and 0 (k = 0.69 and 0.738, respectively) and moderate for grades I and II (k = 0.401 and 0.593, respectively) placentas. According to the Julio classification, the inter-observer agreement coefficients were good for grades 0 and 3 (k = 0.738 and 0.651, respectively), moderate for grades 1 and 2A (0.401 and 0.413, respectively) and poor for grade 2B (k = 0.161). Intra-observer coefficients for the Grannum and Julio classifications ranged from 0.567 to 0.890 and from 0.446 to 0.790, respectively.

Conclusion: Placental maturity grading using the Grannum and Julio classifications demonstrated moderate/good intra- and inter-observer agreements on examination videos evaluation.

Keywords:

• Grannum classification
• placenta
• reproducibility of results
• ultrasonography

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.