The significance of meeting Dawes–Redman criteria in computerised antenatal fetal heart rate assessment

Abstract

ObjectiveTo investigate the significance of not meeting Dawes–Redman criteria on computerised cardiotocography in high‐risk pregnancies.DesignRetrospective observational study.SettingUK university hospital.PopulationHigh‐risk pregnancies undergoing antenatal assessment.MethodsWe interrogated the database for records of computerised fetal heart rate assessment and pregnancy outcomes.Main outcome measuresNeonatal outcome and stillbirths.ResultsExcluding duplicate assessment in the same pregnancy, 14 025 records with complete information on the criteria of normality having been met and the outcome of the pregnancy were available. Criteria were not met for 907 records (6.46%). The gestational age of assessment was lower in the group not meeting criteria of normality. Overall, 32 stillbirths occurred in normally formed fetuses (2.28/1000). Stillbirths were more frequent in the group not meeting criteria (odds ratio [OR] 8.78, 95% CI 4.28–18.02). This finding persisted even after records with abnormally low short‐term variation (STV) were excluded. The confidence intervals around the rate of stillbirth in the two groups overlapped beyond an STV of 8 ms.ConclusionsApproximately 1:16 pregnancies do not meet the criteria of normality. The criteria are not met more often at preterm gestation than at term. The risk of stillbirth was higher in the group not meeting criteria of normality, even if cases with low STV are excluded. Cases not meeting criteria should be followed up closely, unless the STV is ≥8 ms. Stillbirths still occurred in the group meeting criteria, but the rate was lower than in the general population.

Prediction of labour outcomes using prelabour computerised cardiotocogram and maternal and fetal Doppler indices: A prospective cohort study

“…The prelabour Dawes–Redman criteria are used as a clinical test for fetal well‐being. Therefore, ‘Dawes‐Redman criteria not met’ is not currently recommended as an indication for intervention, but careful monitoring may be required 37 . The participants were instructed to use an event marker button to record fetal movements.…”

“…Therefore, 'Dawes-Redman criteria not met' is not currently recommended as an indication for intervention, but careful monitoring may be required. 37 The participants were instructed to use an event marker button to record fetal movements. If there were unsatisfactory CTG findings based on conventional visual assessment during the tracing, on-call obstetricians were notified, and the participant was managed in accordance with our internally published and agreed-upon departmental protocol.…”

A Performance Evaluation of Computerised Antepartum Fetal Heart Rate Monitoring: The Dawes-Redman Algorithm at Term

“…While the algorithm was designed to identify fetuses in a state of wellbeing, its results have also been used to identify at-risk pregnancies. 34,35 Several studies have evaluated components of the Dawes-Redman algorithm (e.g. STV or LTV) in high-risk pregnancies (e.g.…”