Avoiding CTG Misinterpretation

27-Jun-2017



 

This guide provides a brief summary of the Dawes-Redman antenatal CTG Analysis & how it can support you in every day clinical practice by providing a far more robust interpretation of CTGs than the traditional subjective opinion based process.


WHAT IS DAWES-REDMAN CTG ANALYSIS?

  • It is a unique software tool which provides a numeric analysis of the CTG trace and a robust interpretation based on the worldrenowned Dawes-Redman Criteria.
  • This is the result of the largest study of its type ever undertaken, conducted by Professors Dawes, Redman et al, at Oxford University.

Having identified the problems with traditional CTG interpretation, and after dedicating over 35 years’ on-going research with the team at Oxford University, I’m delighted to see our analysis increasingly being used worldwide in Huntleigh’s products… knowing the benefit this gives in helping babies to enter the world safely & avoiding some of the tragic outcomes we see when CTG interpretation goes wrong. Professor Chris Redman

WHY IS IT NEEDED?

Because the traditional approach of assessing a trace by eye is based on highly subjective opinion. This has repeatedly been shown to be a major problem*.

Clinicians do not agree with one another or even themselves when assessing the same trace at different times. This is a particular problem with traces in the “grey zone” inbetween those that are clearly either normal or grossly abnormal.

This is compounded by different levels of experience, plus the fact that even the most experienced observer cannot remember the huge range of patterns and what they signify. Additionally, communication of vague opinion, such as “the trace looks a bit flat” can cause problems as this is so subjective.

ACCURATE MEASUREMENTS

These issues are solved by the Dawes-Redman CTG analysis.

In effect, it brings to the bedside the experience of the entire archive that has contributed to the analysis, now in excess of 100, 000 traces, replacing vague, subjective opinion with robust numeric facts.

The Dawes-Redman CTG analysis ensures consistency and relates the many patterns to outcomes in an evidence-based way.


The Dawes-Redman Analysis can Save lives, Save time, Save money. Dawes-Redman analysis is unique, clinically proven and powerful. Properly adopted into local protocols, it can save time, save money & improve quality of care & outcomes.

IMPROVING OUTCOMES

Providing reassurance & supporting clinical decisions. Dawes-Redman analysis has the potential to avoid the poor outcomes associated with subjective opinion based CTG interpretation.

A tragedy for the family; it’s also very distressing for the clinical team. It backs up clinical decisions & provides a robust defence. Avoiding just one poor outcome has priceless benefits.

INCREASING EFFICIENCY

The Dawes-Redman CTG analysis can report criteria met for a normal trace in as little as 10 minutes. This reduces the time it takes to process mums through busy antenatal clinics by a factor of 3. This frees up staff, beds & equipment, taking the pressure off stretched resources & reducing costs.

Pregnancy & childbirth can be a stressful experience. Spending less time on the fetal monitor helps to make this a less stressful experience, while providing reassurance that the baby is OK, or is receiving the best care & management it needs.

For busy working mums it can also reduce the time she needs to take off work during pregnancy.

REDUCING COSTS

Globally, billions are spent in obstetric litigation or on-going support costs arising from poor outcomes for the life of the individual. In 10 years, the UK spent £3.1B in obstetric litigation (half of all UK NHS litigation costs)**.

If using the Dawes-Redman CTG analysis avoids just one poor outcome it can save millions.

COMPLIMENTING YOUR SKILLS

The Dawes-Redman CTG analysis is not there to take over. It’s there to help make the process of understanding the CTG trace far more robust & provides a powerful defence for when things go wrong. It is also a valuable training tool.

However, it has no knowledge of other aspects of the pregnancy, risk factors, drugs, social factors, ethnic factors, etc. The trace is just one part of a very complex clinical scenario where you are managing two highly interdependent lives – one of whom you cannot communicate with or physically examine.

A FRESH EYES APPROACH

Common practice in some markets is to get a colleague to give a second opinion whenever a trace is interpreted – this is referred to as a “Fresh eyes” approach.

While this may help, it may also confuse, as this may result in two opinions instead of just one, & they may be conflicting!

YOUR EXPERT EYE

Dawes-Redman CTG analysis can be thought of as “Fresh eyes” which give a much more robust & objective assessment.

Responsibility for the clinical management of your patient remains your responsibility at all times. This is simply giving you more reliable information on which to base your clinical judgement & provide a robust, numeric, way of communicating with colleagues.

REASSURANCE YOU CAN RELY ON

Unlike humans, the Dawes-Redman analysis never gets tired, it doesn’t need breaks, get sick or need holidays. It is always on hand, at the bedside, to help.







WHERE CAN I GET THE DAWES-REDMAN CTG ANALYSIS?

The University of Oxford has exclusively licensed its proprietary Dawes-Redman CTG Analysis software to Huntleigh and is available in a number of formats.

Our range of fetal monitors include this feature as standard*, delivering the power of the Dawes-Redman analysis to the bedside with no added equipment, clutter or complications.

More powerful versions of the Dawes-Redman analysis are available as options in our range of CTG 'Viewing & Archiving' software systems. This includes enhanced reports, added features such as graphic trends of key data through the pregnancy, electronic archiving of the analysis, along with the CTG trace and more.

For more information on the Dawes-Redman CTG Analysis, visit our website or Contact us.

References:

  1. *(Bernardes et al, 1997; Devoe et al, 2000; Chauhan et al, 2008)
  2. **Ten Years of Maternity Claims. An Analysis of NHS Litigation Authority Data Oct 2012.
*Market / Model Dependent

Avoiding CTG misinterpretation Avoiding CTG misinterpretation (861 KB)



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