Midwives face numerous challenges in ensuring fetal well-being during pregnancy. One of the primary difficulties is the subjective nature of interpreting fetal heart rate (FHR) traces, which can lead to inconsistent assessments and potential delays in identifying fetal distress. Additionally, the need for timely and accurate detection of potential issues is critical to prevent adverse pregnancy outcomes (APOs). These challenges underscore the importance of reliable and objective tools in fetal monitoring.
The Dawes–Redman® algorithm, a computerised method designed to analyse antepartum FHR monitoring. This algorithm, only available on Huntleigh Healthcare products, provides an objective assessment by categorizing FHR traces as either ‘criteria met’ (indicating fetal well-being) or ‘criteria not met’ (indicating a need for further evaluation). This automated analysis helps in early identification of potential issues, allowing for timely interventions.
A recent study* published in Ultrasound in Obstetrics & Gynecology by Davis Jones et al. (2025) evaluated the effectiveness of the Dawes–Redman algorithm using 30 years of retrospective clinical data from term singleton pregnancies. The study focused on FHR traces obtained within 48 hours prior to delivery, comparing outcomes between normal pregnancy outcomes (NPO) and adverse pregnancy outcomes (APO).
The findings were promising. The algorithm demonstrated a high specificity of 90.7% for ruling out APOs. This means that when the algorithm indicates ‘criteria met,’ there is a high likelihood that the fetus is indeed well, reducing unnecessary interventions. While the sensitivity was lower at 18.2%, the negative predictive value (NPV) was notably high in low-risk settings, reaching 99.1% at a 1% APO prevalence. This high NPV is crucial for reassuring midwives and expectant mothers in low-risk scenarios.
For midwives, the Dawes–Redman CTG analysis® offers several practical benefits. It provides an objective assessment, reducing the subjectivity associated with manual FHR interpretation. This can enhance confidence in clinical decision-making. By identifying FHR traces that do not meet criteria, the algorithm helps in early detection of potential fetal distress, allowing for timely interventions and potentially improving neonatal outcomes. High specificity means fewer false positives, which can reduce unnecessary hospital admissions and interventions, optimizing healthcare resources.
To effectively integrate the Dawes–Redman algorithm into clinical practice, midwives should familiarise themselves with the algorithm, understanding how it works and its interpretation. In high risk pregnancies, the computerised CTG analysis should be used in conjunction with other clinical assessment and diagnostic tools to ensure comprehensive fetal monitoring. Working closely with obstetricians can ensure that any identified issues are promptly addressed, enhancing overall care. Informing mothers about the use of the algorithm and its benefits can help in managing expectations and reducing anxiety.
The Dawes–Redman algorithm represents a significant advancement in antepartum fetal monitoring. Its high specificity make it a reliable tool for midwives, aiding in early clinical decision-making. By integrating this algorithm into practice, midwives can continue to provide high-quality care for both mother and baby.
For further reading, you can access the full study here.
*Davis Jones G, Albert B, Cooke W, Vatish M. Performance evaluation of computerized antepartum fetal heart rate monitoring: Dawes–Redman algorithm at term. Ultrasound Obstet Gynecol 2025; 65: 191–197. DOI: 10.1002/uog.29167.