Midwifes play a crucial role in monitoring the health and well-being of both mother and baby during pregnancy. One of the key tools at their disposal is computerised cardiotocography (CTG), which helps assess fetal heart rate (FHR) patterns. A study by Amarnath Bhide et al. published in BJOG 2023, sheds light on the significance of meeting Dawes–Redman criteria in these assessments.
The study conducted a retrospective observational analysis at a St Georges University Hospital London, focusing on high-risk pregnancies. It included 14,025 records of computerised FHR assessments and their corresponding pregnancy outcomes.
According to the authors’ findings, approximately 6.46% of the assessments did not meet the Dawes–Redman criteria. This non-compliance was more common in preterm pregnancies compared to term pregnancies.
Moreover, the study found that the risk of stillbirth was significantly higher in pregnancies that did not meet the criteria. Specifically, the odds ratio for stillbirth in the non-compliant group was 8.78, indicating a much higher risk compared to those meeting the criteria.
Even after excluding records with abnormally low short term variations (STV), the increased risk of stillbirth persisted. This suggests that non-compliance with Dawes–Redman criteria is a strong indicator of potential complications.
To address these risks, the authors recommended close monitoring and follow-up for pregnancies that do not meet the criteria, especially if the STV is below 8 milliseconds. This proactive approach can help mitigate risks and improve outcomes.
Understanding and utilising the Dawes–Redman criteria can significantly enhance midwives’ and obstetricians’ ability to monitor fetal well-being and identify potential risks early, particularly in high-risk pregnancies.
The study by Bhide et al. highlights the importance of meeting Dawes–Redman criteria in antenatal FHR assessments. By incorporating these criteria into their practice, clinicians can better identify at-risk pregnancies and take timely actions to ensure the health and safety of both mother and baby.
Link to the publication abstract here.