Key result
Computerised analysis of CTG using the Dawes-Redman Criteria may detect fetal compromise antenatally, but clinicians must recognize multiple pathways of fetal damage not covered by standard guidelines.
Why the study?
Intrapartum CTG guidelines rely on uterine contractions absent during the antenatal period, meaning they cannot reliably identify antenatal fetuses at risk of compromise.
Clinicians should be aware that intrapartum CTG guidelines are not reliable for antenatal fetal monitoring and must consider alternative pathways of fetal damage.
Alerts clinicians to Dawes-Redman CTG limitations antenatally; leaves open validation of broader fetal compromise pathways.
There are several national and international guidelines to aid the interpretation of the cardiotocograph (CTG) trace during labour. These guidelines are based on assessing changes in the fetal heart rate (i.e. cardiograph) in response to mechanical and hypoxic stresses during labour secondary to ongoing frequency, duration and strength of uterine contractions (i.e. tocograph). However, during the antenatal period, uterine contractions are absent, and therefore, these intrapartum CTG guidelines cannot be used to reliably identify fetuses at risk of compromise. Computerised analysis of CTG using the Dawes-Redman Criteria could be used to detect fetal compromise. However, clinicians should be aware of the multiple pathways of fetal damage (i.e. inflammation, infection, intrauterine fetal stroke, chronic fetal anaemia, acute feto-maternal haemorrhage and fetal cardiac or neurological disorders) which can cause changes on the CTG trace which may not be recognised by using CTG guidelines.
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Pereira et al. (2020) conducted a review in Fetal compromise. Cardiotocograph (CTG) interpretation was evaluated. Computerised analysis of CTG using the Dawes-Redman Criteria may detect fetal compromise antenatally, but clinicians must recognize multiple pathways of fetal damage not covered by standard guidelines.
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