Pre-eclampsia is a dangerous pregnancy complication, once so mysterious that it was called “the disease of theories”, but the obstetrician Christopher Redman has greatly improved the understanding of how to treat it and why it develops. Redman, who died aged 82, spent his career at the John Radcliffe Hospital in Oxford, where he set up the world-class Silver Star unit to care for women with pre-eclampsia and other complex pregnancies. An early pioneer of computer technology, he created a sonic monitoring device that bears his name, which today is used in about 130 countries to analyze the health of unborn babies and has saved countless lives.
Redman initially intended to become a paediatrician, but his career changed in 1970. Then a junior lecturer in Oxford University’s Department of Medicine, he was asked to conduct a trial on women with high blood pressure due to pre-eclampsia.
Doctors who treat women with pre-eclampsia walk a fine line. It is life-threatening and is only resolved by delivering the baby, but doctors like to buy time if they can by treating the symptoms, as a baby born very early will struggle to survive.
The drugs Redman gave lowered the women’s blood pressure, but did not avert tragedy: all the babies died. The neonatal and maternal facilities in the early 1970s were primitive, pre-eclampsia was a mystery, and Redman in particular was frustrated that identifying when an unborn baby was in distress was largely guesswork.
Redman was a soft-spoken, gentle man, but also very focused and desperate to improve the lot of his patients. When he discovered that midwives in the nearby labor ward had a brand new piece of kit they weren’t using – a fetal heart monitor – he asked to borrow it. Redman discovered the monitor made a big difference. By 1975, the stillbirth rate in his ward had fallen to 5%. Fetal heart monitoring was quickly adopted throughout the hospital, becoming a standard part of care during labor and pregnancy.
Redman was delighted – comparing the innovation to the discovery of penicillin – but he was also keen to go a step further. The interpretation of traces from the fetal heart monitor was subjective and the stakes were high: for example, staff had to judge whether a trace showing a slower heart rate was a red flag, or harmlessly indicated that the baby was sleeping. Redman wanted to create computer software that could accurately interpret heart tracks every time.
In 1977 he met the fetal physiologist Geoffrey Dawesdirector of the Nuffield Institute for Medical Research at Oxford, who initially told him it couldn’t be done. Fortunately, however, Dawes had a change of heart, and he and Redman collaborated, putting thousands of fetal heart traces into a computer database. The software they then developed was able to quickly tell whether a heart trace from an unborn baby met healthy criteria or not.
By 1980 they had a prototype and in 1991 the sonikaid Dawes-Redman CTG analysis went on sale. This initially met with skepticism in obstetrical circles, but when papers were published showing how much human error is present in subjective assessment of traces, computer analysis became the preferred route. NHS England endorsed the Dawes-Redman CTG analysis and today it is used not only in the NHS but in many countries worldwide.
Following his care of women with pre-eclampsia, in 1983 Redman headed a new special care maternal unit at the John Radcliffe Hospital: the Silver Star Unit. It got its name from the practice of adding a star sticker to a woman’s notes to indicate she had a complex pregnancy. The unit is a world-leading center of excellence, teaching and research, supported by two charities that Redman founded: the Silver Star Maternity Fund and Action against Pre-eclampsiaboth of which he supported throughout his life, including running 10 London marathons in his 50s to raise funds.
Caring for women with pre-eclampsia fueled Redman’s desire to understand more about the basic science. After an egg is fertilized, it moves into the uterus, where its outer layer of cells attaches to maternal blood vessels and rapidly grows into the placenta. The process releases chemicals into the mother’s bloodstream. Redman discovered that while all pregnant women have an inflammatory response to the chemicals, in some women the response is very strong, which can adversely affect the placenta’s development and lead to pre-eclampsia. This was an important piece of information and led to many other discoveries. Today, some women at risk are recommended aspirin, which reduces inflammation. Redman also found that while a dysfunctional placenta may be unnoticeable at first, there are some key signs to look out for, such as lower platelet counts and an increase in uric acid production.
Born in Pretoria, South Africa, Redman was one of four children of British parents, Roderick, who worked as an astronomer at the Radcliffe Observatory there, and Kathleen (née Bankcroft), a violin teacher. When World War II ended, his father got a job at Cambridge University, and the family came home to the UK, where Christopher attended the Persian School.
He then studied medicine at St John’s College, Cambridge, qualifying in 1967. He spent a year at Johns Hopkins University in Baltimore, working in pathology, and then a further year in Sheffield in paediatrics, before moving to moved to Oxford. his career in pre-eclampsia and prenatal care, becoming a clinical professor in 1992.
Redman retired in 2009 but remained involved in research, most notably in a trial giving pregnant women selenium to prevent pre-eclampsia. He was at the center of international research as president of the International Society for the Study of Hypertension in Pregnancy and was involved in the ambitious Global Pregnancy Collaborationwhich promotes the sharing of databases between 40 perinatal research centers around the world.
Redman loved films, cycling and the outdoors, spending holidays walking in Scotland or Cornwall. Recently he developed lymphoma.
In the sixth form at school, Redman met Corinna Page at a dance class, and they married in 1964. She survives him, as do his children, Paul, Andrew, Sophie, George and Oliver, and 13 grandchildren.
