Obituary of Christopher Redman

Preeclampsia is a dangerous complication during pregnancy, once so mysterious that it was nicknamed “the disease of theories,” but the gynecologist Christopher Redman has greatly improved our understanding of how to treat it and why it develops. Redman, who has died aged 82, spent his career at the John Radcliffe Hospital in Oxford, where he founded the world-class Silver Star Unit to care for women with pre-eclampsia and other complex pregnancies. He was an early pioneer in computer technology, creating the sonicaid monitoring device that bears his name, and which is now used in around 130 countries to analyse the health of unborn babies and has saved countless lives.

Redman originally wanted to become a pediatrician, but in 1970 his career path changed. He was then a junior lecturer at Oxford University Medical School and was asked to conduct a study of women with high blood pressure due to pre-eclampsia.

Doctors who treat women with preeclampsia walk a fine line. It is life-threatening and can only be cured by delivering the baby, but doctors are eager to buy time if they can by treating the symptoms, because a baby born very early will struggle to survive.

The drugs Redman gave lowered the women’s blood pressure, but did not prevent the tragedy: all the babies died. Neonatal and maternal care were primitive in the early 1970s, preeclampsia was a mystery, and Redman in particular was frustrated that identifying when an unborn baby was in distress was largely guesswork.

Redman was a gentle, kind-hearted man, but also very focused and desperate to improve the lot of his patients. When he discovered that the midwives in the nearby delivery room had a brand-new piece of equipment they weren’t using – a fetal heart monitor – he asked to borrow it. Redman found that the monitor made a huge difference. By 1975, the stillbirth rate in his unit had dropped to 5%. Fetal heart monitoring was quickly implemented throughout the hospital and became a standard part of care during labor and pregnancy.

Redman was excited—he compared the innovation to the discovery of penicillin—but he also wanted to go a step further. Interpreting traces from the fetal heart rate 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 a harmless indication that the baby was asleep. Redman wanted to create computer software that could accurately interpret heart rate traces every time.

In 1977 he met the fetal physiologist Geoffrey Dawesdirector of the Nuffield Institute for Medical Research in Oxford, who initially told him it couldn’t be done. Fortunately, Dawes changed his mind and he and Redman worked together, entering thousands of fetal heart traces into a computer database. The software they then developed could quickly determine whether an unborn baby’s heart trace met health criteria or not.

In 1980 they had a prototype and in 1991 the Sonicaid Dawes-Redman CTG analysis went on sale. It was initially met with scepticism in obstetric circles, but as papers were published showing the extent of human error 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.

After caring for women with pre-eclampsia, Redman led a new special care maternal unit at John Radcliffe Hospital in 1983: the Silver Star Unit. The name derives from the practice of placing a star sticker on a woman’s notes to indicate that she had a complex pregnancy. The unit is a world-leading centre for excellence, teaching and research, supported by two charities that Redman founded: the Silver Star Maternity Fund And Action in preeclampsiaHe supported both causes throughout his life, including running ten London marathons at the age of fifty to raise money.

Caring for women with preeclampsia fueled Redman’s desire to learn more about the basic science. After an egg is fertilized, it moves to the uterus, where the outer layer of cells attaches to the mother’s blood vessels and quickly 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, some women have a very strong reaction that can negatively affect the development of the placenta and lead to preeclampsia. It was a crucial piece of information and led to many other discoveries. Today, some at-risk women are advised to take aspirin, which reduces inflammation. Redman also discovered that while a poorly functioning placenta may go unnoticed at first, there are certain key signs to look for, such as a low platelet count and increased uric acid production.

Redman was born in Pretoria, South Africa, one of four children of British parents, Roderick, who worked there as an astronomer at the Radcliffe Observatory, and Kathleen (née Bankcroft), a violin teacher. When the Second World War ended, his father took a position at Cambridge University and the family returned to the United Kingdom, where Christopher attended the Perse School.

He then studied medicine at St John’s College, Cambridge, graduating 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 Oxford in 1970. There he made a career in pre-eclampsia and antenatal care, becoming a clinical professor in 1992.

Redman retired in 2009 but remained involved in research, notably a trial of selenium given to pregnant women to prevent preeclampsia. He was at the heart 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 worldwide.

Redman enjoyed movies, cycling and the outdoors, spending his holidays walking in Scotland or Cornwall. He was recently diagnosed with lymphoma.

In the sixth grade of high 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.