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The maternal early warning criteria: a proposal from the national partnership for maternal safety

Jill M Mhyre1, Robyn D'Oria, Afshan B Hameed

  • 1Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Central Jersey Family Health Consortium, Inc., North Brunswick, New Jersey; the Departments of Cardiology and Maternal-Fetal Medicine, University of California, Irvine, Irvine, California; the Department of Reproductive Biology, Case Western Reserve University School of Medicine and the Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Cleveland, Ohio; the School of Nursing, Vanderbilt University, Nashville, Tennessee; the Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa; the Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, Illinois; the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Women's Health, University of Louisville, Louisville, Kentucky; and the Department of Obstetrics & Gynecology, Maternal-Fetal Medicine, Columbia University Medical Center, New York, New York.

Obstetrics and Gynecology
|September 9, 2014
PubMed

Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems and describes The Maternal Early Warning Criteria, along with considerations for local implementation.

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