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Obstetric early warning systems to prevent bad outcome
Audrey Catherine Quinn1, Tim Meek, Carl Waldmann
1aDepartment of Anaesthesia, James Cook University Hospital, Middlesbrough bRoyal Berkshire Hospital, Raeding RG1 5AN, UK.
Current Opinion in Anaesthesiology
|April 1, 2016
Summary
Standardizing the obstetric early warning system (ObsEWS) is crucial for improving maternal safety. Robust data collection and evidence-based recommendations are needed for better detection of patient deterioration.
Area of Science:
- Obstetrics
- Medical Device Technology
- Patient Safety
Background:
- Early warning systems (EWS) and rapid response systems were established in 1999.
- The UK National Early Warning Score (NEWS) was launched in 2013.
- A recommendation was made in 2007 for maternity units to use a modified early obstetric warning score chart, leading to varied local systems.
Purpose of the Study:
- To address the need for revision and standardization of the obstetric early warning system (ObsEWS).
- To develop a more sensitive and specific ObsEWS.
Main Methods:
- Development of an ObsEWS by the intercollegiate Maternal Critical Care group.
- Incorporation of six physiological parameters: respiratory rate, oxygen saturations, temperature, systolic blood pressure, diastolic blood pressure, and pulse rate.
Main Results:
- Current ObsEWS lacks robust physiological thresholds for measured parameters.
- There is a need for further research to establish these thresholds for improved sensitivity and specificity.
Conclusions:
- Enhanced focus on maternal morbidity and improved multidisciplinary systems are needed to manage obstetric emergencies.
- Robust ObsEWS, data collection, and electronic systems with evidence-based recommendations are imperative for patient safety and efficient care.
- Standardization will improve the management of critically ill obstetric patients.
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