Classification of maternal morbidity and mortality using an organic dysfunction scale

Area of Science:

• Obstetrics
• Critical Care Medicine
• Maternal Health

Background:

• High-risk pregnancies with organ dysfunction are classified as critically ill or "near miss" by the WHO.
• Current WHO Maternal Severity Index (MSI) and other scales inadequately detect all categories of maternal morbidity and mortality.
• A comprehensive assessment requires considering gestational parameters, spectrum of morbidity, and treatment.

Purpose of the Study:

• To develop and validate a novel scale for classifying maternal morbidity and mortality.
• To accurately detect and grade maternal organic dysfunction.

Main Methods:

• A diagnostic and prognostic test validation study involving 80 obstetric patients in an ICU over one year.
• The new scale was applied in five phases, including scoring, multi-organ dysfunction syndrome (MODS) detection, and comparison with MSI.
• Reliability was assessed using association, reproducibility, and validity tests.

Main Results:

• The scale demonstrated utility in detecting MODS (t Student, P < 0.01), with 93% sensitivity and 65% specificity.
• A positive correlation coefficient (0.5274) was found for the scoring system.
• Scores exceeding 12 points indicated the highest risk (>50% likelihood).

Conclusions:

• The proposed scale accurately detects multi-organ dysfunction syndrome (MODS).
• It provides an objective method for classifying the severity of maternal morbidity and mortality.