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Erschienen in: The Journal of Obstetrics and Gynecology of India 2/2023

01.11.2023 | Original Article

Validating the Performance of Modified Early Obstetrics Warning Score (MEOWS) for Prediction of Obstetrics Morbidity: A Prospective Observational Study in a Tertiary Care Institute in East India

verfasst von: Preeti Yadav, Ranjana Sinha

Erschienen in: The Journal of Obstetrics and Gynecology of India | Sonderheft 2/2023

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Abstract

Background

An early warning score can be used to identify worsening in obstetric patients as they are more prone for deterioration. This study was conducted to evaluate and validate the performance of the modified early obstetric warning system (MEOWS) as a screening tool for early prediction of severe obstetric morbidity.

Methods

This prospective observational study was conducted at obstetrics and gynaecology department, Tata Main Hospital, Jamshedpur, Jharkhand, India. A total of 1800 patients were included over a period of 10 month, from December 2021 to September 2022. Study population included all pregnant women admitted in labour room with > 28 weeks of gestation till 6 weeks postpartum. MEOWS charts were plotted for each patient, score calculated and documented at admission. Patients were categorized based on this score for further management, and follow-up was made till discharge. Outcome assessment was done in terms of ICU admission, length of hospital stays, obstetric morbidity, and maternal mortality. Correlation of each outcome with scoring was evaluated.

Results

The sensitivity of MEOWS in predicting maternal morbidity was 72.91%, specificity 91.87%, positive predictive value 85.96%, and negative predictive value 83.24%. The area under receiver operator characteristic of MEOWS for prediction of maternal mortality was 0.79 (95% CI 0.75–0.82).

Conclusion

MEOWS helps in early recognition of obstetric morbidity even before signs, and symptoms become clinically evident. It is a useful tool for predicting adverse maternal outcome in pregnant women.
Literatur
1.
Zurück zum Zitat Strategies toward ending preventable maternal mortality (EPMM), February 2015 Global strategy. World Health Organization. Strategies toward ending preventable maternal mortality (EPMM), February 2015 Global strategy. World Health Organization.
2.
Zurück zum Zitat WHO, UNICEF, UNFPA, the World Bank, the United Nations Population Division. Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, the World Bank, and the United Nations Population Division. Geneva: World Health Organization; 2014 WHO, UNICEF, UNFPA, the World Bank, the United Nations Population Division. Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, the World Bank, and the United Nations Population Division. Geneva: World Health Organization; 2014
3.
Zurück zum Zitat Souza JP, Cecatti JG, Parpinelli MA, Sousa MH, Serruya SJ. Systematic review of near miss maternal morbidity. Cad Saúde Pública. 2006;22(2):255–64.CrossRef Souza JP, Cecatti JG, Parpinelli MA, Sousa MH, Serruya SJ. Systematic review of near miss maternal morbidity. Cad Saúde Pública. 2006;22(2):255–64.CrossRef
4.
Zurück zum Zitat Kyriacos U, Jelsma J, James M, Jordan S. Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. PLoS ONE. 2014;9(1):e87073.CrossRefPubMedPubMedCentral Kyriacos U, Jelsma J, James M, Jordan S. Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. PLoS ONE. 2014;9(1):e87073.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Subbe CP, Gao H, Harrison DA. Reproducibility of physiological track-and- trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med. 2007;33:619–24.CrossRefPubMed Subbe CP, Gao H, Harrison DA. Reproducibility of physiological track-and- trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med. 2007;33:619–24.CrossRefPubMed
6.
Zurück zum Zitat Chakravarthy K, Pandya ST, Nirmalan PK. Development, and validation of saving mothers’ score: a comprehensive scoring system for early identification of sick mothers. J Obstet Anaesth Crit Care. 2018;8:83–9.CrossRef Chakravarthy K, Pandya ST, Nirmalan PK. Development, and validation of saving mothers’ score: a comprehensive scoring system for early identification of sick mothers. J Obstet Anaesth Crit Care. 2018;8:83–9.CrossRef
7.
Zurück zum Zitat Bircher, Joint Trust Guideline for the use of the Modified Early Obstetric Warning Score (MEOWS) in Detecting the Seriously Ill and Deteriorating Woman. Maternity Guidelines Committee Date approved: 03/07/2020 Version: 6.2. Bircher, Joint Trust Guideline for the use of the Modified Early Obstetric Warning Score (MEOWS) in Detecting the Seriously Ill and Deteriorating Woman. Maternity Guidelines Committee Date approved: 03/07/2020 Version: 6.2.
9.
Zurück zum Zitat Tavares RC, Vieira AS, Uchoa LV, Peixoto Júnior AA, Meneses FA. Validation of an early warning score in pre-intensive care unit. Revista Bras de Terapia Intensiva. 2008;20(2):124–7. Tavares RC, Vieira AS, Uchoa LV, Peixoto Júnior AA, Meneses FA. Validation of an early warning score in pre-intensive care unit. Revista Bras de Terapia Intensiva. 2008;20(2):124–7.
10.
Zurück zum Zitat Bhatia PK, Biyani G, Mohammed S, Sethi P, Bihani P. Acute respiratory failure, and mechanical ventilation in pregnant patient: a narrative review of literature. J Anaesthesiol Clin Pharmacol. 2016;32(4):431.CrossRefPubMedPubMedCentral Bhatia PK, Biyani G, Mohammed S, Sethi P, Bihani P. Acute respiratory failure, and mechanical ventilation in pregnant patient: a narrative review of literature. J Anaesthesiol Clin Pharmacol. 2016;32(4):431.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Ryan HM, Jones MA, Payne BA, Sharma S, Hutfield AM, Lee T, et al. Validating the performance of the modified early obstetric warning system multivariable model to predict maternal intensive care unit admission. J Obstet Gynaecol Canada 2017; 39(9): 728–33, Clinical guidelines for: the use of the Meows. C. Bircher approved by maternity guidelines committee approved on 3/7/23. Ryan HM, Jones MA, Payne BA, Sharma S, Hutfield AM, Lee T, et al. Validating the performance of the modified early obstetric warning system multivariable model to predict maternal intensive care unit admission. J Obstet Gynaecol Canada 2017; 39(9): 728–33, Clinical guidelines for: the use of the Meows. C. Bircher approved by maternity guidelines committee approved on 3/7/23.
12.
Zurück zum Zitat Singh A, Guleria K, Vaid NB, Jain S. Evaluation of maternal early obstetric warning system (MEOWS chart) as a predictor of obstetric morbidity: a prospective observational study. Eur J Obstet Gynecol Reprod Biol. 2016;207:11–7.CrossRefPubMed Singh A, Guleria K, Vaid NB, Jain S. Evaluation of maternal early obstetric warning system (MEOWS chart) as a predictor of obstetric morbidity: a prospective observational study. Eur J Obstet Gynecol Reprod Biol. 2016;207:11–7.CrossRefPubMed
13.
Zurück zum Zitat Radha R, Kokila S, Mukilvizhi S, Venkatesan R. Evaluation of the effectiveness of modified early obstetric warning system in a tertiary health care setup. Int J Sci Stud. 2021;9(1):167–77. Radha R, Kokila S, Mukilvizhi S, Venkatesan R. Evaluation of the effectiveness of modified early obstetric warning system in a tertiary health care setup. Int J Sci Stud. 2021;9(1):167–77.
14.
Zurück zum Zitat Rathore AM, Meena SB, Rani R, Goswami D, Tripathi R. A validation study of early warning system in high-risk pregnant women. Indian J Med Res. 2020;152:519–22.CrossRefPubMedPubMedCentral Rathore AM, Meena SB, Rani R, Goswami D, Tripathi R. A validation study of early warning system in high-risk pregnant women. Indian J Med Res. 2020;152:519–22.CrossRefPubMedPubMedCentral
15.
Metadaten
Titel
Validating the Performance of Modified Early Obstetrics Warning Score (MEOWS) for Prediction of Obstetrics Morbidity: A Prospective Observational Study in a Tertiary Care Institute in East India
verfasst von
Preeti Yadav
Ranjana Sinha
Publikationsdatum
01.11.2023
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India / Ausgabe Sonderheft 2/2023
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-023-01855-8

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