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Early detection of severe maternal morbidity: A retrospective assessment of the role of an Early Warning Score System
Author(s) -
Austin Diana M.,
Sadler Lynn,
McLintock Claire,
McArthur Colin,
Masson Vicki,
Farquhar Cindy,
Rhodes Sharon
Publication year - 2014
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12160
Subject(s) - medicine , early warning score , intensive care unit , emergency medicine , warning system , intensive care medicine , maternal morbidity , multidisciplinary approach , medical emergency , pediatrics , pregnancy , biology , engineering , genetics , aerospace engineering , social science , sociology
Background The Early Warning Scoring ( EWS ) surveillance system is used to identify deteriorating patients and enable appropriate staff to be called promptly. However, there is a lack of evidence that EWS surveillance systems lead to a reduction in severe morbidity. Aims To determine whether as EWS may have improved the detection of severe maternal morbidity or lessened the severity of illness among women with severe morbidity at a large tertiary maternity unit at Auckland City Hospital ( ACH ), N ew Z ealand. Methods Admissions to intensive care, cardiothoracic and vascular intensive care, or an obstetric high‐dependency unit ( HDU ) were identified from clinical and hospital administrative databases. Case reviews and transcribed observation charts were presented to a multidisciplinary review group who, through group consensus, determined whether an EWS might have hastened recognition and/or escalation and effective treatment. Results The multidisciplinary review team determined that an EWS might have reduced the seriousness of maternal morbidity in five cases (7.6%), including three admissions for obstetric sepsis to intensive care unit and two to obstetric HDU for post‐partum haemorrhage. No patient had a complete set of respiratory rate, heart rate, blood pressure and temperature recordings at every time period. Conclusions These findings have been used to support introduction of an EWS to the maternity unit at ACH .