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A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS) *
Author(s) -
Singh S.,
McGlennan A.,
England A.,
Simons R.
Publication year - 2012
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06896.x
Subject(s) - medicine , predictive value , pregnancy , maternal morbidity , intensive care unit , emergency medicine , obstetrics , pediatrics , intensive care medicine , genetics , biology
Summary The 2003–2005 Confidential Enquiry into Maternal and Child Health report recommended the introduction of the modified early obstetric warning system (MEOWS) in all obstetric inpatients to track maternal physiological parameters, and to aid early recognition and treatment of the acutely unwell parturient. We prospectively reviewed 676 consecutive obstetric admissions, looking at their completed MEOWS charts for triggers and their notes for evidence of morbidity. Two hundred patients (30%) triggered and 86 patients (13%) had morbidity according to our criteria, including haemorrhage (43%), hypertensive disease of pregnancy (31%) and suspected infection (20%). The MEOWS was 89% sensitive (95% CI 81–95%), 79% specific (95% CI 76–82%), with a positive predictive value 39% (95% CI 32–46%) and a negative predictive value of 98% (95% CI 96–99%). There were no admissions to the intensive care unit, cardio respiratory arrests or deaths during the study period. This study suggests that MEOWS is a useful bedside tool for predicting morbidity. Adjustment of the trigger parameters may improve positive predictive value.