Implementation of a maternal early warning system during early postpartum. A prospective observational study.

<h4>Objective</h4>To evaluate the implementation of a maternal early warning system (MEWS) for monitoring patients during the first two hours after delivery in a tertiary level hospital.<h4>Methods</h4>Implementation of the criteria between 15 March and 15 September 2018 was...

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Autores principales:	Cristina Ibáñez-Lorente, Rubén Casans-Francés, Soledad Bellas-Cotán, Luis E Muñoz-Alameda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0321f69cd270437b90988b5a5ea2fadd
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spelling	oai:doaj.org-article:0321f69cd270437b90988b5a5ea2fadd2021-12-02T20:11:06ZImplementation of a maternal early warning system during early postpartum. A prospective observational study.1932-620310.1371/journal.pone.0252446https://doaj.org/article/0321f69cd270437b90988b5a5ea2fadd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252446https://doaj.org/toc/1932-6203<h4>Objective</h4>To evaluate the implementation of a maternal early warning system (MEWS) for monitoring patients during the first two hours after delivery in a tertiary level hospital.<h4>Methods</h4>Implementation of the criteria between 15 March and 15 September 2018 was evaluated in 1166 patients. The parameters collected were systolic and diastolic blood pressure, heart rate, oxygen saturation, urine output, uterine involution, and bleeding. Out-of-range values of any of these parameters triggered a warning, and an obstetrician was called to examine the patient. The obstetrician then decided whether to call the anesthesiologist. We carried out a sensitivity-specificity study of triggers and a multivariate analysis of the factors involved in developing potentially fatal disorders (PFD), reintervention, critical care admission, and stay.<h4>Results</h4>The MEWS was triggered in 75 patients (6.43%). Leading trigger was altered systolic blood pressure in 32 patients (42.7%), and 11 patients had a PFD. Twenty-eight triggers were false-negatives. Sensitivity and specificity of the system was 0.28 (0.15, 0.45) and 0.94 (0.93, 0.96), respectively. The multivariate analysis showed a correlation between trigger activation and PFD.<h4>Conclusion</h4>Our MEWS presented low sensitivity and high specificity, with a significant number of false-negatives.Cristina Ibáñez-LorenteRubén Casans-FrancésSoledad Bellas-CotánLuis E Muñoz-AlamedaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252446 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cristina Ibáñez-Lorente Rubén Casans-Francés Soledad Bellas-Cotán Luis E Muñoz-Alameda Implementation of a maternal early warning system during early postpartum. A prospective observational study.
description	<h4>Objective</h4>To evaluate the implementation of a maternal early warning system (MEWS) for monitoring patients during the first two hours after delivery in a tertiary level hospital.<h4>Methods</h4>Implementation of the criteria between 15 March and 15 September 2018 was evaluated in 1166 patients. The parameters collected were systolic and diastolic blood pressure, heart rate, oxygen saturation, urine output, uterine involution, and bleeding. Out-of-range values of any of these parameters triggered a warning, and an obstetrician was called to examine the patient. The obstetrician then decided whether to call the anesthesiologist. We carried out a sensitivity-specificity study of triggers and a multivariate analysis of the factors involved in developing potentially fatal disorders (PFD), reintervention, critical care admission, and stay.<h4>Results</h4>The MEWS was triggered in 75 patients (6.43%). Leading trigger was altered systolic blood pressure in 32 patients (42.7%), and 11 patients had a PFD. Twenty-eight triggers were false-negatives. Sensitivity and specificity of the system was 0.28 (0.15, 0.45) and 0.94 (0.93, 0.96), respectively. The multivariate analysis showed a correlation between trigger activation and PFD.<h4>Conclusion</h4>Our MEWS presented low sensitivity and high specificity, with a significant number of false-negatives.
format	article
author	Cristina Ibáñez-Lorente Rubén Casans-Francés Soledad Bellas-Cotán Luis E Muñoz-Alameda
author_facet	Cristina Ibáñez-Lorente Rubén Casans-Francés Soledad Bellas-Cotán Luis E Muñoz-Alameda
author_sort	Cristina Ibáñez-Lorente
title	Implementation of a maternal early warning system during early postpartum. A prospective observational study.
title_short	Implementation of a maternal early warning system during early postpartum. A prospective observational study.
title_full	Implementation of a maternal early warning system during early postpartum. A prospective observational study.
title_fullStr	Implementation of a maternal early warning system during early postpartum. A prospective observational study.
title_full_unstemmed	Implementation of a maternal early warning system during early postpartum. A prospective observational study.
title_sort	implementation of a maternal early warning system during early postpartum. a prospective observational study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/0321f69cd270437b90988b5a5ea2fadd
work_keys_str_mv	AT cristinaibanezlorente implementationofamaternalearlywarningsystemduringearlypostpartumaprospectiveobservationalstudy AT rubencasansfrances implementationofamaternalearlywarningsystemduringearlypostpartumaprospectiveobservationalstudy AT soledadbellascotan implementationofamaternalearlywarningsystemduringearlypostpartumaprospectiveobservationalstudy AT luisemunozalameda implementationofamaternalearlywarningsystemduringearlypostpartumaprospectiveobservationalstudy
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Implementation of a maternal early warning system during early postpartum. A prospective observational study.

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