The use of the Modified Early Obstetric Warning System (MEOWS) in women after pregnancies: a descriptive study

Abstract

Objectives: to evaluate the modified early obstetric warning system (MEOWS) in women after pregnancies in a tertiary hospital in Brazil. Methods: a descriptive study was conducted with 705 hospitalized women. Vital signs (systolic and diastolic blood pressure, heart rate, respiratory rate, temperature) and lochia were registered on medical records and transcribed into the MEOWS chart of physiological parameters. On this graphic chart, yellow alerts were used to present moderate abnormalities in vital signs, while severe abnormalities were presented in red. The presence of at least one red alert or two yellow alerts were triggered to indicate the need for medical evaluation. Results: although abnormalities were found in the physiological parameters of 49.8% of the women identified from MEOWS triggers, medical evaluation was only requested for three patients (0.8%). Conclusions: in a retrospective application of the use of MEOWS showed a significant number of patients had triggered in which the nursing team did not recognize 99.2% of cases. This finding could be attributed to the fact that MEOWS has not been yet adopted in this service as part of the nursing care. The application of this tool would result in a better care because critical situations would be recognized and corrected quickly, avoiding unfavorable outcomes.

O Uso da Tecnologia na Classificação de Risco Obstétrico: Uma Revisão Integrativa da Literatura

“…Além disso, evidenciou-se que cerca de 40 a 50% das mortes maternas poderiam ser evitadas. A demora no reconhecimento, diagnóstico e tratamento precedem a maioria das mortes ocasionadas por hemorragias, pré-eclampsia/eclampsia e infecção 16 .…”

“…Em 1997, no Reino Unido, foi desenvolvido o primeiro sistema de alerta precoce baseado em parâmetros fisiológicos anormais, com o objetivo de identificar de forma precoce, pacientes com risco de complicações. Segundo algumas pesquisas, as alterações nos parâmetros fisiológicos eram encontradas em até oito horas antes dos eventos desfavoráveis acontecerem 16 .…”

“…Além disso, evidenciou-se que em mulheres grávidas seria inviável a utilização desse método, uma vez que a mulher passa por diversas modificações em seu organismo durante o seu período gestacional, foi então que em 2007, o Reino Unido validou e, recomendou a utilização de um escore de alerta precoce adaptado para população obstétrica (Modified Early Obstetric Warning System-MEOWS) 16 .…”

The use of technology in the classification of obstetric risk: An integrative literature review

“…Delay in recognition, diagnosis, and treatment precede most deaths from bleeding, preeclampsia/eclampsia, and infection. [4] As a result, some physiological changes in vital signs that can occur during pregnancy in young/healthy patients end up hindering the early recognition of clinical decompensation, since these patients have a good response to pathological mechanisms. [11] Edwards, Dore, Van Schalkwyk and Armson (2020) observed in their study that there was a period for the occurrence of physiological deterioration in patients with severe morbidity, and although this event happens slowly and progressively, it ends up going unnoticed.…”

“…According to some research, changes in physiological parameters were found up to eight hours before unfavorable events happened. [4] In addition, it became evident that in pregnant women it would be unfeasible to use this method, since the woman undergoes several changes in her body during her gestational period, it was then that in 2007, the United Kingdom validated and recommended the use of an early warning score adapted for the obstetric population (Modified Early Obstetric Warning System-MEOWS). [4] In this way, several preventive actions are designed every day, in order to improve reception with the obstetric risk classification, one of them is the implementation of the early deterioration alert score (Modified Early Warning System -MEOWS), still in obstetric screening.…”