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INTRODUCTION

The rate of maternal mortality has been increasing in the United States. The maternal mortality rate for 2020 was 23.8/100,000 live births compared with a rate of 17.4 in 2018.1

Severe maternal morbidity (SMM) is considered a near miss for maternal mortality if some conditions are not identified and treated. CDC has a consensus list of 21 SMM indicators.2

The development of maternal early warning system (MEWS) is to increase the early recognition of changes in the mother’s vital signs and clinical conditions leading to prompt evaluation and escalation in the response with the goal of reducing the numbers of women experiencing SMM.2 A validation cohort study revealed that MEWS showed high specificity, more clinically relevant but with lower sensitivity.3

MEWS at Beth Israel Deaconess Medical Center features multidisciplinary collaboration, prompt response with defined actions and guidelines (Fig. 10-1).4

FIGURE 10-1

Beth Israel Deaconess Medical Center© Maternal Early Warning System. October 2016. (Reproduced with permission from Beth Israel Deaconess Medical Center© Maternal Early Warning System. October 2016.)

REFERENCES

1. +
Hoyert  DL. Maternal mortality rates in the United States, 2020. National Center for Health Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm. Accessed April 2022.
2. +
Centers for Disease Control and Prevention. How does CDC identify severe maternal morbidity? https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm. Accessed April 2022.
3. +
Blumenthal  E, Hooshvar  N, McQuade  M,  et al. A validation study of maternal early warning systems: a retrospective cohort study. Am J Perinatol. 2019;36(11):1106–1114.  [PubMed: 30856674]
4. +
Beth Israel Deaconess Medical Center© Maternal Early Warning System. October 2016. Accessed April 2022.

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