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Irish Maternal Early Warning Score

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Abstract

Early Warning Systems (EWS) track the physiological parameters of individual patients and trigger a response when the parameter threshold has been reached. The use of early warning scores in adult hospital medicine has been shown to be beneficial in facilitating the early recognition of the deteriorating patient, thereby enabling prompt treatment. In 2012, a standardised National Early Warning Score was introduced in Ireland for all non-pregnant patients. The 2007 Confidential Enquiry into Maternal and Child Health recommended that EWS be introduced into maternity practice. However, the unique physiological changes of pregnancy even in health means that any scoring system must be specially adapted. The Obstetric Early Warning Score (OEWS) aims to promote early recognition of the pregnant patient at risk of deterioration. In 2013, a standardised Irish Maternity Early Warning System (IMEWS) was introduced nationally. However, the scoring system is only part of the package, once triggered it needs to be effectively communicated and acted upon promptly by appropriately trained clinicians. Despite undoubted shortcomings, the international evidence to date is supportive of the beneficial role of the OEWS in preventing maternal morbidity. Further research is needed to improve the sensitivity and specificity of the OEWS and how to better integrate it into every-day clinical practice.

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Correspondence to Shrijit Nair.

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Appendices

Appendix 1 “Appendices 1 and 2” were captured as the continuation of figures. Figures 1, 2, and 3 contain poor quality of text inside the artwork. Please do not re-use the files that we have rejected or attempt to increase their resolution and re-save. They are originally poor, therefore, increasing the resolution will not solve the quality problem. We suggest that you provide us the original format. We prefer replacement figures containing vector/editable objects rather than embedded images. Preferred file formats are eps, ai, tiff, and pdf.

figure a

An example of an Obstetric Early Warning Score (OEWS) chart, the Irish Maternity Early Warning System (IMEWS).

Appendix 2

figure b

Irish Maternity Early Warning System (IMEWS) escalation policy

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Nair, S., Spring, A., Dockrell, L. et al. Irish Maternal Early Warning Score. Ir J Med Sci 189, 229–235 (2020). https://doi.org/10.1007/s11845-019-02028-1

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