Modified obstetric early warning scoring systems (MOEWS): validating the diagnostic performance for severe sepsis in women with chorioamnionitis

Edwards, Sian; Grobman, William A.; Lappen, Justin R.; Winter, Cathy; Fox, Robert; Lenguerrand, Erik; Draycott, Timothy

doi:10.1016/j.ajog.2014.11.007

Cited by 143 publications

(84 citation statements)

References 15 publications

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“…Other tools such as eclampsia boxes [21,45] and maternity-specific early warning charts [22,46] have also been introduced, all of which require teaching and training to use them.…”

Section: Myth 2: Training Is Knowledge Transfermentioning

confidence: 99%

“…There are also new screen-based simulators available for phones and tablets (e.g., http:// castleandersen.dk/apps/simmon/) that are low cost, and they may be paired with task-based training models when the simulated emergencies require the display and use of medical observations, for example, sepsis [46].…”

Section: Myth 7: All Training Models and Mannequins Are Usefulmentioning

confidence: 99%

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Myths and realities of training in obstetric emergencies

Draycott

Collins

Crofts

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…Other tools such as eclampsia boxes [21,45] and maternity-specific early warning charts [22,46] have also been introduced, all of which require teaching and training to use them.…”

Section: Myth 2: Training Is Knowledge Transfermentioning

confidence: 99%

Section: Myth 7: All Training Models and Mannequins Are Usefulmentioning

confidence: 99%

Myths and realities of training in obstetric emergencies

Draycott

Collins

Crofts

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…51 Generic early warning scores cannot be used in the maternity or paediatric populations; 52,53 instead, specialized charts need to be used for these groups. 54 International relevance A number of studies have shown that early warning scores can be used in countries with limited healthcare resources, such as Uganda, 55,56 , Tanzania 57, 58 and South Africa. 59,60,61 However, disease and population differences may strongly influence the performance of early warning scores.…”

Section: Influence On Clinical Outcomesmentioning

confidence: 99%

Strengths and limitations of early warning scores: A systematic review and narrative synthesis

Downey

Tahir

Randell

et al. 2017

International Journal of Nursing Studies

203

166

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“…Furthermore, experts report that clinical criteria must be applied with great care in the obstetric patient where, sometimes, only one or even none of the above findings are present despite a severe infection [4]. For this reason modified obstetric early warning scoring systems (MOEWS) have been developed for pregnant women [54]. MOEWS systems vary widely in terms of alert thresholds, format, and accuracy.…”

Section: Discussionmentioning

confidence: 99%

“…MOEWS systems vary widely in terms of alert thresholds, format, and accuracy. However, none of the current existing tools have shown good performance in predicting the development of severe sepsis [54, 55]. A limitation of this review is that we did not include these MOEWS or SOS (Sepsis in Obstetrics) scores as potential sources of criteria for identification of septic women.…”

Section: Discussionmentioning

confidence: 99%

Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation

et al. 2017

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BackgroundThere is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis.MethodsAll original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. A multidisciplinary international panel of experts was surveyed through an online consultation in March-April 2016 on their opinion on the existing sepsis definitions, including new definition of sepsis proposed for the adult population (2016 Third International Consensus Definitions for Sepsis and Septic Shock) and importance of different criteria for identification of maternal sepsis. The definition was agreed using an iterative process in an expert face-to-face consensus development meeting convened by WHO and Jhpiego.ResultsStandardizing the definition of maternal sepsis and aligning it with the current understanding of sepsis in the adult population was considered a mandatory step to improve the assessment of the burden of maternal sepsis by the expert panel. The literature review and expert consultation resulted in a new WHO consensus definition “Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, child-birth, post-abortion, or post-partum period”. Plans are in progress to validate the new WHO definition of maternal sepsis in a large international population.ConclusionThe operationalization of the new maternal sepsis definition requires generation of a set of practical criteria to identify women with sepsis. These criteria should enable clinicians to focus on the timely initiation of actionable elements of care (administration of antimicrobials and fluids, support of vital organ functions, and referral) and improve maternal outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-017-0321-6) contains supplementary material, which is available to authorized users.

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Modified obstetric early warning scoring systems (MOEWS): validating the diagnostic performance for severe sepsis in women with chorioamnionitis

Cited by 143 publications

References 15 publications

Myths and realities of training in obstetric emergencies

Myths and realities of training in obstetric emergencies

Strengths and limitations of early warning scores: A systematic review and narrative synthesis

Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation

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