Early Warning Systems Save the Lives of New Moms & Babies
When a mother dies or if she is serious injured in childbirth, it is frequently due to a late response to well known medical warning signs. There are several tools used by doctors and medical facilities to test mothers to identify those who are in jeopardy of maternal mortality (death) or morbidity (serious injury or illness). They are called early warning systems.
The importance of early warning systems
For every mother who dies in childbirth, there are many more who experience a serious, long-term injury, called severe maternal morbidity (SMM). In Maryland, the incidence of SMM in was 197 per 10,000 deliveries, according to 2018 data. Fortunately, there are several tests that maternity wards use to observe and prevent maternal morbidity and mortality.
If you or a loved one is pregnant, it is important that these early warning systems are performed regularly. There should be assessments at routine visits and there should be actions if assessment scores indicate risk of mortality or morbidity. If these tests are not performed, it can lead to high risk deliveries, and even the death of the mother or her baby.
The Tests
The medical science of obstetrics has developed several early warning system tests to search for abnormalities or high-risk factors related to the mother’s health. When they are properly tested and identified, there are actions and medical interventions that can be done to mitigate the risk to the mother and child.
The American Journal of Perinatology, there are three significant early warning systems for maternity:
MEOWS (Modified Early Obstetric Warning system)
Physiological parameters | Yellow alert | Red alert |
Respiration rate | 21–30 | < 10 or > 30 |
Oxygen saturation | < 95 | |
Temperature | 35–36 | < 35 or > 38 |
Systolic blood pressure | 150–160 or 90–100 | < 90 or > 160 |
Diastolic blood pressure | 90–100 | > 100 |
Heart rate | 100–120 or 40–50 | > 120 or < 40 |
Pain score | 2–3 | |
Neurological response | Voice | Unresponsive, pain |
MEWC (Maternal Early Warning Criteria)
Systolic BP; mm Hg | < 90 or > 160 |
Diastolic BP; mm Hg | > 100 |
Heart rate; beats per min | < 50 or > 120 |
Respiratory rate; breaths per min | < 10 or > 30 |
Oxygen saturation; % on room air | < 95 |
Oliguria; mL/h for ≥2 h | < 35 |
MEWT (Maternal Early Warning Trigger)
“Yellow” triggers | |
Systolic BP; mm Hg | < 80 or 156–160 |
Diastolic BP; mm Hg | < 45 or 106–110 |
Heart rate; beats per min | < 50 or 111–130 |
Respiratory rate; breaths per min | < 12 or 25–30 |
Temperature, degrees centigrade | ≤36 |
Oxygen saturation; % on room air | 90–93 |
Altered mental status | |
“Red” triggers | |
Nursing clinically uncomfortable with patient status | |
Temperature, degrees centigrade | ≥38 |
Respiratory rate; breaths per min | > 30 |
Oxygen saturation; % on room air | < 90% |
Heart rate; beats per min | > 130 |
Systolic BP; mm Hg | > 160 |
Respiratory rate; breaths per min | > 30 |
Diastolic BP; mm Hg | > 110 |
Mean arterial pressure; mm HG | < 55 |
Source: American Journal of Perinatology,
When You Lose a Loved One to Maternal Death or Morbidity
Severe maternal morbidity and mortality are often preventable. Early warning systems are part of the standard of care to alert care providers of critical information that is necessary to ensure maternal safety. If you or a loved one was injured or died during childbirth, and you suspect that it could have been prevented, it is important to have a professional investigation by legal firm with experience in birth injury law. You might never get the truth without a partner that treats you like family. It could be that the injury was unavoidable; however, when mistakes are made, it often requires legal action to determine the truth. Medical mistakes do happen, and the consequences for the victim have incredibly expensive economic costs, as well as and non-economic costs (e.g., pain & suffering). At Brown & Barron, we help families arrive at the truth of what happened, and we help these families move forward with fair financial recovery. Contact Brown & Barron online or call 410-346-0206 for a free consultation.