Wasnik Arti M, Acharya Neema, Mahakalkar Manjusha G
Obstetrics and Gynaecology, Kasturba Nursing College, Sevagram, Wardha, IND.
Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 31;16(7):e65887. doi: 10.7759/cureus.65887. eCollection 2024 Jul.
Background The majority of complications and deaths related to childbirth are concentrated in developing and disadvantaged nations, where the rates are unacceptably elevated. These incidents predominantly occur in the vicinity during the intrapartum period and immediately after childbirth. The peripartum period is especially critical for expectant mothers, as it represents the time when a significant number of complications and deaths occur. This study aimed to develop, validate, and assess the efficacy of the maternal morbidity screening (MMS) tool for predicting peripartum morbidity. Methodology The study was conducted in two phases: Phase one involved developing, validating, and piloting the MMS tool, while Phase two focused on evaluating and comparing the MMS tool with the modified early obstetric warning system (MEOWS) chart for predicting peripartum morbidity. An observational analytical clinical study design was utilized. Result In Phase one, the MMS tool was developed and validated by subject experts, resulting in a reliability score of 0.90. Therefore, the tool was deemed reliable and valid. Phase two results revealed that obstetric morbidity in the maternal morbidity group was 66.66%, higher than the 32% observed with the MEOWS chart. The MMS tool demonstrated significantly higher sensitivity at 95.24%, specificity at 89.50%, and predictive value at 98.50%, yielding an overall accuracy of 90.50%. In comparison, the MEOWS chart exhibited a sensitivity of 70.51%, specificity of 86.81%, predictive value of 92.94%, and accuracy of 83.71%. Conclusion The occurrence of maternal morbidity in the trigger zone was significantly higher than in the non-trigger zone in the MMS tool. The MMS tool was significantly more effective as a predictor of peripartum morbidity compared to the MEOWS chart.
与分娩相关的大多数并发症和死亡集中在发展中国家和处境不利的国家,这些国家的发生率高得令人无法接受。这些事件主要发生在分娩期及产后不久的附近地区。围产期对孕妇尤为关键,因为这是大量并发症和死亡发生的时期。本研究旨在开发、验证和评估用于预测围产期发病情况的孕产妇发病筛查(MMS)工具的有效性。
该研究分两个阶段进行:第一阶段涉及开发、验证和试用MMS工具,而第二阶段则侧重于评估MMS工具并将其与改良早期产科预警系统(MEOWS)图表进行比较,以预测围产期发病情况。采用了观察性分析临床研究设计。
在第一阶段,MMS工具由专家开发并验证,可靠性得分为0.90。因此,该工具被认为是可靠和有效的。第二阶段的结果显示,孕产妇发病组的产科发病率为66.66%,高于MEOWS图表观察到的32%。MMS工具的敏感性显著更高,为95.24%,特异性为89.50%,预测值为98.50%,总体准确率为90.50%。相比之下,MEOWS图表的敏感性为70.51%,特异性为86.81%,预测值为92.94%,准确率为83.71%。
在MMS工具中,触发区孕产妇发病的发生率显著高于非触发区。与MEOWS图表相比,MMS工具作为围产期发病预测指标的效果显著更好。