Preoperative early physiologic warning scores in the parturients undergoing cesarean section: a prospective study.

BACKGROUND

Early physiologic warning scores (EPWS) are used to detect clinical deterioration by monitoring vital signs and early warning signs. However, their role in the obstetric population, particularly during the preoperative period before cesarean delivery, remains underexplored.

OBJECTIVE

To evaluate the effectiveness of three maternal early physiologic warning systems—Modified Early Obstetric Warning Score (MEOWS), Maternal Early Warning Criteria (MEWC), and Maternal Early Warning Triggers (MEWT)—in predicting short-term maternal and neonatal outcomes in the parturient patients undergoing cesarean section.

METHODS

In this prospective observational study, 304 parturient patients scheduled for cesarean delivery at a tertiary care hospital were evaluated. Preoperative physiological data were used to calculate MEOWS, MEWC, and MEWT scores. Patients were classified into “high risk” (Group 1) or “no risk” (Group 2) categories based on predefined thresholds. Primary outcomes included intensive care unit (ICU) admission and neonatal APGAR scores. Secondary outcomes involved Aldrete scores, intraoperative hemodynamic parameters, and type of anesthesia.

RESULTS

Patients identified as “high risk” by MEOWS had significantly lower neonatal APGAR and maternal Aldrete scores, along with higher systolic and diastolic blood pressures and heart rates ( < 0.05). MEOWS also more effectively predicted ICU admission compared to MEWC and MEWT ( < 0.05). No maternal deaths were recorded. Emergency procedures were more frequent in patients identified as “high risk” by MEWC and MEWT.

CONCLUSIONS

MEOWS, MEWC, and MEWT scores can help identify preoperative high-risk patients who may require cesarean sections. MEOWS demonstrated superior sensitivity in predicting postoperative complications and ICU admission. Incorporating EPWS in the preoperative evaluation may improve maternal and neonatal outcomes.