Prioritizing Maternal Sepsis: National Adoption of an Obstetric Early Warning System to Prevent Morbidity and Mortality

J Obstet Gynaecol Can. 2020 May;42(5):640-643. doi: 10.1016/j.jogc.2019.11.072. Epub 2020 Mar 12.

Abstract

Sepsis is one of the leading causes of maternal morbidity and mortality. Analyses have determined that delays in early recognition and prompt initiation of appropriate management are key contributing factors in maternal sepsis deaths. Recent cases of sepsis-related maternal morbidity and mortality across Canada have highlighted the urgent need for a national standardized approach to the detection and treatment of maternal sepsis. The SOGC has established a national multidisciplinary maternal sepsis task force to address this priority. The adoption of a national modified obstetric early warning system (MEOWS) is recommended as a key first step. This early warning scoring (EWS) system will facilitate early detection of maternal clinical deterioration and mandate timely escalation of care appropriate for the severity of illness. There is currently limited use of EWSs in Canada. Introducing a national EWS and a standardized maternal sepsis management guideline provides a tremendous opportunity to improve maternal care. A standardized approach will facilitate future evidence-based evaluation and refinement of the tool, and enable the reduction of preventable maternal morbidity and mortality from sepsis, as well as all causes duplicated.

Keywords: early warning score; infectious; maternal mortality; pregnancy complications; pregnancy outcome.

MeSH terms

  • Canada
  • Early Warning Score*
  • Female
  • Guidelines as Topic*
  • Humans
  • Maternal Death*
  • Maternal Mortality
  • Morbidity
  • Pre-Eclampsia*
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Sepsis / diagnosis
  • Sepsis / mortality
  • Sepsis / prevention & control*