Early assessment systems in the identification of maternal diseases: systematic review

  • Jarbas Galvao Universidade Regional de Blumenau-FURB.
  • Jean Carl Silva Universidade da Região de Joinville
Keywords: Maternal mortality, Morbidity, Early alert system, Complications in pregnancy, Near miss

Abstract

Early assessment systems applied to pregnant women, describing vital parameters, similarities/differences, and the efficaciousness of such tools, are analyzed. Systematic review was based on databases MEDLINE, SciELO, LILACS, BIREME and PubMed, with 191 scientific articles. The articles without the theme as focus were excluded and only 16 papers were analyzed. Results showed four evaluation tools applied to patients to predict physiological deterioration, namely, EWS, NEWS, MEWS, MEOWS. The tools had relevant positive points, such as indicators of care management, hospital and social costs, even though further studies were needed for better evaluation. MEOWS is the best tool for maternal conditions, albeit non-validated, and should be adapted to physiological changes related to different diseases. Further studies on this tool should be undertaken to improve its specificity and make it more reliable as a near miss predictor.

Author Biographies

Jarbas Galvao, Universidade Regional de Blumenau-FURB.
Mestre em Desenvolvimento Regional, (FURB), SC. Docente do Departamento de Enfermagem da Fundação Universidade Regional de Blumenau (FURB), Blumenau (SC), Brasil.
Jean Carl Silva, Universidade da Região de Joinville
Doutor em Ciências Médicas (Unifesp), São Paulo, (SP). Docente do Departamento de Medicina da Universidade Regional de Joinville e do Programa de Pós-Graduação Saúde e Meio Ambiente (Univille), Joinville, (SC), Brasil.

References

ABBOTT, T. E. et al. A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions. Eur J Intern Med, v. 35, p.78-82, nov.2016. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/27346295>.

ALAM N, et al. The impact of the use of the Early Warning Score (EWS) on patient outcomes: A systematic review. Resuscitation, v.85,n.5,p587-594, 2014.

ALAM, N. et al. Exploring the performance of the National Early Warning Score (NEWS) in a European emergency department. Resuscitation, v. 90, p. 111-115, 2015.

BOTELHO, N. M. et al. Causes of maternal death in Pará State, Brazil. Revista Brasileira de Ginecologia e Obstetrícia, v. 36, n. 7, p. 290-295, 2014.

BRASIL. Ministério da Saúde. Secretarias de Políticas de Saúde. Área Técnica da Saúde da Mulher. Urgências e emergências maternas: guia para diagnóstico e conduta em situações de risco de morte materna. Brasília (DF): Ministério da Saúde, 2000. Disponível em: .

BRASIL. Ministério da Saúde. Secretaria de atenção à saúde. Departamento de ações programáticas estratégicas. Gestação de alto risco. 5. ed. Brasília: 304, 2009. (Serie A. Normas e manuais técnicos).

CARLE, C.; ALEXANDER, P.; COLUMB, M.; JOHAL, J. Design and internal validation of an obstetric early warning score: secondary analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database. Anaesthesia, v. 68, n. 4, p. 354-67, Apr 2013. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/23488833>.

COOKSLEY, T. KITLOWSKI, E.; HAJI-MICHAEL, P. Effectiveness of Modified Early Warning Score in predicting outcomes in oncology patients. Qjm: An International Journal of Medicine, v. 105, n. 11, p. 1083-1088, 2012.

CORREIA, N. et al. Improving recognition of patients at risk in a Portuguese general hospital: results from a preliminary study on the early warning score. International Journal of Emergency Medicine, Berlin/Heidelberg, v. 7, n. 1, p. 1-8, 2014.

DE-LA-TORRE-UGARTE-GUANILO, M. C. at al. Revisão sistemática: noções gerais. Revista da Escola de Enfermagem USP, São Paulo, v. 45, n. 5, p. 1260-1266, out. 2011. Disponível em: <http://www.scielo.br/scielo.php?>. doi: http://dx.doi.org/10.1590/

ECCLES, S. R. et al. Improving specificity whilst maintaining sensitivity of the National Early Warning Score in patients with chronic hypoxaemia. Resuscitation, v. 85, n. 1, p. 109-111, 2014.

GUIMARÃES, P. V et al. Validação de instrumento para avaliação de pacientes graves em ventilação mecânica, segundo o ABCDE. Revista Eletrônica de Enfermagem, v. 17, n. 1, p. 43-50, 2015.

HOGAN, H. et al. Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study. BMJ quality & safety, p. bmjqs-2012-001159, 2012.

HOIKKA,M.; LÄNKIMÄKI,S.; SILFVAST,T.; ALA-KOKKO, T.I. Medical priority dispatch codes-comparison with National Early Warning Score.(Report). Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, v. 24, n.1, 2016.

ISAACS, R. A. et al. A national survey of obstetric early warning systems in the United Kingdom: five years on. Anaesthesia, v. 69, n. 7, p. 687-692, 2014.

JABIR, M. et al. Maternal near miss and quality of maternal health care in Baghdad, Iraq. BMC Pregnancy and Childbirth, v. 13, n. 1, p. 11, 2013.

KYRIACOS, U. et al. Monitoring vital signs: development of a modified early warning scoring (MEWS) system for general wards in a developing country. PLoS One, v. 9, n. 1, p. e87073, 2014.

KRUISSELBRINK, R. et al. Modified Early Warning Score (MEWS) Identifies Critical Illness among Ward Patients in a Resource Restricted Setting in Kampala, Uganda: A Prospective Observational Study. PLoS One, San Francisco, v. 11, n. 3, 2016.

LAPPEN, J. R.; KEENE, M.; LORE, M.; GROBMAN, W. A.; GOSSETT, D. R. Existing models fail to predict sepsis in an obstetric population with intrauterine infection. American Journal of Obstetrics and Gynecology, v. 203, n. 6, p. 573.e1-573.e5, 2010.

MACKINTOSH, N. et al. Recent Findings from King’s College Advance Knowledge in Health and Medicine [Value of a modified early obstetric warning system (MEOWS) in managing maternal complications in the peripartum period: an ethnographic study].(Report). Health & Medicine Week, p. 3197, 2014.

MATIAS J.P, et al. Comparison of two methods for the investigation of maternal mortality in a municipality of the Brazilian Southeast. Rev Bras Ginecol Obstet. V.31,n.11,p 559-565, 2009.

MERRIEL, A. et al. Implementation of a modified obstetric early warning system to improve the quality of obstetric care in Zimbabwe. International Journal of Gynecology & Obstetrics, v. 136, n. 2, p. 175-179, 2017.

NAKAMURA,P.M. et al. Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS): uma avaliação do seu desempenho para a identificação do near miss materno. Cad Saude Publica, v. 29, n. 7, p. 1333-45, 2013.

NIRMAL, GHATA M.; RAMACHANDRAN, ARUN. Dispersion of a passive tracer in the pressure-driven flow of a non-colloidal suspension Soft Matter, v. 12, n. 38, p. 7920-7936. 2016.

PATTINSON, R. C. Near misses: a useful adjunct to maternal death enquiries. Br Med Bull, v. 67, p. 231-43, 2003.

RECINE,U. et al. The change of hospital internal medicine: A study on patients admitted in internal medicine wards of 8 hospitals of the Lazio area, Italy. Italian Journal of Medicine, v. 9, n. 3, p. 252-259, 2015.

REICHENHEIM, M. E. et al. G. Severe acute obstetric morbidity (near-miss): a review of the relative use of its diagnostic indicators. Archives of gynecology and obstetrics, v. 280, n. 3, p. 337-343, 2009.

SILVA, L. A. et al. A qualidade de uma rede integrada: acessibilidade e cobertura no pré-natal. Rev. pesqui. cuid. fundam.(Online), v. 7, n. 2, p. 2298-2309, 2015.

SINGH,S. et al. A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS). Anaesthesia, Oxford, UK, v. 67, n. 1, p. 12-18, 2012.

SINGH,A. et al. Evaluation of maternal early obstetric warning system (MEOWS chart) as a predictor of obstetric morbidity: a prospective observational study. European Journal of Obstetrics and Gynecology, v. 207, p. 11-17, 2016.

SMITH, G. B. Have we found the perfect early warning score? A view of ViEWS. Resuscitation, v. 84, n. 6, p. 707-708, 2013.

SOARES,V.M.N. et al. Causas de mortalidade materna segundo níveis de complexidade hospitalar. Rev Bras Ginecol Obstet, p. 536-543, 2012.

SUBBE, C. P. et al. Validation of a modified Early Warning Score in medical admissions. QJM, v. 94, n. 10, p. 521-526, 2003.

SUBBE, C. P. et al. Effect of introducing the Modified Early Warning score on clinical outcomes, cardio? pulmonary arrests and intensive care utilisation in acute medical admissions*. Anaesthesia, Oxford, UK, v. 58, n. 8, p. 797-802, 2003.

WHEELER, I, et al. Early warning scores generated in developed healthcare settings are not sufficient at predicting early mortality in Blantyre, Malawi: a prospective cohort study. PLoS One, v. 8,n. 3, p. e59830, 2013.

WORLD HEALTH ORGANIZATION. Evaluating the quality care for severe pregnancy complications: The WHO near miss approach for maternal health. WHO, Geneva, 2011.

Published
2018-02-12
Section
Artigos de Revisão