Monitoring, also known as clinical surveillance, is ongoing patient assessments, which will identify problems and trigger responses.1 A warning system is a process that defines observation criteria and sets a limit to trigger a response.1 Although non-obstetric warning systems have existed for nearly twenty years, there has not been a system to use for obstetric women until recently.
Maternal morbidity and mortality are still on the rise in the United States. Severe maternal morbidity has risen over 200% in the United States from 1993 to 2014.2 There are some known reasons for this increase; increases in maternal age, pre-pregnancy obesity, preexisting chronic medical conditions, and cesarean delivery.3 Hemorrhage, hypertension, infection, and venous thrombosis with delays in recognition, diagnosis, and treatment are the cause of many preventable maternal deaths.1
From 2003 to 2005, the Saving Mothers’ Lives report recommended a modified early obstetric warning system. This system assessed vital signs and scored the woman based on the results. An algorithm was then used to determine what the woman needed. The score showed whether the woman was fine, needed closer monitoring, or needed immediate attention.4