title: The maternal early warning criteria: a proposal from the national partnership for maternal safety.
abstract: Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems and describes The Maternal Early Warning Criteria, along with considerations for local implementation.
authors.affiliation: Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Central Jersey Family Health Consortium, Inc., North Brunswick, New Jersey; the Departments of Cardiology and Maternal-Fetal Medicine, University of California, Irvine, Irvine, California; the Department of Reproductive Biology, Case Western Reserve University School of Medicine and the Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Cleveland, Ohio; the School of Nursing, Vanderbilt University, Nashville, Tennessee; the Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa; the Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, Illinois; the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Women's Health, University of Louisville, Louisville, Kentucky; and the Department of Obstetrics & Gynecology, Maternal-Fetal Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Mhyre
authors.forename: Robyn
authors.initials: R
authors.lastname: D'Oria
authors.forename: Afshan B
authors.initials: AB
authors.lastname: Hameed
authors.forename: Justin R
authors.initials: JR
authors.lastname: Lappen
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Holley
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Hunter
authors.forename: Robin L
authors.initials: RL
authors.lastname: Jones
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: King
authors.forename: Mary E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D000328:Adult; D001364:Awareness; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D008429:Maternal Welfare; D061214:Patient Safety; D011247:Pregnancy; D011295:Prenatal Care; D011315:Preventive Medicine / Q000458:organization & administration*; D018570:Risk Assessment