OBJECTIVE: The objective of this study was to develop a scoring system for identifying women with near-miss maternal morbidity, and differentiating these women from those with severe but not life-threatening conditions. STUDY DESIGN AND SETTING: The study was conducted at the University of Illinois Medical Center at Chicago (UIMC), which is a tertiary care hospital with approximately 2,220 births per year. UIMC is in a major urban area serving a predominantly African-American and Latina population. This article focuses on five clinical factors: organ failure (>/=1 system), extended intubation (>12 hr), ICU admission, surgical intervention, and transfusion (>3 units), grouped into several scoring system alternatives. The total score on each scoring system was calculated as the weighted sum of the clinical factors present for each woman. RESULTS: The five-factor scoring system had the highest specificity (93.9%), but the four-factor scoring system, which eliminated organ system failure for simplification of data collection, still had a specificity of 78.1%. CONCLUSION: Near-miss morbidities identified using the scoring systems presented can be incorporated into clinical case review and epidemiologic studies to enhance the monitoring of obstetric care and to improve estimates of the incidence of life-threatening complications in pregnancy.
OBJECTIVE: The objective of this study was to develop a scoring system for identifying women with near-miss maternal morbidity, and differentiating these women from those with severe but not life-threatening conditions. STUDY DESIGN AND SETTING: The study was conducted at the University of Illinois Medical Center at Chicago (UIMC), which is a tertiary care hospital with approximately 2,220 births per year. UIMC is in a major urban area serving a predominantly African-American and Latina population. This article focuses on five clinical factors: organ failure (>/=1 system), extended intubation (>12 hr), ICU admission, surgical intervention, and transfusion (>3 units), grouped into several scoring system alternatives. The total score on each scoring system was calculated as the weighted sum of the clinical factors present for each woman. RESULTS: The five-factor scoring system had the highest specificity (93.9%), but the four-factor scoring system, which eliminated organ system failure for simplification of data collection, still had a specificity of 78.1%. CONCLUSION: Near-miss morbidities identified using the scoring systems presented can be incorporated into clinical case review and epidemiologic studies to enhance the monitoring of obstetric care and to improve estimates of the incidence of life-threatening complications in pregnancy.
Authors: William A Grobman; Jennifer L Bailit; Madeline Murguia Rice; Ronald J Wapner; Uma M Reddy; Michael W Varner; John M Thorp; Kenneth J Leveno; Steve N Caritis; Jay D Iams; Alan T Tita; George Saade; Yoram Sorokin; Dwight J Rouse; Sean C Blackwell; Jorge E Tolosa; J Peter Van Dorsten Journal: Obstet Gynecol Date: 2014-04 Impact factor: 7.661
Authors: Laura Schummers; Jennifer A Hutcheon; Michele R Hacker; Tyler J VanderWeele; Paige L Williams; Thomas F McElrath; Sonia Hernandez-Diaz Journal: Epidemiology Date: 2018-05 Impact factor: 4.822
Authors: Elizabeth J Conrey; Susan E Manning; Cynthia Shellhaas; Nicholas J Somerville; Sarah L Stone; Hafsatou Diop; Kristin Rankin; Dave Goodman Journal: Matern Child Health J Date: 2019-08
Authors: L M Taft; R S Evans; C R Shyu; M J Egger; N Chawla; J A Mitchell; S N Thornton; B Bray; M Varner Journal: J Biomed Inform Date: 2008-09-14 Impact factor: 6.317
Authors: Laura Schummers; Jennifer A Hutcheon; Sonia Hernandez-Diaz; Paige L Williams; Michele R Hacker; Tyler J VanderWeele; Wendy V Norman Journal: JAMA Intern Med Date: 2018-12-01 Impact factor: 21.873
Authors: Samira M Haddad; José G Cecatti; Mary A Parpinelli; João P Souza; Maria L Costa; Maria H Sousa; Fernanda G Surita; João L Pinto E Silva; Rodolfo C Pacagnella; Rodrigo S Camargo; Maria V Bahamondes; Vilma Zotareli; Lúcio T Gurgel; Lale Say; Robert C Pattinson Journal: BMC Public Health Date: 2011-05-08 Impact factor: 3.295