University of Oxford researchers have developed a new maternity early warning score that is set to be rolled out across the English NHS.
The system helps healthcare providers identify and respond to signs of deterioration in pregnant women.
Maternity early warning scores (MEWS) are widely used throughout hospitals in the UK to highlight when additional care is needed to protect the health of the expectant mother and baby.
However, the team from the University of Oxford recognised the need to provide solid observational evidence for a standardised national MEWS.
This is because the majority of MEWS have been developed by clinical consensus and their implementation varies widely across the country.
The research involved measuring vital sign measurements from more than 1,000 pregnant women who took part in the 4P (Pregnancy Physiology Pattern Prediction) study.
Professor Peter Watkinson, a consultant at Oxford University Hospitals NHS Foundation Trust who led the 4P study, and his team used statistical modelling to determine appropriate thresholds for vital signs.
These included blood pressure, heart rate, respiratory rate, temperature, and oxygen levels.
These thresholds were then used to assign numerical scores, with higher scores indicating more concerning vital sign measurements.
Tony Kelly and Hannah Rutter at NHS England’s National Maternity and Neonatal Programme led a group of representative stakeholders to use this observational evidence to support the creation of the English National MEWS.
The new system triggers unnecessary alerts less frequently in healthy pregnant women compared to existing MEWS systems used in the UK.
Professor Watkinson said: "The main goal when we embarked on the Oxford Biomedical Research Centre-funded 4P study was to develop a standardised, evidence-based early warning system that could benefit women during and shortly after pregnancy across the country.
"We are delighted that, by working with maternity experts at NHS England, we are now on the verge of achieving this."
Stephen Gerry, senior medical statistician at the University of Oxford's Nuffield Department, said: "Our goal was to create a MEWS that is intuitive and familiar to clinicians, while grounding it in research evidence.
"By using prospectively collected vital sign data we were able to develop thresholds that reflect normal physiological values during pregnancy."
Tony Kelly and Hannah Rutter added: "The new National MEWS tool will allow us to improve the quality and consistency in the identification of episodes of deterioration in the pregnant population.
"The overall aim is that, through early identification, escalation and response the National MEWS tool will be used to assess and manage deterioration of all pregnant women and people in every organisation across England by March 2026."
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