Globally every day, about 830 women die due to complications of pregnancy and child
birth. Of these deaths, 99% occur in low-resource settings, and most could be prevented.
Use of Modified Early Obstetric Warning System (MEOWS) would be appropriate. MEOWS is a monitoring
chart intended to identify mothers at risk and initiate the right action, at right
time by the appropriately skilled clinicians, at a time when treatment might make
a difference to reduce maternal mortality and morbidity.
To determine the sensitivity, specificity and predictive values of Modified Early
Obstetric Warning System (MEOWS) in correctly identifying women at risk of developing
obstetric morbidity in St. Francis Hospital_Nsambya between January and February,
The study was a prospective cohort study conducted at St. Francis Hospital Nsambya,
maternity ward, from January to February 2016. MEOWS monitoring tool was used alongside
502 respondent mothers were enrolled in the study. 160patients (31.9%) triggered
and of which: 11.5% of them had obstetric morbidity which included postpartum haemorrhage-35.5%,
preeclampsia-26.3%, suspected infection-22.4%, third degree perineum tear-5.3%,
anaesthetic complications-4% and prolong hospital stay-7%. MEOWS was 81.7% sensitive
(95% CI 80-94%), 76.3% specific (95% CI 74-81%), with a positive predictive value
36.3% (95% CI 31-44%) and negative predictive value of 96.2% (95% CI 94-99%).
MEOWS chart is even effective for use in low resource setting, like Uganda.
Keywords: Modified Early
Obstetric Warning System (MEOWS). Sensitivity. Validity. Predictive values. Maternal
Morbidity. Maternal Mortality.
. Ahrens, T. S. O. K. (2006). Comparison of Three
New Generation Pulse Oximeters in a Medical Intensive Care Unit. Crit Care Med. 2006, 34: A85.
. Buderer, N. M. (1996). Statistical methodology:
Incorporating the prevalence of disease into sample size calculation for sensitivity
and specificity. Acad Emerg Med 1996,
. Cioffi, J. (2000a) Nurses’ experiences of making
decisions to call emergency assistance to their patients. Journal of Advanced Nursing, 32: 108–114.
. ICF International
Inc. (2012). Uganda Demographic and Health
Survey 2011. Kampala: UBOS.
. Isaacs, R.
A., Wee, M. Y. K., Bick, D. E., Sheppard,
Z. A., Thomas, S., Hundley, V., Smith, G. B., Van.
. Teijlingen, E. and Thomas, P. W. (2014). A national
survey of obstetric early warning systems in the United Kingdom: five years on. Journal of the Association of the Anaesthetists
of Great Britain and Ireland, 69 (7). https://doi.org/10.1111/anae.12708.
. Lewis, G. (ed). (2007). the confidential Enquiry into Maternal and Child Health (CEMACH) Saving
Mothers’ Lives: reviewing maternal deaths to make motherhood safer - 2003- 2005.
The Seventh Report on Confidential Enquiries into Maternal Deaths in the United
Kingdom. London: CEMACH.
. Mangum, B.W. (1995). “Reproducibility of the Temperature
of the Ice Point in Routine Measurements,” NIST
Tech. Note 1411.
. Marc, V. D. V., Helen, S. and Lauren, A. P. (2013).
Maternal Critical Care: A Multidisciplinary
Approach. New York: Cambridge University Press.
. Melanie, F. C. (2014). A modified early obstetric
warning system. British Journal of Midwifery,
. Ministry of Health [MOH]. (2010). Statistical Abstract 2010. Kampala: Author
Say, L., Chou, D., Gemmill, A., Tunçalp Ö., Moller, A. B., Daniels, J. D. (2014).
Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health, 2 (6): 323-333.
. Singh, S., McGlennan, A., England, A. and Simons,
R. (2012). A validation study of the CEMACH recommended modified early obstetric
warning system (MEOWS). Anaesthesia, 67(1),
. Uganda Bureau of Statistic [UBOS]. (2012). Uganda Demographic and Health Survey 2011.
. United Nations [UN]. (2015). Global Strategy for Women's, Children's and Adolescents'
Health, 2016-2030. New York: Author.
. World Health Organization [WHO]. (2005). World Health Report. Geneva: Author.