ABSTRACT
Critical illness is relatively rare in pregnant and postpartum women, but can rapidly evolve. An early warning system (EWS) is a protocol designed to identify patients who are at risk of complications or impending medical deterioration and to secure skilled clinical help by the bedside. Maternal EWSs are modified to account for the normal physiological changes of pregnancy and to specifically detect the unique disease processes in the pregnant parturient. There are five main pathological conditions that cause the vast majority of severe maternal morbidity and mortality in pregnancy and the postpartum period. These include the following: hemorrhage, sepsis, hypertensive disorders, cardiovascular dysfunction and venous thromboembolism. The 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the United Kingdom highlighted cases where the early warning signs of maternal collapse went unrecognized. The California Pregnancy-Associated Mortality Review Committee suggested that 41% of maternal deaths had a good to strong chance of being prevented with improvements in clinical care.
