Role of MEOWS as A Predictor of Peripartum Morbidity: A Prospective Study in A Tertiary Care Teaching Institute

Abstract

Background: Maternal morbidity and mortality remain unacceptably high in low-resource settings. Early recognition of clinical deterioration is essential to prevent adverse maternal outcomes. The Modified Early Obstetric Warning Score(MEOWS) is a bedside tool designed to detect physiological abnormalities and escalate care. Aims: To assess the efficacy and predictive accuracy of the Modified Early Obstetric Warning Score(MEOWS) chart in identifying women at high risk for peripartum complications in a tertiary care hospital setting in Uttar Pradesh, India. Study Design:  institution-based observational study with a prospective design. Setting and Duration of Study: Department of Obstetrics and Gynecology of the Moti Lal Nehru Medical College and Kamala Nehru Memorial Hospital, Prayagraj, Uttar Pradesh and was conducted for 12 months, from May 2023 to May of 2024. Methodology: A prospective observational study was conducted over a period of 12 months among 200 pregnant women at ≥37 weeks of gestation. Participants were classified into triggered and non-triggered groups based on their obstetrics and medical complication. MEOWS parameters were recorded during labour and at postpartum intervals. The primary outcomes included maternal complications, HDU/ICU transfer, and neonatal outcomes. Statistical analysis was performed using SPSS 22, with significance set at p<0.05. Results: Out of 200 participants, 27% women were in the triggered group. Women of Triggered group had significantly higher rates of HDU/ICU transfers (70.4% vs. 3.4%, p<0.001), postpartum haemorrhage (18.5% vs. 2.7%), and hypertensive crises (16.7% vs. 2.1%). Neonatal complications such as low birth weight (24.1% vs. 4.8%) and NICU admission >24 hours (18.5% vs. 4.1%) were also more frequent. MEOWS demonstrated a sensitivity of 91%, specificity of 78.5%, and overall accuracy of 82%. Conclusion: MEOWS is an effective and practical tool for early detection of maternal and neonatal complications. Its integration into routine obstetric monitoring can improve outcomes, particularly in resource-constrained settings. Broader implementation and training are recommended to enhance maternal healthcare delivery.