Implementation and efficacy of “saving mothers score” in predicting maternal morbidity and improving maternofetal outcome

Abstract

Background:“Saving Mothers Score” (SMS) was developed and validated as a comprehensive obstetric score for identification of sick mothers. This study aimed to evaluate the efficacy of the SMS chart to predict maternal morbidity and improve maternal and fetal outcomes. Materials and Methods: A single-center randomized study was done on 700 subjects of two groups from February 2017 to 2018. The subjects were treated as per the existing hospital norms in Group A (n = 360) and SMS chart was used in addition to the hospital norms in Group B (n = 340). Results: Demographic data, preterm deliveries, and cesarean delivery rate were not significantly different in both groups. Postpartum hemorrhage was significantly more in Group A when compared with Group B where SMS chart was used (unadjusted odds ratio 3.22, 95% confidence interval: 1.59, 6.97, P = 0.0004). The overall morbidity was higher (P = 0.0001) in Group A. The mean hospital stay was longer in Group A (P = 0.0001). Neonatal morbidity was 14.4% in Group A and 10.3% in Group B (P = 0.169). APACHE II (mean 10.87, range 0–18) and SOFA (mean 7.75, range 0–12) scores were determined along with SMS (mean 18.87, range 5–26) in eight critically ill parturients. There was no maternal mortality in this series. Conclusion: SMS predicts maternal morbidity and can help initiation of appropriate treatment to improve maternal and hence fetal outcome. Multicentric studies are needed for further evaluation and comparison of SMS to APACHE II and SOFA scores.

Keywords

• Critically ill mother
• maternal morbidity
• maternal mortality
• obstetric score