Deteksi Pasien Obstetrik Kritis dengan Maternal Early Warning System
Abstract
Adaptasi fisiologis yang terjadi pada ibu hamil dapat menyamarkan tanda-tanda penyakit maternal berat. Ini mempersulit identifikasi kolaps maternal yang akan terjadi. Penggunaan early warning system (EWS) yang dimodifikasi untuk penggunaan pada pasien ibu hamil dan postpartum akan membantu dalam identifikasi, treatment dini, dan penanganan pasien yang memiliki, atau akan mengalami, penyakit kritis. Maternal Early Warning System (MEWS) seharusnya mengidentifikasi pasien yang berisiko untuk mengalami perburukan pada saat intervensi dini dapat mencegah perburukan ke morbiditas berat MEWS telah digunakan secara ekstensif dalam praktek obstetrik, tetapi sistem yang digunakan sangat bervariasi. Parameter-parameter yang sering dimasukkan dalam MEWS antara lain denyut jantung, tingkat pernapasan, tekanan darah, dan tingkat kesadaran. Dari berbagai MEWS yang telah dikembangkan, ada tiga MEWS utama, yaitu (1) modified early obstetric warning system (MEOWS), (2) Maternal Early Warning Criteria (MEWC), dan (3) Maternal Early Warning Trigger (MEWT) tool. Hingga kini masih belum diketahui sistem MEWS apa yang terbaik, dan setiap rumah sakit mungkin memerlukan penyesuaian dalam parameter MEWS. Literatur yang ada menunjukkan kemungkinan manfaat dan mendukung penggunaan MEWS. Implementasi dan penggunaan MEWT telah dikaitkan dengan penurunan morbiditas maternal komposit dan morbiditas maternal berat. Akan tetapi, respon apa yang optimal untuk setting tertentu agar memperbaiki pelayanan maternal setelah tanda peringatan muncul hingga kini masih belum jelas.
Detection of Critically Ill Obstetric Patients with Maternal Early Warning System
Abstract
Physiological adaptations that develop in pregnant women may obscure signs of severe maternal diseases. These causes difficulties in identifying the impending maternal collapse. An early warning system (EWS) modified for pregnant and postpartum women may assist in identification, early treatment, and management of patients who already or will develop critical illness. Maternal Early Warning System MEWS has been extensively used in obstetric practices; however, the systems used in preactice are varied. The most considered parameters for MEWS are heart rate, respiratory rate, blood pressure, and level of consciousness. From many MEWS developed, three primary MEWS existed, (1) modified early obstetric warning system (MEOWS), (2) Maternal Early Warning Criteria (MEWC), dan (3) Maternal Early Warning Trigger (MEWT) tool. There is still no consensus regarding which MEWS is superior, and different hospitals may require adjustments in MEWS parameters. The existing literatures suggested the potential benefit of MEWS and supported MEWS in clinical practice. Implementation and adoption of MEWS had been associated with reduced composite maternal morbidities and severe maternal morbidities. However, the optimal response for certain settings to improve maternal services after warning system has been activated is still lacking.
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References
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Jurnal Anestesi Obstetri Indonesia
