# Utilizing Maternal Morbidity as a Novel Screening (MMS) Tool for Predicting Peripartum Morbidity at a Rural Tertiary Care Teaching Hospital in Central India

## TL;DR

This study introduces a new maternal morbidity screening tool that better predicts childbirth complications than existing methods in a rural Indian hospital.

## Contribution

A novel maternal morbidity screening (MMS) tool was developed and shown to outperform the MEOWS chart in predicting peripartum morbidity.

## Key findings

- The MMS tool achieved 90.50% accuracy in predicting peripartum morbidity.
- MMS had higher sensitivity (95.24%) and specificity (89.50%) compared to the MEOWS chart.
- Obstetric morbidity was 66.66% in the maternal morbidity group using MMS versus 32% with MEOWS.

## Abstract

Background

The majority of complications and deaths related to childbirth are concentrated in developing and disadvantaged nations, where the rates are unacceptably elevated. These incidents predominantly occur in the vicinity during the intrapartum period and immediately after childbirth. The peripartum period is especially critical for expectant mothers, as it represents the time when a significant number of complications and deaths occur. This study aimed to develop, validate, and assess the efficacy of the maternal morbidity screening (MMS) tool for predicting peripartum morbidity.

Methodology

The study was conducted in two phases: Phase one involved developing, validating, and piloting the MMS tool, while Phase two focused on evaluating and comparing the MMS tool with the modified early obstetric warning system (MEOWS) chart for predicting peripartum morbidity. An observational analytical clinical study design was utilized.

Result

In Phase one, the MMS tool was developed and validated by subject experts, resulting in a reliability score of 0.90. Therefore, the tool was deemed reliable and valid. Phase two results revealed that obstetric morbidity in the maternal morbidity group was 66.66%, higher than the 32% observed with the MEOWS chart. The MMS tool demonstrated significantly higher sensitivity at 95.24%, specificity at 89.50%, and predictive value at 98.50%, yielding an overall accuracy of 90.50%. In comparison, the MEOWS chart exhibited a sensitivity of 70.51%, specificity of 86.81%, predictive value of 92.94%, and accuracy of 83.71%.

Conclusion

The occurrence of maternal morbidity in the trigger zone was significantly higher than in the non-trigger zone in the MMS tool. The MMS tool was significantly more effective as a predictor of peripartum morbidity compared to the MEOWS chart.