Abstract
Objective To validate a five-factor scoring system that identifies parturients who experience
near-miss morbidity.
Study Design and Setting This study was conducted in an urban, tertiary care hospital over a 2-year period.
A narrative case summary was prepared for women with high potential for significant
obstetric morbidity. The summary was then reviewed by three physicians, and the extent
of morbidity was assigned based on subjective assessment. The same cases were then
scored using the proposed five-factor scoring system previously described by Geller
et al. Test characteristics of the scoring system were assessed.
Results Eight hundred fifteen cases with a high potential for significant morbidity were
identified. Subjective review and the scoring system classified 4.5% and 4.2% as near-miss
morbidity, respectively, with the scoring system having a corresponding sensitivity
of 81.1% (95% confidence interval 64.8 to 92.0%) and a specificity of 99.5% (95% confidence
interval 98.7 to 99.9%).
Conclusion The scoring system produced similar results to those obtained at its initial development
and demonstrated acceptable sensitivity and specificity for identifying near-miss
morbidity.
Keywords
near-miss morbidity - maternal mortality - scoring system
