Background and Objective:
This study aims to evaluate the use of the Modified Early Obstetric Warning Score (MEOWS) in identifying obstetric patients at risk of infection or sepsis. The study assesses the correct application of the scale and its impact on clinical decision-making a year after its integration into the obstetric unit of San Raffaele Hospital.

Methods:
The study was carried out as an internal audit by the Quality and Risk Management Area in July 2022. A 16-item checklist was built to assess 51 randomly selected medical records. The scoring system used in the checklist ranged from 0 to 1 (never to always) to evaluate the records.

Results:
Analysis of medical records showed that 43% included a complete evaluation of the parameters, while 33% were almost always complete. Nearly all the records (92%) were accurately completed with date, time of assessment, and reference range. Patients were assigned correctly to clinical deterioration risk classes, with 48 classified as low risk, two as intermediate risk, and one as high risk. In the case of low-risk women, MEOWS was 64% ""always"" and 28% ""almost always"" correctly performed every 12/24 hours, as indicated by the scale. Of the 14 low-risk patients who underwent a cesarean section, MEOWS monitoring was “always” performed correctly in 73% of cases and “almost always” performed correctly in 21% of cases every 12 hours until the third day. In patients with complicated cesarean sections, gestational hypertension, infection, PROM, or other pathologies, a proper assessment was performed in 63% of these cases every 4 hours.

Conclusion:
Integration of the MEOWS scale resulted in a compliance rate of approximately 76% among the staff, which could be improved through further awareness-raising actions. Results also showed that its use effectively monitors obstetric patients clinical condition, optimizing the diagnostic and therapeutic plan.