Use of the Maternal Foetal Triage Index: Addressing the Third Delay in Obstetrics

Abstract PURPOSE: While several scales have been developed specifically for obstetric triage, the Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated for women attending the triage area of a tertiary hospital. This study intends to evaluate the effect of MFTI score on third delay and maternal and neonatal outcomes.METHODS: A prospective observational study was conducted over a convenience sample of 1000 subjects who attended the Labour and Delivery Unit of a tertiary care hospital over a period of one year. Assessment included maternal history, baseline vital signs and obstetric examination. The woman was categorised as per the MFTI scale and directed to the appropriate area for further management. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance.RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean section, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 (p<0.0001). The average time spent in the triage room was 30±17minutes. Maternal and neonatal outcomes were analysed according to priority based on OBICU admissions, mortality, NICU admissions and stillbirths and found to be significant.CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low-resource emergency obstetric setting. This also simplified handover of subjects, improved documentation and decreased time to secondary healthcare provider assessment.