Effectiveness and Implementation of Obstetric Triage During Pregnancy and Childbirth: A Systematic Review

Obstetric triage systems play a vital role in ensuring timely care for pregnant women, yet their implementation and effectiveness vary across healthcare settings. This systematic review synthesizes evidence on the impact of standardized obstetric triage systems on care timeliness, staff competency, and maternal-fetal outcomes, while examining barriers and facilitators to successful implementation in diverse contexts. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search across six databases (PubMed, Embase, Scopus, Web of Science, CINAHL, IEEE Xplore). Eligible studies evaluated obstetric triage interventions, reported quantitative or mixed-methods data on implementation/effectiveness outcomes (e.g., time to assessment, length of stay (LOS), staff knowledge), and were peer-reviewed. 11 studies met inclusion criteria and were evaluated using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for risk of bias; seven were rated as low risk. Due to heterogeneity in interventions, outcomes, and settings (high- vs low-resource), a narrative synthesis was performed. Key findings demonstrated that standardized triage tools significantly reduced the time from patient arrival to initial evaluation by a healthcare provider (time to provider assessment) and LOS in high-resource settings. In low-resource contexts, locally adapted models reduced median waiting times from 40 minutes to five minutes, though systemic barriers like understaffing persisted. Successful implementation relied on staff training and workflow integration, while variability in adoption reflected organizational culture. Limitations included heterogeneity precluding meta-analysis and under-representation of low-resource settings. Obstetric triage standardization enhances care efficiency, but effectiveness depends on contextual adaptation and multidisciplinary engagement. Future research should prioritize randomized controlled trials (RCTs), cost-effectiveness analyses, and tailored strategies for low-resource settings.