ABSTRACT Background: Maternal mortality and severe maternal morbidity are pressing global health issues, especially in low- and middle-income countries. Prognostic tools in the intensive care unit (ICU) are crucial for guiding timely interventions. While general severity scoring systems such as Acute Physiology and Chronic Health Evaluation II and SAPS II are widely applied, their accuracy is limited in pregnancy. This review focuses on the Sequential Organ Failure Assessment (SOFA) score, particularly the delta SOFA (DeltaSOFA), as a prognostic indicator for maternal outcomes in obstetric ICU settings. Methods: Published literature was retrieved from electronic databases, including PubMed, Scopus, and Google Scholar, using key terms related to “SOFA score,” “DeltaSOFA,” “maternal mortality,” and “obstetric ICU.” Peer-reviewed original articles, reviews, and clinical studies examining the prognostic value of SOFA or DeltaSOFA scores in obstetric ICU patients were included. Studies lacking obstetric-specific data or prognostic outcomes were excluded. Relevant information was systematically extracted regarding score components, predictive performance, advantages over static scoring systems, limitations, and clinical applicability in maternal critical care. Results: Evidence indicates that the DeltaSOFA score provides a dynamic, sensitive prediction of maternal mortality compared to static systems. It reflects organ dysfunction trends over time, aiding decision-making and resource allocation. However, limitations exist, including non-adapted parameters for pregnancy physiology and inconsistent application across studies. Conclusions: DeltaSOFA emerges as a promising prognostic tool for maternal outcomes in ICUs, though standardized obstetric-specific modifications and further research are needed to optimize its clinical use.
Shah et al. (2026) studied this question.