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Table 1 Criteria for inclusion of near miss cases (modified from Mantel et al 1998)

From: Obstetric near miss and deaths in public and private hospitals in Indonesia

Organ dysfunction
Cardiac dysfunction Pulmonary oedema, cardiac arrest, cardiac failure
Pulmonary embolism -
Vascular dysfunction Hypovolaemia requiring two or more units of blood, blood loss with hypovolaemic shock (systolic blood pressure < 90 mmHg or undetectable pulse), infusion and/or transfusion of > = 1 litre in 2 hours, free flow infusiona, massive haemorrhage recorded in notes
Immunological dysfunction Septic shock
Respiratory dysfunction Intubation or ventilation for reasons other than general anaesthesia, oxygen saturation on pulse oximetry < 90% leading to ventilation
Renal dysfunction Oliguria < 30 ml per hour or < 400 ml per 24 hours, shock not responsive to intravascular rehydration or diuresis, haemodialysis
Liver dysfunction Jaundice in pre-eclampsia, abnormal liver function tests
Coagulation dysfunction Acute thrombocytopenia, prolonged bleeding time, abnormal Activated Partial Thromboplastine Time (APTT) or Prothrombine Time (PT), coagulopathy
Cerebral dysfunction Coma, cerebral oedema, seizures other than eclampsia
Management based criteria
  Intensive care admission, emergency hysterectomy, needs resuscitation, anaesthetic accident, referral to tertiary hospital
Clinical diagnosis
  Eclampsia, uterine rupture, ectopic pregnancy
  1. a free flow infusion refers to a massive infusion of fluids in case of shock