Table 4 The WHO maternal near-miss criteriaa
From: Maternal near miss and mortality in a tertiary care hospital in Rwanda
Identification criteria | |
|---|---|
Cardiovascular dysfunction | • Shock |
• Use of continuous vasoactive drugs | |
• Cardiac arrest | |
• Cardio-pulmonary resuscitation | |
• Severe hypoperfusion (lactate > 5 mmol/L or > 45 mg/dL) | |
• Severe acidosis (pH < 7.1) | |
Respiratory dysfunction | • Acute cyanosis |
• Gasping | |
• Severe tachypnea (respiratory rate > 40 bpm) | |
• Severe bradypnea (respiratory rate < 6 bpm) | |
• Severe hypoxemia (PAO2/FiO2 < 200 or O2 saturation < 90 % for ≥60 min) | |
• Intubation and ventilation not related to anesthesia | |
Renal dysfunction | • Oliguria non responsive to fluids/diuretics |
• Dialysis for acute renal failure | |
• Severe acute azotemia (creatinine ≥ 300 umol/ml or ≥ 3.5 mg/dL) | |
Coagulation/hematologic dysfunction | • Failure to form clots |
• Massive transfusion of blood or red cells (≥5 units) | |
• Severe acute thrombocytopenia (<50,000 platelets/ml) | |
Hepatic dysfunction | • Jaundice in the presence of pre-eclampsia |
• Severe acute hyperbilirubinemia (bilirubin > 100 umol/L or > 6.0 mg/dL) | |
Neurologic dysfunction | • Prolonged unconsciousness (lasting ≥ 12 hours)/coma (including metabolic coma) |
• Stroke | |
• Status epilepticus/uncontrollable fits | |
• Total paralysis | |
Uterine dysfunction | • Hemorrhage or infection leading to hysterectomy |