Severe maternal complications |
1. Severe postpartum hemorrhage |
2. Severe pre-eclampsia |
3. Eclampsia |
4. Sepsis or severe systemic infection |
5. Ruptured uterus |
6. Severe complications of abortion |
Critical interventions or intensive care unit use |
1. Admission to intensive care unit |
2. Interventional radiology |
3. Laparotomy (includes hysterectomy, excludes caesarean section) |
4. Use of blood products |
Near-miss criteria |
A. Clinical organ dysfunction |
1. Acute cyanosis |
2. Gasping |
3. Respiratory rate higher than 40 or lower than 6 bpm |
4. Shock |
5. Cardiac arrest |
6. Oliguria non-responsive to fluids or diuretics |
7. Any loss of consciousness lasting for more than 12 h |
8. Stroke |
9. Uncontrollable fit or status epilepticus |
10. Global paralysis |
11. Jaundice in the presence of pre-eclampsia |
B. Laboratory markers |
12. O2 saturation less than 90 % for more than 60 min |
13. PaO2/FiO2 less than 200 mmHg |
14. Creatinine more than 3.5 mg/dL |
15. Bilirubin more than 6.0 mg/dL |
16. pH less than 7.1 |
17. Lactate more than 5 mEq/L |
18. Acute thrombocytopenia (<50,000 platelets) |
C. Management-based criteria |
19. Hysterectomy after infection or hemorrhage |
20. Use of continuous vasoactive drugs |
21. Cardio-pulmonary resuscitation |
22. Dialysis for acute renal failure |
23. Any non-anesthetic intubation or ventilation |
24. Transfusion of more than 5 units of blood or red cells |