From: Validating the WHO maternal near miss tool: comparing high- and low-resource settings
Group A | Severe complications/potentially life threatening conditions |
A0 | Severe postpartum hemorrhage |
A1 | Severe pre-eclampsia |
A2 | Eclampsia |
A3 | Sepsis or severe systemic infection |
A4 | Ruptured uterus |
Group B | Critical interventions or intensive care unit admission |
B0 | Use of blood products (includes any blood transfusion) |
B1 | Interventional radiology (uterine artery embolization) |
B2 | Laparotomy (other than caesarean section) |
B3 | Admission to Intensive Care Unit |
Group C | Organ dysfunction/life-threatening conditions |
C0 | Cardiovascular dysfunction: Shock, cardiac arrest (absence of pulse/ heart beat and loss of consciousness), use of continuous vasoactive drugs, cardiopulmonary resuscitation, severe hypoperfusion (lactate >5 mmol/l or >45 mg/dl), severe acidosis (pH <7.1) |
C1 | Respiratory dysfunction: Acute cyanosis, gasping, severe tachypnea (respiratory rate > 40 breaths per minute), severe bradypnea (respiratory rate < 6 breaths per minute), intubation and ventilation not related to anesthesia, severe hypoxemia (O2 saturation < 90% for ≥60 min or PAO2/FiO2 < 200) |
C2 | Renal dysfunction: Oliguria non-responsive to fluids or diuretics, dialysis for acute renal failure, severe acute azotemia (creatinine ≥300 μmol/ml or ≥3.5 mg/dl) |
C3 | Coagulation/ hematologic dysfunction: Failure to form clots, massive transfusion of blood or red cells (≥5 units), severe acute thrombocytopenia (<50,000 platelets/ml) |
C4 | Hepatic dysfunction: Jaundice in the presence of pre-eclampsia, severe acute hyperbilirubinemia (bilirubin >100 μmol/l or >6.0 mg/dl) |
C5 | Neurologic dysfunction: Prolonged unconsciousness (lasting ≥12 h)/coma (including metabolic coma), stroke, uncontrollable fits/status epilepticus, total paralysis |
C6 | Uterine dysfunction/ hysterectomy: Uterine hemorrhage or infection leading to hysterectomy |