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Table 2 Rate of agreement on inclusion of selected MNM parameters for use in sub-Saharan Africa

From: Adaptation of the WHO maternal near miss tool for use in sub–Saharan Africa: an International Delphi study

Parameter Round 1 (n = 52) Round 2(n = 50) Round 3 (n = 47)
Strongly Agree Agree Neutral Disagree Strongly disagree Median Decision % Decision % Decision
1. Cardiac arrest 48 1 1 1 1 5 Accepted 100 Accepted
2. Shock 44 6 1 1 0 5 Accepted 100 Accepted
3. Loss of consciousness lasting >12 h 43 4 3 0 2 5 Accepted 98 Accepted
4. Hysterectomy for haemorrhage or infection 43 7 0 1 1 5 Accepted 98 Accepted
5. Stroke 39 7 3 1 2 5 Accepted 92 Accepted
6. Uncontrolled fits/total paralysis 38 10 3 0 1 5 Accepted 96 Accepted
7. Cardiopulmonary resuscitation 38 6 3 2 3 5 Accepted 98 Accepted
8. Gasping 36 6 4 1 5 5 Accepted 92 Accepted
9. Failure to form clots/coagulation disorder 34 8 6 3 1 5 Accepted 96 Accepted
10. Oliguria non-responsive to fluids or diuretics 33 9 5 5 0 5 Accepted 92 Accepted
11. Transfusion of blood 33 6 4 5 4 5 Accepted 90 Accepted
12. Loss of consciousness & ketoacidosis in urine 33 9 4 3 3 5 Accepted 90 Accepted
13. Jaundice in the presence of pre-eclampsia 31 11 6 2 2 5 Accepted 84 Accepted
14. Acute cyanosis 30 6 7 4 5 5 Accepted 92 Accepted
15. Respiration rate > 40 or <6/min 30 10 7 4 1 5 Accepted 94 Accepted
16. Intubation & ventilation not related to anaesthesia 30 6 7 6 3 5 Accepted 92 Accepted
17. Oxygen saturation < 90% for ≥60 min 24 6 9 8 5 4 May be accepted 80·4 Accepted
18. Creatinine ≥300 μmol/l or ≥3.5 mg/dl 23 13 4 7 5 4 May be accepted 73·9 Accepted
19. Dialysis for acute renal failure 21 6 3 10 12 4 May be accepted 67·4 May be accepted 66 Rejected
20. Acute thrombocytopenia <50,000/ml) 20 17 7 4 4 4 May be accepted 69·6 Maybe accepted 72·3 Accepted
21. Use of continuous vasoactive drugs 18 11 10 8 5 4 May be accepted 67·4 May be accepted 61·7 Rejected
22. Bilirubin >100 μmol/l or >6.0 mg/dl 17 12 9 8 6 4 May be accepted 52·2 Rejected
23. pH <7.1 11 13 9 5 14 3 Rejected 21·7 Rejected
24. PaO2/Fi2 < 200 mmHg 8 10 13 8 13 3 Rejected 18 Rejected
25. Lactate >5 mEq/ml 8 10 8 14 12 2 Rejected 17·4 Rejected
26. Uterine rupturea 44 2 4 0 2 5 Accepted 94 Accepted
30. Sepsis or severe systemic infectiona 41 3 5 1 2 5 Accepted 90 Accepted
34. Eclampsiaa 41 9 0 0 2 5 Accepted 88 Accepted
28. Laparotomy other than CSa 30 14 5 1 2 5 Accepted 78 Accepted
27. Pulmonary edemaa 28 10 8 2 4 5 Accepted 78 Accepted
29. Admission to the ICUa 23 10 6 6 7 4 May be accepted 63 May be accepted 59·6 Rejected
36. Diabetic Keto Acidosisa 23 15 6 3 4 4 May be accepted 65·2 May be accepted 61·7 Rejected
33. Severe malariaa 21 14 8 5 4 4 May be accepted 73·9 Accepted
31. Obstructed laboura 17 14 8 6 7 4 May be accepted 54·3 Rejected
32. Severe anaemiaa 16 15 11 5 5 4 May be accepted 69·6 May be accepted 61·7 Rejected
35. Severe HIV related illnessesa 13 22 10 3 4 4 May be accepted 69·6 May be accepted 57·4 Rejected
37. Interventional radiologya 8 2 11 13 18 2 Rejected 6·5 Rejected
  1. CS Caesarean Section, ICU Intensive Care Unit, May be accepted
  2. a parameters from literature