Table 1 Inclusion criteria for near miss mother (WHO)
Severe maternal complications | Critical interventions or intensive care unit use |
|---|---|
Severe postpartum hemorrhage Severe pre-eclampsia or eclampsia Sepsis or severe systemic infection Ruptured uterus Severe complications of abortion | Admission to intensive care unit Interventional radiology Laparotomy (includes hysterectomy, excludes caesarean section) Use of blood products |
Life-threatening conditions (near-miss criteria) | |
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) | 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) |
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) | Coagulation/haematological 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 µmol/l or > 6.0 mg/dl) | Neurological dysfunction Prolonged unconsciousness (lasting ≥ 12 h)/coma (including metabolic coma), stroke, uncontrollable fits/status epilepticus, total paralysis |
Uterine dysfunction Uterine hemorrhage or infection leading to hysterectomy | |