Table 1 Identification criteria of maternal near-miss as used by the WHO 2011
Dysfunctional system | Clinical criteria | Laboratory markers | Management based proxies |
|---|---|---|---|
Cardiovascular | Shock Cardiac arrest | severe hypo perfusion (lactate > 5 m mol/l or > 45 mg/dl) severe acidosis (pH < 7.1) | Use of continuous vasoactive drugs Cardio pulmonary resuscitation |
Respiratory | Acute cyanosis Gasping severe tachypnea (respiratory rate > 40 breaths per minute) severe bradypnea (respiratory rate < 6 breaths per minute) | severe hypoxemia (O2 saturation < 90% for ≥60 min or PAO2/FiO2 < 200) | Intubation and ventilation not related to anesthesia |
Renal | Oliguria non-responsive to fluids or diuretics | Severe acute azotemia (creatinine ≥300 μmol/ml or ≥3.5 mg/dl) | Dialysis for acute renal failure |
Coagulation/hematological | Failure to form clots | severe acute thrombocytopenia (< 50,000 platelets/ml) | Massive transfusion of blood or red cells (≥5 units) |
Hepatic | Jaundice in the presence of pre-eclampsia | severe acute hyperbilirubinemia (bilirubin > 100 μmol/l or > 6.0 mg/dl) | |
Neurological | Prolonged unconsciousness (lasting ≥12 h)/coma (including metabolic coma), stroke, uncontrollable fits/status epileptics, total paralysis | ||
Uterine | Uterine hemorrhage or infection leading to hysterectomy |