Table 2.
Occurrence of adverse maternal outcomes following first assessment, by mortality or morbidity event
|
PIERS-ML group (N=8843) |
External validation group (N=2901) |
||||||
|---|---|---|---|---|---|---|---|
| Within 2 days of first assessment (n=814 outcomes of 590 women) | Within 7 days of assessment (n=1156 outcomes of 813 women) | At any time before primary discharge (n=1530 outcomes of 1083 women) | Within 2 days of first assessment (n=96 outcomes of 83 women) | Within 7 days of assessment (n=115 outcomes of 99 women) | At any time before primary discharge (N=121) | ||
| Maternal death | 0 | 1 (0·1%) | 2 (0·1%) | 1 (1%) | 1 (0·9%) | 1 (0·7%) | |
| Central nervous system | |||||||
| Eclamptic seizures | 49 (6%) | 63 (5·4%) | 75 (4·9%) | 22 (22·9%) | 22 (19·1%) | 25 (17·7%) | |
| Glasgow coma score <13 | 14 (1·7%) | 15 (1·3%) | 20 (1·3%) | .. | .. | .. | |
| Stroke or reversible ischaemic neurological deficit | 4 (0·5%) | 5 (0·4%) | 6 (0·4%) | 0 | 0 | 0 | |
| Transient ischaemic attack | 0 | 1 (0·1%) | 1 (0·1%) | .. | .. | .. | |
| Cortical blindness | 3 (0·4%) | 5 (0·4%) | 6 (0·4%) | 1 (1%) | 1 (0·9%) | 1 (0·7%) | |
| Posterior reversible encephalopathy | 4 (0·5%) | 5 (0·4%) | 5 (0·3%) | ||||
| Cardiorespiratory | |||||||
| Positive inotropic support required | 4 (0·5%) | 5 (0·4%) | 8 (0·5%) | .. | .. | .. | |
| Infusion of a third injectable antihypertensive | 17 (2·1%) | 28 (2·4%) | 33 (2·2%) | .. | .. | .. | |
| Myocardial ischaemia or infarction | 4 (0·5%) | 5 (0·4%) | 6 (0·4%) | 2 (2·1%) | 2 (1·7%) | 2 (1·4%) | |
| Oxygen saturation less than 90% | 53 (6·5%) | 85 (7·4%) | 114 (7·5%) | 2 (2·1%)* | 2 (1·7%)* | 3 (2·1%)* | |
| At least 50% fractional inspired oxygen for at least 1 h | 29 (3·6%) | 50 (4·3%) | 72 (4·7%) | 2 (2·1%)* | 2 (1·7%)* | 3 (2·1%)* | |
| Intubation other than for caesarean birth | 23 (2·8%) | 34 (2·9%) | 47 (3·1%) | 2 (2·1%)* | 2 (1·7%)* | 3 (2·1%)* | |
| Pulmonary oedema | 55 (6·8%) | 82 (7·1%) | 96 (6·3%) | 2 (2·1%) | 3 (2·6%) | 3 (2·1%) | |
| Haematological | |||||||
| Blood transfusion | 243 (29·9%) | 348 (30·1%) | 460 (30·1%) | 29 (30·2%) | 36 (31·3%) | 53 (37·6%) | |
| Platelet count <50 × 109 per L, without transfusion | 85 (10·4%) | 104 (9%) | 112 (7·3%) | 5 (5·2%) | 8 (7%) | 9 (6·4%) | |
| Hepatic | |||||||
| Dysfunction | 23 (2·8%) | 30 (2·6%) | 44 (2·9%) | 5 (5·2%) | 5 (4·3%) | 5 (3·5%) | |
| Haematoma or rupture | 0 | 0 | 0 | 2 (2·1%) | 2 (1·7%) | 2 (1·4%) | |
| Renal | |||||||
| Acute renal insufficiency in women without chronic kidney disease | 3 (0·4%) | 5 (0·4%) | 9 (0·6%) | 8 (8·3%)† | 8 (7%)† | 8 (5·7%)† | |
| Acute renal failure in women with chronic kidney disease | 36 (4·4%) | 45 (3·9%) | 52 (3·4%) | 8 (8·3%)† | 8 (7%)† | 8 (5·7%)† | |
| Dialysis | 2 (0·2%) | 7 (0·6%) | 11 (0·7%) | 0 | 0 | 0 | |
| Other | |||||||
| Placental abruption | 75 (9·2%) | 98 (8·5%) | 129 (8·4%) | 17 (17·7%) | 25 (21·7%) | 29 (20·6%) | |
| Severe ascites | 30 (3·7%) | 50 (4·3%) | 65 (4·2%) | 0 | 0 | 0 | |
| Bell's palsy | 3 (0·4%) | 3 (0·3%) | 6 (0·4%) | 0 | 0 | 0 | |
*
Respiratory failure (pulmonary oedema accompanied by severe hypoxaemia with need for intubation or mechanical ventilation).
†
Acute kidney injury (serum creatinine >2 mg/dL [>176·8 mM]). All other outcomes have been defined in the appendix (pp 4–5).