Table 1.
WHO criteria and modified WHO criteria of organ system dysfunctions for detection of maternal near miss (MNM)
| WHO Criteria for MNM detection | Modified WHO criteria for MNM detection at hospital | Modified WHO criteria for MNM detection at community |
|---|---|---|
| 1) Cardiovascular dysfunction | 1) Cardiovascular dysfunction | 1) Cardiovascular dysfunction |
| Shock | Shock | Shock |
| Cardiac arrest | Cardiac Arrest | Cardiac Arrest |
| Severe hypoperfusion (lactate >5 mmol/L or >45mg/dL) | Severe hypoperfusion (lactate >5 mmol/L or >45 mg/dL) | |
| Severe acidosis (pH<7.1) | Severe acidosis (pH<7.1) | |
| Use of continuous vasoactive drugs | Use of continuous vasoactive drugs | |
| Cardio-pulmonary resuscitation | Cardio-pulmonary resuscitation | |
| 2) Respiratory dysfunction | 2) Respiratory dysfunction | 2) Respiratory dysfunction |
| Acute cyanosis | Acute cyanosis | Acute cyanosis |
| Gasping | Gasping | Severe tachypnea (respiratory rate>40 breaths per minute) |
| Severe tachypnea (respiratory rate>40 breaths per minute) | Severe tachypnea (respiratory rate>40 breaths per minute) | |
| Severe bradypnea (respiratory rate<6 breaths per minute) | Severe bradypnea (respiratory rate<6 breaths per minute) | Severe bradypnea (respiratory rate<6 breaths per minute) |
| Severe hypoxemia | Severe hypoxemia | |
| (O2 saturation <90% for _60 min or PAO2/FiO2<200) | (O2 saturation <90% for _60min or PAO2/FiO2<200) | |
| Intubation and ventilation not related to anaesthesia | Intubation and ventilation not related to anaesthesia | |
| 3) Renal dysfunction | 3) Renal dysfunction | 3) Renal dysfunction |
| Oliguria non responsive to fluids or diuretics | Oliguria non responsive to fluids or diuretics | Oliguria non responsive to fluids or diuretics |
| Severe acute azotemia | Severe acute azotemia | |
| (creatinine >300umol/ml or >3.5 mg/dL) | (creatinine >300umol/ml or >3.5mg/dL) | |
| Dialysis for acute renal failure | Dialysis for acute renal failure | |
| 4) Coagulation dysfunction | 4) Coagulation dysfunction | 4) Coagulation/Hematologic dysfunction |
| Failure to form clots | Failure to form clots | Excessive bleeding per vagina |
| Severe acute thrombocytopenia | Severe acute thrombocytopenia | |
| (<50,000 platelets/ml) | (<50,000 platelets/ml) | |
| Massive transfusion of blood or red cells (≥5 units) | Massive transfusion of blood or red cells (≥5 units) | |
| 5) Hepatic dysfunction | 5) Hepatic dysfunction | 5) Hepatic dysfunction |
| Jaundice in the presence of pre-eclampsia | Jaundice in the presence of pre-eclampsia | Jaundice in the presence of pre-eclampsia |
| Severe acute hyperbilirubinemia (bilirubin>100 umol/L or > 6.0 mg/dL) | Severe acute hyperbilirubinemia (bilirubin>100 umol/L or > 6.0 mg/dL) | |
| 6) Neurologic dysfunction | 6) Neurologic dysfunction | 6) Neurologic dysfunction |
| Prolonged unconsciousness or coma (lasting >12 hours) | Prolonged unconsciousness or coma (lasting >12 hours) | Prolonged unconsciousness or coma (lasting >12 hours) |
| Stroke | Stroke | Stroke |
| Uncontrollable fit/status epilepticus | Uncontrollable fit/status epilepticus | Global paralysis |
| Global paralysis | Global paralysis | |
| 7) Uterine dysfunction | 7) Uterine dysfunction | |
| Uterine infection or haemorrhage leading to hysterectomy | Uterine infection or haemorrhage leading to hysterectomy |