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Table 1 WHO criteria and modified WHO criteria of organ system dysfunctions for detection of maternal near miss (MNM)

From: Maternal near-miss and mortality in Sayaboury Province, Lao PDR

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