Pre-validation of the WHO organ dysfunction based criteria for identification of maternal near miss

Table 1 Proportion of women dead or surviving (near miss) a severe maternal morbidity according to laboratory, management and combined criteria for maternal near miss proposed by WHO

WHO criteria#	Death		Near Miss		Mortality rate (%)
	n	%	n	%
Laboratory based criteria
PaO₂/FiO₂ <200 mmHg	10	55.6	48	7.3	17.2
Higher creatinine ≥3.5 mg/dl	4	22.2	17	2.6	19.0
Higher bilirubin total >6.0 mg/dl	5	27.8	9	1.4	35.7
Lower pH <7.1	5	27.8	4	0.6	55.6
Lower platelet count <50,000	8	44.4	51	7.8	13.6
Any laboratory *	15	83.3	108	16.5	12.2
Management
Use of vasoactive drugs	16	88.9	63	9.6	20.2
Hysterectomy	4	22.2	47	7.2	7.8
Blood transfusion ≥5 units	4	22.2	38	5.8	9.5
Invasive mechanical ventilation ≥ 1 h	16	88.9	91	13.9	14.9
Hemodialysis	3	16.7	4	0.6	42.9
CPR	10	55.6	4	0.6	71.4
Any management	17	94.4	145	22.1	10.5
Combined (laboratory and management)	18	100.0	194	29.6	8.5
(Total number of SMM)	18		655

# The clinical criteria were not included in this current evaluation
* The following laboratory criteria were not included: Oxygen saturation <90% for ≥60 min; lactate >5; loss of consciousness with glycosuria and ketonuria
SMM: severe maternal morbidity; CPR: cardio pulmonary resuscitation.

ISSN: 1742-4755