From: Obstetric near miss and deaths in public and private hospitals in Indonesia
Organ dysfunction | |
---|---|
Cardiac dysfunction | Pulmonary oedema, cardiac arrest, cardiac failure |
Pulmonary embolism | - |
Vascular dysfunction | Hypovolaemia requiring two or more units of blood, blood loss with hypovolaemic shock (systolic blood pressure < 90 mmHg or undetectable pulse), infusion and/or transfusion of > = 1 litre in 2 hours, free flow infusiona, massive haemorrhage recorded in notes |
Immunological dysfunction | Septic shock |
Respiratory dysfunction | Intubation or ventilation for reasons other than general anaesthesia, oxygen saturation on pulse oximetry < 90% leading to ventilation |
Renal dysfunction | Oliguria < 30 ml per hour or < 400 ml per 24 hours, shock not responsive to intravascular rehydration or diuresis, haemodialysis |
Liver dysfunction | Jaundice in pre-eclampsia, abnormal liver function tests |
Coagulation dysfunction | Acute thrombocytopenia, prolonged bleeding time, abnormal Activated Partial Thromboplastine Time (APTT) or Prothrombine Time (PT), coagulopathy |
Cerebral dysfunction | Coma, cerebral oedema, seizures other than eclampsia |
Management based criteria | |
 | Intensive care admission, emergency hysterectomy, needs resuscitation, anaesthetic accident, referral to tertiary hospital |
Clinical diagnosis | |
 | Eclampsia, uterine rupture, ectopic pregnancy |