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Table 1 List of parameters presented for evaluation and suggested in the study

From: Adaptation of the WHO maternal near miss tool for use in sub–Saharan Africa: an International Delphi study

Original parameters

Suggested parameters (=14)

WHO Parameters (=25)

 1. Acute cyanosis

 2. Gasping

 3. Respiratory rate > 40 or <6/min

 4. Shock

 5. Oliguria non responsive to fluids or diuretics

 6. Failure to form clots

 7. Loss of consciousness lasting more than 12 h

 8. Cardiac arrest

 9. Stroke

 10. Uncontrollable fit/total paralysis

 11. Jaundice in the presence of pre-eclampsia

 12. Oxygen saturation < 90% for >60 min

 13. PaO2/FiO2 < 200 mmHg

 14. Creatinine >300 μmol/l or >3.5 mg/dl

 15. Bilirubin >100 μmol/l or >6.0 mg/dl

 16. pH <7.1

 17. Lactate >5 mEq/ml

 18. Acute thrombocytopenia (<50,000 platelets/ml)

 19. Loss of consciousness and ketoacids in urine

 20. Use of continuous vasoactive drugs

 21. Hysterectomy following infection or haemorrhage

 22. Massive transfusion of blood or red cells (≥5 units)

 23. Intubation and ventilation for >60 min not related to anaesthesia

 24. Dialysis for acute renal failure

 25. Cardio-pulmonary resuscitation

Parameters from the literature (=12)

 26. Uterine rupture

 27. Sepsis or severe systemic infection

 28. Eclampsia

 29. Laparotomy other than CS

 30. Pulmonary edema

 31. Admission to the ICU

 32. Diabetic Keto Acidosis

 33. Severe malaria

 34. Obstructed labour

 35. Severe anaemia

 36. Severe HIV related illnesses

 37. Uterine artery embolization

1. Severe abortion complications

2. Failed tracheal intubation requiring anaesthetic reversal

3. Maternal indication to terminate pregnancy

4. Kussmaul respiration

5. Severe dehydration

6. Confusion

7. Ketotic breath

8. Acute kidney injury

9. Uterine tamponade

10. Ligation of internal iliac vessels

11. Severe hypotension (SBP < 90 mmHg lasting >60 min)

12. Pre-eclampsia with the presence of oliguria or respiratory disorder

13. Severe PPH (>1000 ml of blood) within 24 h of delivery

14. Severe pre-eclampsia with ICU admission

  1. CS Caesarean Section, ICU Intensive Care Unit, HIV Human Immunodeficiency Virus, SBP Systolic Blood Pressure, PPH Postpartum haemorrhage