Table 1

The WHO maternal near-miss criteria*

Identification criteria


Cardiovascular dysfunction

• Shock

• Use of continuous vasoactive drugs

• Cardiac arrest

• Cardio-pulmonary resuscitation

• Severe hypoperfusion (lactate > 5 mmol/L or > 45 mg/dL)

• Severe acidosis (pH < 7.1)

Respiratory dysfunction

• Acute cyanosis

• Gasping

• Severe tachypnea (respiratory rate > 40 bpm)

• Severe bradypnea (respiratory rate < 6 bpm)

• Severe hypoxemia (PAO2/FiO2 < 200 or O2 saturation < 90% for ≥60 min)

• Intubation and ventilation not related to anaesthesia

Renal dysfunction

• Oliguria non responsive to fluids/diuretics

• Dialysis for acute renal failure

• Severe acute azotemia (creatinine ≥ 300 umol/ml or ≥ 3.5 mg/dL)

Coagulation/hematologic dysfunction

• Failure to form clots

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

• Severe acute thrombocytopenia (< 50,000 platelets/ml)

Hepatic dysfunction

• Jaundice in the presence of pre-eclampsia

• Severe acute hyperbilirubinemia (bilirubin > 100 umol/L or > 6.0 mg/dL)

Neurologic dysfunction

• Prolonged unconsciousness (lasting ≥ 12 hours)/coma (including metabolic coma)

• Stroke

• Status epilepticus/uncontrollable fits

• Total paralysis

Uterine dysfunction

• Haemorrhage or infection leading to hysterectomy


* Detailed information available at references [16] and [24]

Souza et al. BMC Health Services Research 2011 11:286   doi:10.1186/1472-6963-11-286

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