From: The world health organization multicountry survey on maternal and newborn health: study protocol
Identification criteria | |
---|---|
Clinical organ dysfunction | • Respiratory rate > 100 breaths per minute |
• Cyanosis in room air | |
• Absence of regular breathing pattern (gasping respiration or frequent apnoea) | |
• Cardiac arrest | |
• Persistent bradycardia < 80 bpm | |
• Persistent tachycardia > 200 bpm | |
• Poor capillary filling (> 5s) | |
• Subaponeurotic haemorrhage | |
• Seizures | |
• Severe neurological depression (inability to suck) | |
• Severe pallor | |
• Visible jaundice in first 24 hours | |
• Any active, non traumatic, bleeding (e.g. GI bleeding, pulmonary haemorrhage) | |
• Visible haematuria | |
• Anuria > 24 hours | |
• Apathetic/Poor tolerance of feeds | |
• Abdominal distension and vomiting | |
• Brachial plexus injury | |
• Skull fracture | |
Laboratory markers of organ dysfunction | • Saturation by pulse oximetry < 85% in room air |
• pCO2 > 65 mmHg | |
• Serum pH < 7.1 | |
• Haematocrit < 30% | |
• Haemoglobin < 10 g/dl | |
• Glucose < 30 mg/dl or < 1.7 mmol/l | |
• White cell count < 4000 cells/mm3 | |
• Neutropaenia < 1000 cells/mm3 | |
• Raised C-Reactive Protein within 48 hours > 10 mg/dlx. | |
• X-ray signs of intestinal obstruction/perforation | |
• X-ray signs of skull fracture | |
Management indicators of severity | • Any intubation (at birth or anytime within first week) |
• Nasal CPAP | |
• Ventilation | |
• Surfactant administration | |
• Cardio-pulmonary resuscitation (cardiac massage) | |
• Use of any vasoactive drug | |
• Volume expansion | |
• Use of anticonvulsants | |
• Use of phototherapy in the first 24 hours | |
• Exchange transfusion | |
• Use of any blood products | |
• Use of steroids to treat refractory hypoglycaemia | |
• Use of therapeutic IV antibiotics | |
• Any surgery requiring general anaesthesia | |
Other conditions highly associated with severity in perinatal health | • Birth weight < 1500 g |
• Gestational age at birth < 31 weeks | |
• Apgar score 5 minutes < 5 |