I liked the overall theme and she really does look terrified. The worm in the mouth was also a nice touch. You're very talented with lighting and colours. The dirt is also perfect.
I also like the fact that she has blonde hair. Unintentional or not, it gives her more of an innocent appearance, making her suffering seem worse.
I do, however, feel that the worms could have been arranged a bit more scattered around on the edges. It does look like it's been placed over carefully.
Other than that, I think you did a great job and a splendid execution indeed.