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Bibliographical entry (without author) :

Mortalité maternelle : les complications obstétricales évitables Journal de Gynécologie Obstétrique et Biologie de la Reproduction Vol 30, N° SUP 6 - octobre 2001 pp. 232-

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URL(s) : JGYN-10-2001-30-S6-0368-2315-101019-ART4

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En France, depuis 1996, une enquête confidentielle permanente enregistre la mortalité maternelle. Le Comité National étudie les dossiers pour déterminer les causes de la mort, leur évitabilité et proposer des recommandations. En 1996 et 97, on a relevé 196 décès dont 165 ont pu être analysés : 123 (74 %) sont de causes obstétricales directes, 97 cas, représentent 78 % des morts obstétricales et se répartissent ainsi : 31 hémorragies (25 % des décès obstétricaux) dont 19 hémorragies de la délivrance, 20 HTA gravidiques (16 %) dont 10 éclampsies et 7 prééclampsies sévères, 16 embolies amniotiques (13 %), 11 accidents thromboemboliques (9 %) et 10 infections (8 %). les experts considèrent que 54 % des décès obstétricaux seraient évitables : 87 % des hémorragies, 80 % des infections, 65 % des HTA gravidiques, mais les embolies amniotiques restent inévitables. Les explications en sont des traitements inadéquats, des retards de prise en charge, des refus de soins, des fautes professionnelles et des diagnostics non faits. Pour éviter ces morts obstétricales directes, des recommandations sont proposées concernant les hémorragies de la délivrance, les prééclampsies et éclampsies, les infections materno-foetales et les thromboembolies.

Abstract (English)  :

Maternal mortality: avoidable obstetrical complications
Since 1996, maternal mortality is registered as part of a permanent confidential inquiry in France. The National Committee has studied all cases recorded to assess the cause of death and the avoidable obstetrical complications involved. Recommendations are proposed.

In 1996 and 1997, there were 196 maternal deaths in France; 165 could be analyzed. The cause was obstetrical in 123 cases (74%), non-obstetrical in 26 (16%), and unidentified in 16 (10%). Ninety-seven direct deaths occurred (78% of the obstetrical mortality cases); 31 cases of hemorrhage including 19 post partum, 20 cases of pregnancy-induced hypetension, 10 cases of eclampsia and 7 of pre-eclampsia, 16 cases of amniotic fluid embolism, 11 cases of thromboembolism and 10 cases of sepsis. The National Committee considered that 54% of these deaths were avoidable: 87% for hemorrhage, 80% for sepsis, and 65% for hypertensive diseases. The deaths due to amniotic fluid embolism were not considered avoidable. This mortality stemmed from substandard care, delayed treatment, missed diagnosis, and professional errors.

Clinical recommendations are proposed for post partum hemorrhage, pre-eclampsia and eclampsia, prevention of maternal infection, and thromboembolism prophylaxy.

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Keywords :

➡ infections ; prevention ; eclampsia (pre-) ; postpartum hemorrhage ; maternal death rate

Author of this record :

Emmanuelle Phan — 30 Dec 2009
➡ latest update : Marion Corbe — 30 Dec 2009

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