{
    "abstract": "Between 2013 and 2015, six maternal deaths were due to hypertensive disorders. During this period, the maternal mortality ratio was 0.2/100,000 live births. Hypertensive disorders were responsible for 2% of maternal deaths in France and for 5% of direct maternal mortality. All these deaths happened after the delivery. Mode of delivery was a cesarean section when the hypertensive complication started before the delivery (4/6; 67%). Three had DIC during the immediate post-partum. Five women were under 35 years old. Only one had a BMI over 30. Four out of six patients were primiparous. One woman was Afro-Caribbean. Medical care was estimated non-optimal in 100% of the cases. In three cases, it was prenatal care and in three cases it was obstetrical care during delivery; anesthesia and intensive care were suboptimal in five cases. Eighty percent of these deaths seemed to be preventable. The main causes of suboptimal management were inappropriate or insufficient obstetrical and/or anesthetic treatments, and delayed optimal treatment. The analysis of these maternal deaths offers the opportunity to stress major points to optimize medical management in case of hypertensive disorders during pregnancy such as management of eclampsia (use of magnesium sulfate) or recognition of DIC when HELLP syndrome is diagnosed.",
    "authors": [
        {
            "affiliation": "Service gyn\u00e9cologie obst\u00e9trique et m\u00e9decine de la reproduction, CHU de Caen, universit\u00e9 de Caen, avenue C\u00f4te-de-Nacre, 14033 Caen cedex 09, France. Electronic address: dreyfus-m@chu-caen.fr.",
            "firstname": "M",
            "initials": "M",
            "lastname": "Dreyfus"
        },
        {
            "affiliation": "Service de r\u00e9animation polyvalente p\u00f4le de soins critiques, h\u00f4pital de Lens, 99, route de la Bass\u00e9e, 62307 Lens, France.",
            "firstname": "M",
            "initials": "M",
            "lastname": "Jonard"
        },
        {
            "affiliation": "D\u00e9partement d'anesth\u00e9sie-r\u00e9animation, h\u00f4pital Trousseau, AP-HP, 26, avenue du Dr Arnold-Netter, 75012 Paris, France.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Rigouzzo"
        },
        {
            "affiliation": "Gyn\u00e9cologue-obst\u00e9tricien, CHR de Mulhouse Sud-Alsace, 68051 Mulhouse, France.",
            "firstname": "P",
            "initials": "P",
            "lastname": "Weber"
        },
        {
            "affiliation": null,
            "firstname": null,
            "initials": null,
            "lastname": null
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2020 Elsevier Masson SAS. All rights reserved.",
    "doi": "10.1016/j.gofs.2020.11.014",
    "journal": "Gynecologie, obstetrique, fertilite & senologie",
    "keywords": [
        "Eclampsia",
        "Gestational hypertension",
        "Grossesse",
        "HELLP syndrome",
        "Hypertension gravidique",
        "Maternal death",
        "Mort maternelle",
        "Preeclampsia",
        "Pregnancy",
        "Pr\u00e9\u00e9clampsie",
        "\u00c9clampsie"
    ],
    "methods": null,
    "publication_date": "2020-11-09",
    "pubmed_id": "33161188",
    "results": null,
    "title": "[Maternal deaths due to hypertensive disorders in France 2013-2015].",
    "xml": "<Element 'PubmedArticle' at 0x788504609cb0>"
}