Skip to Main content Skip to Navigation
Master Thesis

Décès maternels par embolie amniotique : une étude nationale en France

Abstract : Background: a structured definition of amniotic fluid embolism (AFE) based on 4 criteria was proposed for use in research by the SMFM and the AFE Foundation. The objective of this study was to review AFE-related maternal deaths in France (2007-2011) according to the presence or not of all 4 diagnostic criteria. Methods: maternal deaths due to AFE were identified by the National Experts Committee of the French Confidential Enquiry into Maternal Deaths (CNEMM) (n=39). The maternal mortality ratio (MMR) for AFE was calculated. We applied the structured definition to AFE-related maternal deaths identified by the CNEMM. We described the characteristics of women, pregnancies and deliveries; clinical and biological features of AFE; and specific laboratory tests by the presence or not of all 4 diagnostic criteria. Management of obstetric hemorrhage and quality of care according to the experts were described. Results: the MMR from AFE was 0,95/100,000 live births (95CI 0,67-1,3). Detailed clinical data were collected for 36 women: 21 (58%) had all 4 diagnostic criteria and 15 (42%) had at least one missing. Documented early coagulopathy was missing for 14 women. Opportunities to improve care included timely performance of indicated hysterectomy (n=13) and improved transfusion practices (n=9). In the context of maternal cardiac arrest, for 5 of 13 women, fetal extraction was performed within 5 min. Conclusions: the structured definition of AFE for research studies would exclude more than 1/3 of AFE-related maternal deaths identified by the CNEMM. Inclusion of clinical coagulopathy as diagnostic criterion for AFE would reduce this proportion to 14%.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [30 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01704086
Contributor : Université Paris Descartes - Scd <>
Submitted on : Thursday, February 8, 2018 - 11:29:40 AM
Last modification on : Friday, March 27, 2020 - 2:53:29 AM
Long-term archiving on: : Wednesday, May 9, 2018 - 12:20:12 PM

File

ThExe_ZLOTNIK_Diane_DUMAS.pdf
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-01704086, version 1

Citation

Diane Zlotnik. Décès maternels par embolie amniotique : une étude nationale en France. Médecine humaine et pathologie. 2017. ⟨dumas-01704086⟩

Share

Metrics

Record views

75

Files downloads

1261