title: [Perinatal mortality and quality of clinical management in the Aurore network from 2005 to 2011. Implementation of morbidity and mortality conferences].
abstract: OBJECTIVE
  Evaluate the incidence of perinatal mortality and evaluate the percentage of non optimal care management of fatal pregnancies between 2005 and 2011 in the Rhone-Alpes region in France, by the use of the Aurore network. Evaluate the development of morbi-mortality revues (MMR) in this region.
  
  
  METHODS
  Retrospective study of perinatal mortality in the Aurore network, from 2005 to 2011. Systematic analysis of care management (adapted, non adapted, non evaluable), of each perinatal death that occurred in the Aurore network, by a multidisciplinary committee during regional MMR.
  
  
  RESULTS
  The incidence of perinatal mortality has diminished from 2005 to 2011 (8,4‰ vs. 6,4‰, P<0.07) as well as the percentage of non adapted care management (13% vs. 5,6%, P<0.001). An underestimation of irregularities in the fetal heart rate was described in 34% of per partum deaths. The percentage of optimal care management was significantly higher when the obstetrician was in the maternity rather than on call at home (P<0.03) and in type 3 maternities compared to type 1 and 2 maternities (P<0.04). The attendance of the MMR organized in the AURORE network progressed between 2006 and 2011.
  
  
  CONCLUSIONS
  Since 2005, a decrease in perinatal mortality and in non-adapted care management was observed. More studies are necessary to evaluate the link between the development of MMR in this network and the amelioration of these two indicators.
authors.affiliation: Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France. Electronic address: charlotte.roux01@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Roux-Terrier
authors.affiliation: Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France; Inserm U846, Stem Cell and Brain Research Institute, université de Lyon-1, 18, avenue Doyen-Lepine, 69500 Bron, France; UMR-S 846, 69003 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Huissoud
authors.affiliation: Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Carrabin
authors.affiliation: Pôle information médicale évaluation recherche, hospices civils de Lyon, 69003 Lyon, France; EA « santé-individu-société », Inserm 4129, université de Lyon-1, 69002 Lyon, France; Faculté de médecine, université Lyon-1 Nord, 69008 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Colin
authors.affiliation: Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France; Réseau Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France; EA « santé-individu-société », Inserm 4129, université de Lyon-1, 69002 Lyon, France; Faculté de médecine, université Lyon-1 Nord, 69008 Lyon, France.
authors.forename: R-C
authors.initials: RC
authors.lastname: Rudigoz
authors.affiliation: Réseau Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France. Electronic address: corinne.dupont@chu-lyon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Dupont
mesh_terms: D019058:Community Networks / Q000458:organization & administration* / Q000592:standards; D004493:Education / Q000458:organization & administration / Q000592:standards; D005260:Female; D005602:France / Q000453:epidemiology; D006284:Health Plan Implementation; D006771:Hospitals, Maternity / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D009017:Morbidity; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control; D011787:Quality of Health Care / Q000592:standards / Q000639:trends; D012189:Retrospective Studies
keywords: Assurance qualité; Care management; Morbid-mortality revues; Mortalité périnatale; Obstetrics; Obstétrique; Perinatal mortality; Perinatal network; Revue de morbi-mortalité; Réseau de périnatalité