title: [Study of the 21 cases of thromboembolism from the 4th report of national confidential enquiry into maternal death in France in 2007-2009].
abstract: OBJECTIVE
  The Confidential National Enquiry on Maternal Mortality identified 254 deaths in France from 2007 to 2009. Thromboembolism venous disease led to 31 deaths, becoming the 3rd cause of maternal mortality. This study analyses the 21 enquiry files obtained by the National Expert Committee on Maternal Mortality (CNEMM).
  
  
  METHODS
  Clinical characteristics, arising circumstances and imaging exams were collected in the 20 patients deceased by pulmonary embolism (PE). After excluding two incomplete files, we looked for the PE Risk Factors (RF) in order to sort patients out according to 4 levels of risk (low, moderate, high and major).
  
  
  RESULTS
  The main RF were: non-Caucasian ethnic origin (n=8), age over 35years (n=7), diabetes (n=6) and emergency or unplanned caesarean section (n=6). The average number of RF was 3.7: 73% were low, 18% moderate. Among 7 autopsies performed, 6 resulted in PE diagnostic. Only 67% of eligible patients had an imaging exam.
  
  
  CONCLUSIONS
  The search for the RF of thromboembolism accidents, in particular the low RF, should be improved to establish an adapted prophylactic therapy. Autopsy or even post-mortem imaging should be implemented when diagnosis is uncertain in order to avoid over-/under-estimating death incidence caused by PE.
authors: Département d'anesthésie-réanimation, université Paris-Sud (Paris XI), hôpital Antoine-Béclère, groupe hospitalier universitaire Paris-Sud, AP-HP, 157, rue de la porte de Trivaux, 92141 Clamart, France. Electronic address: julierenner2403@yahoo.fr.
authors: J
authors: J
authors: Renner
authors: Département d'anesthésie-réanimation, université Paris-Sud (Paris XI), hôpital Antoine-Béclère, groupe hospitalier universitaire Paris-Sud, AP-HP, 157, rue de la porte de Trivaux, 92141 Clamart, France. Electronic address: frederic.mercier@abc.aphp.fr.
authors: F J
authors: FJ
authors: Mercier
mesh_terms: D000328:Adult; D005602:France / Q000453:epidemiology; D006801:Humans; D063130:Maternal Death / Q000706:statistics & numerical data*; D008428:Maternal Mortality / Q000208:ethnology*; D011655:Pulmonary Embolism / Q000401:mortality*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000401:mortality*; D055815:Young Adult
keywords: Cerebral venous thrombosis; Embolie pulmonaire; Facteurs de risque; Maternal mortality; Mortalité maternelle; Obstetric; Obstétrique; Pulmonary embolism; Risk factors; Thrombophlébite cérébrale