MATERNAL DEATHS AND SUBSTANDARD CARE - THE RESULTS OF A CONFIDENTIAL SURVEY IN FRANCE

Objective: Confidential enquiries were carried out to attempt to under stand why the level of maternal mortality has been high in France, Stu dy Design: A descriptive retrospective survey has been carried out, Fi ve administrative regions participated in the survey, All maternal dea ths - according to the WHO definition - that occurred in these regions over a period of at least 1 year were studied, A specialist completed a full medical questionnaire for each death. Then a committee of medi cal experts determined the reasons for the death and whether it might have been avoided. Results: Forty-six deaths were recorded, 39 of whic h were classified as maternal. Haemorrhages were the leading underlyin g cause, then embolisms and hypertensive diseases. Of the 39 deaths, 1 7 were determined to have been certainly avoidable, and nine more prob ably avoidable. More than half of all maternal deaths were related to inappropriate or substandard care. These results are discussed in the light of the British and Dutch experience with confidential enquiries into maternal deaths. Conclusion: There is no clear explanation why th e French maternal mortality rate is high, but the study points out som e malfunctions in health care service.