Benhamou D, Chassard D, Mercier F J, Bouvier-Colle M-H
Service d'anesthésie-réanimation, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
Ann Fr Anesth Reanim. 2009 Jan;28(1):38-43. doi: 10.1016/j.annfar.2008.11.002. Epub 2008 Dec 19.
To describe the main results and recommendations from the seventh report on confidential enquiry into maternal death in the United Kingdom (UK) (2003-2005).
Comparison with the most recent French data (1999-2001).
Maternal mortality tends to increase and indirect causes are more common than direct causes. Causes of deaths and their respective ranking are strikingly different with what is observed in France. This can probably be ascribed to the increasing role of obesity, maternal age, tobacco use and diabetes in the UK. Cardiac disease now ranks first among indirect causes and is linked in half of cases to ischaemic heart disease. This contrasts with the French situation where cardiac death remains rare. Thromboembolic disease remains the main cause of direct deaths while the role of haemorrhage has decreased. This also contrasts with the French situation where haemorrhage remains of concern. Sepsis is now the second cause in the UK (at the same level than preeclampsia), while it is a rare cause in France. In both French and UK reports, substandard care remains of concern in many cases of direct deaths. Anaesthesia is now a rare cause of death (n=6) although the UK report emphasizes that in a large number of cases, anaesthesia has contributed to death because of substandard care (n=31). In many cases, the report highlights the deleterious role of unsupervised residents.
The United Kingdom report integrates modern strategies that might improve patient safety, including systems failure analysis, incident reporting and registries. Systematic auditing (with proposition of auditable standards) might also prove important in facilitating implementation of the top ten recommendations. All these strategies might also be implemented in France and hopefully might prove to be also beneficial here.
描述英国（UK）孕产妇死亡保密调查报告第七号（2003 - 2005年）的主要结果和建议。
与法国最新数据（1999 - 2001年）进行比较。
孕产妇死亡率呈上升趋势，间接原因比直接原因更为常见。死亡原因及其各自排名与法国的情况显著不同。这可能归因于肥胖、孕产妇年龄、吸烟和糖尿病在英国所起的作用日益增加。心脏病现在在间接原因中排名第一，半数病例与缺血性心脏病有关。这与法国的情况形成对比，在法国心脏性死亡仍然很少见。血栓栓塞性疾病仍然是直接死亡的主要原因，而出血的作用已经下降。这也与法国的情况形成对比，在法国出血仍然令人担忧。败血症现在是英国的第二大死因（与子痫前期处于同一水平），而在法国是罕见死因。在法国和英国的报告中，许多直接死亡病例中护理不达标仍然令人担忧。麻醉现在是罕见的死亡原因（n = 6），尽管英国报告强调在大量病例中，麻醉因护理不达标导致了死亡（n = 31）。在许多情况下，报告强调了无监督住院医生的有害作用。
英国报告纳入了可能改善患者安全的现代策略，包括系统故障分析、事件报告和登记。系统审计（提出可审计标准）在促进十大建议的实施方面可能也很重要。所有这些策略也可能在法国实施，有望在这里也证明是有益的。
