Rossignol M, Jonard M, Cohen H
Département d'anesthésie-réanimation et SMUR, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75465 Paris, France.
Service de réanimation polyvalente, pôle de soins critiques, hôpital de Lens, 99, route de la Bassée, 62307 Lens, France.
Gynecol Obstet Fertil Senol. 2021 Jan;49(1):73-78. doi: 10.1016/j.gofs.2020.11.013. Epub 2020 Nov 5.
Between 2013 and 2015, 20 maternal deaths were associated with stroke. Stroke was the main cause of death in 16 cases (12 hemorrhagic strokes [75%], 1 ischemic stroke and three cerebral thrombophlebitis). In the four other cases, the stroke was a complication of another pathology. The 16 deaths directly related to stroke account for 5.7% of all maternal deaths (maternal mortality ratio of 0.7/100,000 live births vs. 0.9/100,000 over the period 2010-2012, NS). Stroke occurred during pregnancy in 8 cases (50%). Three patients died without giving birth and the 5 others gave birth by emergency caesarean section. In the remaining eight cases (50%), stroke occurred between day 0 and day 54 during the post-partum period. The mean age was 35.5 years, with 9 women being more than 35 years old (56%). One or more factors of sub-optimal care were present in 28% of the cases, and 8% of deaths were considered possibly or probably preventable. The last four strokes were associated with another pathology (eclampsia [n=2], hepatic cirrhosis [n=1], possible complication of spinal anesthesia [n=1]).
2013年至2015年期间，20例孕产妇死亡与中风有关。中风是16例（12例出血性中风[75%]、1例缺血性中风和3例脑静脉血栓形成）的主要死因。在其他4例中，中风是另一种病理情况的并发症。与中风直接相关的16例死亡占所有孕产妇死亡的5.7%（孕产妇死亡率为0.7/10万活产，而2010 - 2012年期间为0.9/10万活产，无显著性差异）。8例（50%）中风发生在孕期。3例患者未分娩即死亡，另外5例通过急诊剖宫产分娩。在其余8例（50%）中，中风发生在产后0至54天。平均年龄为35.5岁，9名女性年龄超过35岁（56%）。28%的病例存在一个或多个护理欠佳因素，8%的死亡被认为可能或很可能是可预防的。最后4例中风与另一种病理情况相关（子痫[n = 2]、肝硬化[n = 1]、可能的脊髓麻醉并发症[n = 1]）。
