Publications by authors named "Morau E"
Article Synopsis
- Obstetric hemorrhage is a significant cause of maternal mortality that can be largely prevented, yet surgical injury during cesarean sections has become more common in France as a contributing factor to this issue.
- A nationwide study analyzed maternal deaths from surgical injuries during cesareans in France from 2007 to 2018, revealing a concerning trend of increasing mortality ratios despite overall improvements in maternal health outcomes.
- Key findings indicate that factors such as obesity, prior cesareans, and inadequate facilities played a significant role in these deaths, highlighting the need for improved care processes and risk factor management to enhance maternal safety.
Article Synopsis
- The study analyzed changes in the incidence and causes of maternal deaths due to obstetric hemorrhage in France from 2001 to 2015, focusing on the impact of national guidelines implemented in 2004 and updated in 2014.
- Findings revealed a significant drop in the maternal mortality ratio (MMR) from 2.3 to 0.8 per 100,000 livebirths, with a notable decrease in deaths from uterine atony.
- Despite improved clinical care, 88% of maternal deaths from hemorrhage were still considered preventable, highlighting areas needing further improvement in diagnosis and surgical management.
Background: Specific guidelines to manage caesarean delivery anaesthesia are lacking. A European multicentre study, ACCESS investigates caesarean delivery anaesthesia management in European centres. In order to identify ACCESS participating centres, a registration survey was created.
View Article and Find Full Text PDF[Maternal mortality due to Amniotic Fluid Embolism in France 2016-2018].
Gynecol Obstet Fertil Senol
April 2024
Article Synopsis
- * The majority of cases occurred during labor, with an average time from symptom onset to death being about 4 hours and 45 minutes, highlighting the rapid progression of the condition.
- * Preventability was suggested for 35% of these deaths, indicating opportunities for improvement in medical skills, communication, and health care organization; autopsies were conducted in 38% of the cases.
[Maternal mortality and health care organization in France 2016-2018].
Gynecol Obstet Fertil Senol
April 2024
Article Synopsis
- When assessing mortality cases, the organization of care is a crucial element, focusing on factors like the right place of care, timely transfers, adequate resources, and communication between caregivers.
- From 2016-2018, 24% of assessed cases showed preventability factors related to care organization, with communication issues being the most common, followed by inappropriate care settings and insufficient resources.
- To improve care, better emergency response in maternity units and enhanced coordination with other medical sectors are needed, particularly in managing patients with combined psychiatric and somatic issues.
[Maternal mortality due to obstetric haemorrhage in France 2016-2018].
Gynecol Obstet Fertil Senol
April 2024
Article Synopsis
- Between 2016 and 2018, there were 20 maternal deaths due to obstetric haemorrhage, resulting in a mortality ratio of 0.87 per 100,000 live births and accounting for 7.4% of all maternal deaths within a year.
- The rate of maternal mortality from obstetric haemorrhage has decreased significantly since the early 2000s, but it remains a leading direct cause of maternal deaths, with many cases considered preventable due to shortcomings in care.
- Most deaths from haemorrhage during this period occurred during caesarean deliveries, often linked to complications like uterine rupture and surgical injuries, highlighting the need for hospitals to be prepared for such emergencies.
[Maternal mortality due to cardiovascular diseases in France 2016-2018].
Gynecol Obstet Fertil Senol
April 2024
Article Synopsis
- Between 2016 and 2018, cardiovascular diseases were the leading cause of maternal deaths in France, with a mortality ratio of 1.8 per 100,000 live births, showing a slight increase from the previous period.
- Most deaths were due to cardiac issues, predominantly aggravated by pregnancy, while 13 deaths were linked to vascular causes.
- The study indicates that there is potential to prevent 56% of these deaths, highlighting the need for better multidisciplinary care, regular risk assessments, and active participation from the women themselves in managing their health.
Study Objective: During the COVID crisis, pre-anesthesia teleconsultations were widely used leading to savings in time and money. However, the non-inferiority of this system has not yet been evaluated.
Design: Prospective, randomized, controlled, single-blind non-inferiority study.
Objective: Telemedicine has widely expanded during the coronavirus disease-2019 pandemic. Our objective was to evaluate the feasibility, safety, effectiveness, and satisfaction of pre-anaesthesia telephone consultation (PATC).
Methods: From December 2015 to October 2016, a prospective survey was administered to anaesthesiologists, nurse anaesthetists, and patients of the ambulatory and maxillofacial departments.
Objective: To describe the clinical profile, management, and potential preventability of maternal cardiovascular deaths.
Methods: We conducted a retrospective, descriptive study of all maternal deaths resulting from a cardiovascular disease during pregnancy or up to 1 year after the end of pregnancy in France from 2007 to 2015. Deaths were identified through the nationwide permanent enhanced maternal mortality surveillance system (ENCMM [Enquête Nationale Confidentielle sur les Morts Maternelles]).
Global health is an important and far-reaching concept in which health and access to surgical and anaesthetic care is crucial. Universal access to anaesthesia is a challenge in many countries. Manpower shortages are an important cause of difficulties and each European country has found different ways of facing a lack of healthcare professionals.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess the prevalence of maternal sudden death (MSD) in France and compare characteristics between women whose deaths were explained versus unexplained.
- A total of 83 cases of MSD were identified from 2007-2012, making up 16% of all maternal deaths; 61% of these deaths had an explained cause, while 39% were unexplained.
- The results indicated significant differences in factors such as hospital treatments and postmortem investigations, suggesting a need for enhanced training for healthcare providers and systematic autopsies to improve understanding and prevention of MSD.
Guidelines for the management of urgent obstetric situations in emergency medicine, 2022.
Anaesth Crit Care Pain Med
October 2022
Objective: To provide recommendations on the management of urgent obstetrical emergencies outside the maternity ward.
Design: A group of 24 experts from the French Society of Emergency Medicine (SFMU), the French Society of Anaesthesia and Intensive Care Medicine (SFAR) and the French College of Gynaecologists and Obstetricians (CNGOF) was convened. Potential conflicts of interest were formally declared at the outset of the guideline development process, which was conducted independently of industry funding.
In an effort to avoid travel and interpersonal contact, the COVID-19 health crisis was an opportunity to offer preanesthesia teleconsultation (TCs) to patients scheduled for surgery. We studied the technical feasibility and patient experiences of these TCs using a 4-point Likert scale questionnaire. Eighty-six patients out of 139 responded.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to compare the effectiveness of remifentanil and sufentanil for performing feticide after 22 weeks of gestation in France, focusing on time to fetal asystole and other safety measures.
- - A randomized trial included 66 women divided into two groups, with results showing no significant differences in time to fetal asystole or procedure success rates between the two drugs.
- - Both remifentanil and sufentanil were safe, with no severe maternal side effects, and tissue examinations showed no significant differences in cellular modifications.
[Maternal mortality in France 2013-2015: An evolving profile].
Gynecol Obstet Fertil Senol
January 2021
Labour epidural analgesia and autism: give the right information to mothers!
Anaesth Crit Care Pain Med
February 2021
Maternal death from haemorrhage is decreasing: in the last 15 years the number of deaths has been halved. This improvement demonstrates the progress made in hemorrhage management as a result of collective efforts. The number of deaths in this triennium is 22, representing 8.
View Article and Find Full Text PDF[Maternal Deaths due to Amniotic Fluid Embolism in France 2013-2015].
Gynecol Obstet Fertil Senol
January 2021
Amniotic fluid embolism remains the 3rd cause of maternal death in France, with a stable rate and 28 deaths in this triennium, representing 10.7% of maternal deaths and a maternal mortality ratio of 1.2/100,000 live births.
View Article and Find Full Text PDF[Maternal mortality due to cardiovascular disease in France 2013-2015].
Gynecol Obstet Fertil Senol
January 2021
Between 2013 and 2015, cardiovascular diseases became one of the two leading causes of maternal mortality, with 36 deaths (13.7% of maternal deaths). The overall maternal mortality ratio for cardiovascular diseases is 1.
View Article and Find Full Text PDF[Normal childbirth: physiologic labor support and medical procedures. Guidelines of the French National Authority for Health (HAS) with the collaboration of the French College of Gynaecologists and Obstetricians (CNGOF) and the French College of Midwives (CNSF) -- Text of the Guidelines (short text)].
Gynecol Obstet Fertil Senol
December 2020
Objective: The objective of these guidelines is to define for women at low obstetric risk modalities that respect the physiology of delivery and guarantee the quality and safety of maternal and newborn care.
Methods: These guidelines were made by a consensus of experts based on an analysis of the scientific literature and the French and international recommendations available on the subject.
Results: It is recommended to conduct a complete initial examination of the woman in labor at admission (consensus agreement).