Maternal mortality due to cardiovascular diseases in France 2016-2018 ; Mortalité maternelle par pathologies cardiovasculaires en France 2016–2018

International audience ; Between 2016 and 2018, cardiovascular diseases were responsible for 41 deaths, making it the leading cause of maternal death within 42 days postpartum in France. The maternal mortality ratio (MMR) for cardiovascular disease is 1.8 per 100,000 NV, a non-significant increase compared with the 2013-2015 triennium (MMR of 1.5 per 100,000 NV). Deaths from cardiac causes accounted for the majority (n=28), with 26 deaths secondary to cardiac disease aggravated by pregnancy (indirect deaths) and 2 deaths related to peripartum cardiomyopathy (direct deaths). Deaths from vascular causes (n=13) corresponded to 9 aortic dissections and 4 ruptures of large vessels, including 3 ruptures of the splenic artery. Preventability of death (possible or probable) was found in 56% of cases compared with 66% in the previous triennium. Care was considered sub-optimal in 57% of cases, down from 72% in the 2013-2015 triennium. In women with known cardiovascular disease, the areas for improvement concern multidisciplinary follow-up, repeated assessment of the cardiovascular risk (WHO grade) and early referral to an expert centre (expert cardiologists, obstetricians, anaesthetists and intensive care). In all pregnant women or women who have recently given birth, a cardiovascular etiology should be considered in the presence of suggestive symptoms (dyspnea, chest or abdominal pain). Ultrasound "point of care" examination (fluid effusions, cardiac dysfunction) and cardiac enzymes assay can help in the diagnosis. Finally, the woman must be involved in her own care. ; Entre 2016 et 2018, les maladies cardiovasculaires sont responsables de 41 décès, ce qui en font la première cause de mort maternelle dans les 42 j post-partum en France. Le ratio de mortalité maternelle (RMM) par maladies cardiovasculaires est de 1,8 pour 100 000 NV, augmentation non significative par rapport au triennium 2013–2015 (RMM de 1,5 pour 100 000 NV). Les décès de causes cardiaques sont majoritaires (n = 28), avec 26 décès secondaires à une ...