[International and French maternal mortality]

International and French maternal mortality. Maternal mortality, defined as the death of a woman during pregnancy and 42 days following delivery, remains a major challenge to health systems worldwide and a known indicator of development. As did the Millennium Development Goal 5, France health ministry targeted a reduction in maternal mortality ratio. Organizations have been developed through the last decade to reach this objective: a triennial maternal deaths national enquiry analyzes the reported cases and evaluates the evitability of the event. Recommendations are produced regarding the major causes of maternal deaths. French maternal mortality ratio varies from 8 to 12 /100,000 births. The major causes are direct obstetric causes (postpartum hemorrhage, thromboembolism, amniotic fluid embolism and preeclampsia, but also rarely sepsis and anaesthesia). The major indirect obstetric causes are cardiopathies, vascular diseases and miscellaneous. Deaths may be due to non-obstetrical causes such as suicides and trauma. In France, the first cause of maternal death is postpartum hemorrhage that represented 33% of the mortality, two triennium ago. This rate have been reduced to 18% and the factors contributing to this reduction were 2004 PPH prevention and management practice guidelines publication updated in 2014 and their diffusion supported by the French society of Anesthesia Intensive Care (SFAR) and the French National Society of Gynecologists and Obstetricians (CNGOF) as well as the midwifes organizations. The perinatal health care networks were actors of this improvement in medical care practices and organization. However a large improvement margin exists to better reduce the maternal mortality ratio in our country.