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The generalized reporting of the deaths of women during pregnancy or postpartum by care providers is fundamental for ensuring the best knowledge of the national profile of these cases and for improving care and its organization; these reports can be made through the perinatal networks and via the death certificate.

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The participation of clinicians and health care facilities in the national confidential enquiry of maternal mortality (ENCMM) is essential to ensure the collection of the most relevant information for each case.

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The collective review by audit of these maternal deaths locally at the level of the hospital or of the perinatal network is essential for identifying methods of prevention in the local context. The lessons drawn from the examination of all the maternal deaths in the framework of a national confidential enquiry complement those drawn from local reviews.

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Autopsies allow the diagnosis of rare diseases that sometimes preexisted the pregnancy and that are sometimes familial. The proportion of maternal deaths for which an autopsy was performed (30%) remains insufficient in France. This observation should lead to local, regional, and national consideration of how to remove the obstacles to the implementation of autopsies. In all cases, it is possible to sign the death certificate stating that there is a medicolegal obstacle, which opens up the possibility of a medicolegal autopsy.

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If an autopsy is impossible or while awaiting it, a whole-body CT scan, rapidly performed, can identify some causes of death.

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Vaccination against influenza is recommended in the epidemic period for all pregnant women, regardless of gestational age.

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A disease existing before the pregnancy and that constitutes a situation at clear maternal risk (especially heart disease, psychiatric disorders, neurological diseases, and cancer) makes it essential to conduct a preconception evaluation of the disease and inform the woman of the risks involved. This evaluation should be multidisciplinary, bringing together obstetricians, anesthesiologists, and specialists of the disease concerned, and it should be documented. If the situation so warrants, pregnancy will be clearly advised against from a medical point of view, and this opinion will be documented in writing.

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This maternal risk assessment, before or at the beginning of pregnancy, must also allow planning for the management of the pregnancy (a "roadmap" mentioning the appropriate setting and care providers) according to the risks anticipated for mother and child. Referral to the hospital most appropriate for this management must take place as early as possible.

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Screening for psychosocial vulnerability and asking about psychiatric and addiction history is part of the examination of pregnant women and can be facilitated by simple tools.

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During prenatal consultations and more particularly at the first one, the physical examination must systematically include cardiac auscultation and a breast examination.

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In the case of acute maternal disease during pregnancy, maternal exploration and resuscitation prevail over emergency fetal operative delivery, unless there is associated fetal distress.

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If the complication is not obstetric, the woman must first be referred to a center with the resources necessary for its specific management and not in principle toward the maternity ward and its ED (for example, stroke or aortic dissection).

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In an in hospital cardiac arrest, cardiopulmonary resuscitation is based on 3 principles: