CH Vendée

CH Vichy

CH Vienne

CH Villeneuve Saint Georges

CHI Créteil

CHI Poissy

GHER Saint Benoit

CHU Amiens

CHU Angers

CHU Béclère

CHU Besançon

CHU Bondy

CHU Bordeaux

CHU Brest

CHU Caen

CHU Clermont-Ferrand

CHU Conception

CHU Croix Rousse

CHU Dijon

CHU FME Lyon

CHU Grenoble

CHU Guadeloupe

CHU Hôpital Nord

CHU Lille

CHU Limoges

CHU Lyon Sud

CHU Martinique

CHU Montpellier

CHU Nancy

CHU Nantes

CHU Necker

CHU Nice

CHU Nîmes

CHU Poitiers

CHU Port Royal

CHU Reims

CHU Rennes

CHU Robert Debré

CHU Rouen

CHU Saint Etienne

CHU Salpetrière

CHU Schiltigheim

CHU Strasbourg

CHU Saint Pierre

CHU Tenon

CHU Toulouse

CHU Tours

CHU Trousseau

CH Saint Vincent de Paul

Clinique Le Creusot

Hôpital des Diaconesses

Hôpital Privé des Côtes d'Armor

Hôpital Saint Joseph

Institut Mutualiste Montsouris

Medipole Hôpital Mutualiste

Clinique Belledonne

Clinique de l'Anjou

Clinique des Orchidées

Clinique du Val d'Ouest

Clinique Durieux

Clinique Émailleurs Limoges

Clinique Keraudren

Clinique Mathilde Rouen

Clinique Rive Gauche Toulouse

Clinique Victor Pauchet

Hôpital Privé Océane Vannes

Polyclinique du Beaujolais

Polyclinique sainte Thérèse
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# Résumé

## État des lieux des connaissances et prise en charge de la pré-éclampsie dans les maternités françaises

**Introduction** : Les pathologies hypertensives gravidiques sont la 2ème cause de mortalité maternelle dans le monde et sont responsables de 16% des décès néonataux. La prévalence de la pré-éclampsie (PE) en France est de 2,3%. La PE est responsable de 22% des cas de prématurité avant 34 semaines d'aménorrhées (SA). La PE peut entrainer des dysfonctions d'organes maternels et des une morts fœtales in utero. La prise charge des PE, qui doit être pluridisciplinaire, s'établit sur des protocoles permettant des pratiques homogènes et standardisées. Dans ce contexte, notre objectif était d'évaluer les pratiques actuelles de prise en charge de la PE dans les maternités françaises en 2024 à l'aune des dernières RPC sur le sujet.

**Matériel et méthodes** : Il s'agit d'une enquête descriptive nationale sur la période du 1er avril 2024 au 1er août 2024. Nous avons contacté 456 maternités.

**Résultats** : Nous avons recueilli les réponses de 170 maternités de différents types et statuts (CHU, CHG, hôpitaux privés). Un protocole de prise en charge des PE était retrouvé dans 92% des cas, sans différence significative selon le type ou le statut (p=0,3). Les biomarqueurs étaient dosés dans 27% des maternités mais plus fréquemment dans les types 3 (p=0,003). Une prise en charge ambulatoire était possible dans 78% des établissements. En cas d'éclampsie, le sulfate de magnésium était utilisé en 1ère intention dans 67% des cas (p=0,013). En cas de PE sévère, 37% des maternités poursuivaient la grossesse jusqu'à 37 SA et plus.

**Conclusion** : Les pratiques déclarées par les maternités étaient globalement concordantes avec les recommandations récentes du CNGOF bien que nous ayons révélé quelques disparités.

**Mots-clés** : Pré-éclampsie, Enquête de pratique, Ambulatoire, Antihypertenseur, Accouchement

## Current knowledge and management of pre-eclampsia in French maternity hospitals

**Introduction** : Pregnancy-related hypertensive disorders are the 2nd leading cause of maternal mortality worldwide, and are responsible for 16% of neonatal deaths. The prevalence of pre-eclampsia (PE) in France is 2.3%. PE is responsible for 22% of premature births before 34 weeks' amenorrhea (SA). PE can lead to maternal organ dysfunction and fetal death in utero. The management of EP, which must be multidisciplinary, is based on protocols that enable uniform, standardized practices. In this context, our aim was to evaluate current EP management practices in French maternity units in 2024, in the light of the latest CPRs on the subject.

**Material and methods** : This was a national descriptive survey covering the period from April 1, 2024 to August 1, 2024. We contacted 456 maternity hospitals.

**Results** : We collected responses from 170 maternity units of different types and status (CHU, CHG, private hospitals). An EP management protocol was found in 92% of cases, with no significant difference according to type or status (p=0.3). Biomarkers were measured in 27% of maternity units, but more frequently in type 3 (p=0.003). Outpatient management was possible in 78% of facilities. In cases of eclampsia, magnesium sulfate was used as 1st-line treatment in 67% of cases (p=0.013). In cases of severe PE, 37% of maternity units continued the pregnancy until 37 or more weeks' gestation.

**Conclusion** : The practices reported by maternity units were broadly in line with recent CNGOF recommendations, although we did find some disparities.

**Key words** : Pre-eclampsia, Practice survey, Ambulatory, Antihypertensive, Delivery