[Audits and confidential enquiry: thoughts on the technique used by the French National Committee for the reduction of maternal deaths].

This study demonstrates the need for a confidential approach to medial information when the objective is to improve medical practices, as was the goal of the French National Committee for the reduction of maternal deaths. This approach is the exact opposite of a litigation where the goal is to determine "guilt". Confidential analysis of maternal deaths is not designed to find a guilty person, but rather to identify the mechanisms leading to a maternal death in order to correct the organizational or medical practice leading to failure. We review here similar actions taken to reduce other types of medical accidents such as anesthesia deaths. The confidential approach has been found to be pertinent in the perinatal audit conducted in the Seine-Saint-Denis region, including all fetal and neonatal deaths, that has shown measurable reduction in the number of fetal deaths.