Atypical and isolated posterior reversible encephalopathy syndrome in postpartum without preeclampsia: a case report.

Posterior reversible encephalopathy syndrome (PRES) is a neurological complication frequently found during brain exploration for severe preeclampsia when it is associated with neurological signs. Being a newly discovered entity, its mechanism of genesis is still based on a hypothesis not yet confirmed. The clinical case that we report highlights an atypical PRES syndrome occurring in postpartum without any signs of preeclampsia. The patient had suffered a state of convulsive dysfunction after delivery without hypertension and the diagnosis of PRES syndrome was confirmed based on the results of the brain computed tomography (CT) scan, she showed signs of clinical improvement on the fifth day of postpartum. Our case report calls into question the association between PRES syndrome and preeclampsia that we find in literature and puts a big question mark on the causal link between the two in pregnant women.

Primary angiosarcoma of the breast: a case report.

Primary angiosarcoma of the breast is an extremely rare tumour with a difficult diagnosis and poor prognosis. We report a case of primary breast angiosarcoma diagnosed in the pathology department of the University Hospital of Oujda. An analysis of the epidemiological, diagnostic and therapeutic aspects of this type of tumour is made in this manuscript. Mastectomy is the standard treatment; the place of radiotherapy and chemotherapy is not well established. We report a case of a 18- year-old woman having an infectious symptomatology of the right breast for which she received an anti-infectious therapy inducing regression of inflammatory symptoms presented with a quick growing mass. Initial core needle biopsy showed a malignant vascular proliferation. The patient underwent a mastectomy. The tumor histology showed papillary formations and vascular structures lined by atypical cells with hyperchromatic nucleus and eosinophilic cytoplasm. The tumor cells expressed CD34 and CD31 but were negative for cytokeratin. The diagnosis of angiosarcoma grade I was made. The patient is now receiving chemotherapy. She is still alive.

[Epidemiological profile of maternal complications related to cesarean section at the Al Farabi Hospital in Oujda]. / Le profil épidémiologique des complications maternelles de la césarienne au CHR EL Farabi Oujda.

In Morocco cesarean section rate has increased from 2% in 1992 to 16% in 2011. This was associated with increased per- and postoperative mortality and morbidity, which was 19% in our case series. This study is the first of its kind to be conducted in the eastern region of Morocco and aims to analyze the comprehensive epidemiologic profile of maternal complications related to cesarean section on the basis of 2417 cases observed in the Maternity Department at the El Farabi Hospital, Oujda. We conducted an observational, descriptive, retrospective study of a series of 2416 patients undergoing cesarean section in the Maternity Department at the El Farabi Hospital, Oujda, over the period 1 January 2011-31 December 2013. Out of 24464 deliveries, 2416 were cesarean sections, reflecting a rate of 9.87%. The frequency of complications related to cesarean section was 19.45%. Postoperative complications accounted for 63.6% of the complications dominated by infection. Haemorrhagic complications accounted for 25.53% of all complications. 4 cases of maternal deaths were recorded. If the increased rate of cesarean sections has contributed to improve maternal-fetal prognosis, the surgical act itself is not complication-free, which leads us to review its indications for improved patient management.

Uterine necrosis following a combination of uterine compression sutures and vascular ligation during a postpartum hemorrhage: A case report.

INTRODUCTION: The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. CLINICAL CASE: We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39°C). At day 3 of postoperative period, the patient developed a fever (39°C) associated with diffuse abdominal pain, diarrhea and non-fetid lochia. At day 5, she presented a state of sepsis. Abdominal and pelvic CT objectified gas bubbles in the uterine myometrium suggestive of necrosis. An exploratory laparotomy was performed. After adhesiolysis, exploration found a complete necrosis of the uterus DISCUSSION: There are many surgical techniques for the management of postpartum bleeding, and hysterectomy remains the reference solution in this context. However, new conservative surgical techniques that are easier to perform and are less aggressive have emerged and are becoming more commonly used. CONCLUSION: We emphasize on the importance of choosing surgical techniques that lead to the preservation of uterine vascularization.