[Medical termination of pregnancy. Indications, techniques and complications. Report of 55 cases]. / Les interruptions medicales de grossesse (IMG). Indications, techniques et complications. A propos de 55 cas.

We tried through this study to reassemble the cases of medical termination of pregnancy for foetal or maternal anomalies and analyse the epidemiological characteristics of our population and the procedures of induction of labour. We report a retrospective study about 55 cases of medical termination of pregnancy during 20 months indexed in service "C" of the centre of maternity and neonalogy in collaboration with the service of fetopathology. 12.73% of our patients were older than 38 years. The incidence of medical termination of pregnancy during the same period was about 1.90 cases/100 deliveries. Maternal indications was reported in 34.55% of cases and neurological malformations dominate the foetal anomalies (47.22%). Extra-amniotic saline infusion was used in 52.72% of cases and was responsible of all the complications observed (16.36%).

[Diagnosis of holoprosencephalia. Report of 17 cases]. / Diagnostic de l'holoprosencephalie. A propos de 17 cas.

OBJECTIVE: To establish the epidemiologic profile of holoprosencephalia and determine benefits of ultrasound and foetopathologic examination to the diagnostic. METHODS AN MATERIAL: [corrected] Retrospective study about 17 cases of holoprosencephalia observed in CMNT between Janaury 1992 and September 2000. RESULTS: Ultrasound diagnosis was made in 13 cases (75%). Ultrasound criteria were; absence of median structure of the brain and unique ventricule. The prognosis was always bad. Foetopathologic examination revealed 7 cases of lobar holoproencephalia and 10 of semi lobar. Fascial dysmorphia were noted in 82% of cases. CONCLUSION: The foetopathology and genetic counselling looking for fascial, dysmorphia in family's members gives a good evaluation of recurrences.

[Antenatal diagnosis and contribution of fetopathologic examination in the management of omphalocele]. / Diagnostic antenatal et apport de l'examen foetopathologique dans la prise en charge de l'omphalocele.

The omphalocele is an average coelosomie, frequency of which is estimated at 1/5000 births. We confront diagnosis antenatal with the exam foetopathologic in purpose of 41 cases of omphalocele brought together over a period going from January 1, 1991 till December, 2000 in the unity of foetopathologie from the CMNT. The frequency of omphaloceles is 4.88% of the children malformed and of 1.64% of the set (group) of the performed an autopsy children. An association malformative was found in 85.4% of cases and a karyotype typical aberration trisomie 13.18 and 21 was identified in 17% of cases. The preview of the children bearers of this deformation is especially bound (connected) to the existence and to the gravity of associated abnormalities. The omphalocele required a multidisciplinary making coverage intervernir obstetriciens, néonatologistes, surgeons pediatre and foetopathologistes.

[Prolonged pregnancy: apropos of a series of 102 cases]. / Grossesses prolongées: a propos d'une série de 102 cas.

UNLABELLED: It was a retrospective and continuous prospective study about 102 post-term pregnancy recensed on a 14 months period. The aim of this study is to evaluate our management of post term pregnancy and the peto-maternal morbidity and mortality. RESULTS: Frequency of post-term pregnancy in our study is 5.92%, in rate of session sector is not higher it is of 18.62. There is no maternal mortality. Neonatal mortality is a about 19/1000, the rate of neonatal morbidity is 2.9%.

[Fetal pathology study of 88 cases of letal spina bifida]. / Etude foeto-pathologique de 88 cas de spina bifida létaux.

Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.

[Contraception with Depo-Provera. Report of a series of 930 women]. / Contraception par Dépo-Provéra. A Propos d'une serie de 930 femmes.

In this study, Dépo-Provéra was evaluated in 930 women. It is a retrospective longitudinal bicentric study: We revealed the following results: The average age is 30.8 years. 66.6% the women have between 1 and 3 children. The nulliparous represent 17%. In 84.3%, it is the first used contraceptive method. The first injection was done in the post abortion in 65.3% of the cases. Pearl index is 0.46. Thus, the efficacy level is 99.54%. Amenorrhea is the most frequent trouble; its incidence within a year is 52.3%. It the first cause of abandon. The other troubles of the cycle disappear within 12 months. The acceptability is 34.8% year women.

[Value of ambulatory diagnostic hysteroscopy. A review of a series of 292 cases]. / Intérêt de l'hystéroscopie diagnostique en ambulatoire. A propos d'une serie de 292 cas.

This is a retrospective study including 292 ambulatory diagnostic hystéroscopies realised during a period of 1 year and a half. The mid age of our patients is 44 years. The main indications are haemorrhage, infertility and abnormal ultrasound findings. The exams are carried out under analgesia. Its sensibility is good concerning the endométrial pathology. As a matter of fact, it equals 100% for adénocarcinomas, it varies from 56.5 to 77.3% for hyperplasia, 100% for endométrial polyps and from 88 to 90% for endométrial atrophy. In contrast, it is worse for the myométrial pathology such as adénomyose and sub mucosal myomas. Besides its sensibility, the tolerance of this exam allows its ambulatory realisation permitting a considerable economy.

[Total septate uterus with hemi-vagina and homolateral renal dysplasia]. / L'utérus cloisonné total avec hémi-vagin borgne et rein dysplasique homolatéral.

We report a rare case of uro-genital malformation in 18 years old girl. The malformation associate total septus uteri, hemivagina atretica dextra and homolateral dysplastic kidney. Dysmenorrhea, purulent discharges from cervix and vaginal tumor evocated the diagnosis, which was confirmed by ultrasonography, hysteroscopy and coelioscopy. Therapeutic attitude was total resection of vaginal septus and right nephrectomy. At today, seven cases were published in international literature. In all cases, renal aplasia was reported. Embryologic acknowlegements can't explain this malformation.

[Cerebral hemorrhage in utero. Diagnosis and management. A case report]. / Hémorragie cérébrale in utero. Diagnostic et conduite à tenir. A propos d'un cas.

The authors report a case of massive intracerebral haemorrhage which was diagnosed in utero by ultrasound. The ultrasound of the brain showed a total disorganisation of all known structures with the appearance of unhomogeneous zones spread across both hemispheres and including a large dilatation of the ventricles. Transcervical puncture of the fontanelle allowed the delivery of a stillborn child without other congenital abnormalities. CMV infection was thought to be the cause. A review of the literature shows that there are different ways of treating this conditions depending on the ultrasound appearances. The prognosis must be very guarded and depends on the aetiology.

[Intrauterine hydatidosis. A case report]. / Hydatidose intra-utérine. A propos d'un cas.

The authors describe a rare case of an intra uterine hydatid cyst in a 60 year old woman. Hydatid vesicles were found in the vagina. The diagnosis was made histologically. A total hysterectomy was carried out. The authors discuss the aetiology and pathogenicity of an occurrence at this site. Conservative treatment is suggested for young female patients.