[Early diagnosis and management of cervical ectopic pregnancy]. / Diagnostic precoce et prise en charge des grossesses cervicales.

BACKGROUND: Cervical pregnancy is the rarest of ectopic pregnancy. The classical treatment remains hysterectomy, in particular when diagnosis is made late. The possibilities of more and more premature diagnoses, sometimes before any clinical expression, let suspect the possibility of conservative treatments. We report two cases of medical treatment for early diagnosed cervical pregnancies. AIM: Through a review of the literature, we resume diagnostic criteria and various therapeutic possibilities. CASE REPORTS: The two cases were diagnosed in the first trimester. The treatment consisted in intramuscular administration of methotrexate. The first patient had ultrasound-Guided feticide before the administration of methotrexate. CONCLUSION: Actually, vaginal ultrasound allows early diagnosis of cervical pregnancies, even before the beginning of vaginal bleeding. This advancement allowed conservative treatment. In this situation, current reference is the methotrexate to which can be associated an intracardiac potassium chloride injection in case of embryo positive heart activity.

[The managment of serious pregnant disease in the intensive care unit]. / Prise en charge en reanimation des pathologies obstetricales graves.

We report a retrospective study over a period of 4 years and half and bearing on 59 patients that require an intensive care. The number of childbirth during this period was 22237 with 8.97% of Caesareans. The main obstetrical diseases was: gravidic toxaemia 75.5%, uterine inertia 7%, cardiopathy 5% of the cases. The reasons for the transfer were: eclamptic state in 27% of the cases, hémostasis disorder 22% of the cases, and acute pulmonary oedema 18.6% of the cases. Average duration of hospitalization was 3.18 days. Five cases of death were noted.