[Urinary complications and sequelae of carcinoma of the cervix treatment (author's transl)]. / Séquelles et complications urinaires du traitement des cancers du col utérin.

The authors describe the sequelae and urinary complications of:--radiotherapy only in 524 patients, stage I to III treated between 1960 and 1974;--721 operations performed between 1968 and 1974, according to the protocol of treatment as used in the Fondation Curie. This reveals:--for irradiated patients, no iatrogenic damage to the upper urinary tract, whilst bladder complications were often present. No major complication was found in this group;--for operated patients, the surgical act was without harmful consequence in the 672 cases when the operation was foreseen in the initial protocol (0,6% of chief complications). On the other hand, surgery performed for persistent tumour or recurrence after exclusive radiotherapy showed 8 per cent of chief complications. In this group they analyse the factors that might influence ureterohydronephroses, especially the extent of node dissection and associated external irradiation.

[Early discharge from maternity: problems, exigencies and recommendations]. / Sorties précoces de maternité: problèmes posés, exigences, recommandations.

Early discharge 72 hours after delivery remains the mother choice, although the final decision is taken by the midwife as well as the paediatrician of the unit, and never before the third day. A follow-up at home is systematically proposed during at least two days. Specially trained midwives of the maternity are in charge of this follow up. A one year evaluation of this practice shows that early discharge, after good clinical evaluation, with regular follow up as long as necessary, is not responsible for infants rehospitalisations as a result of undiagnosed pathology or maternal incompetence.

[Isolated splenic metastases of cancer of the ovary]. / Métastases spléniques isolées d'un cancer de l'ovaire.

The authors present a case history of a patient whose most recent relapse occurred 7 years after the initial laparotomy carried out for bilateral ovarian stage III cystadenocarcinoma diagnosed by biological follow-up (CA 125) which occurred because of isolated splenic metastases which were identified thanks to ultrasound examination. The literature, which has been searched fails to show a clinical description of a case with metastases localised just to this site. We propose an explanation of the mechanism and an analysis of the methods of follow-up that can be carried out showing that it is useful to use CA 125 as a checK on epithelial tumours of the ovary.

[Maturation of immature teratomas of the ovary. Apropos of a case and review of the literature]. / Maturation des tératomes immatures de l'ovaire. A propos d'un cas et revue de la littérature.

We report a case history of a 20 year old woman, primiparous, who had an immature teratoma of the ovary that developed. In June 1982 the diagnosis of an ovarian tumour of the right ovary was made after she had complained of pain in her pelvis, of metrorrhagia and ascites had been discovered. At that time we removed her right tube and ovary. There were no other lesions in the abdomen. The anatomopathological examination of the specimen revealed an immature grade II teratoma. She received six cycles of chemotherapy which consisted of a combination of Bleomycin, Velbe and Cysplatin between July and December. A second-look laparotomy was carried out in February 1983. This showed that she had multiple secondary diffuse peritoneal lesions. Because of this total hysterectomy with the removal of the other tube and ovary and omentectomy were carried out. Histological examination showed lesions of a mature teratoma-grade 0. In October 1986 ultrasound showed two parenchymatous lesions in the liver. These were removed and the anatomopathological study showed that these were mature teratomata, identical to those that had been found at the second-look laparotomy. The patient is now considered to be cured after being free from trouble for the last 58 months. Looking through the international publications on these conditions has turned up 40 similar cases. The phenomenon of maturation seems to be of a good prognosis as compared with those where the teratomas stayed immature.(ABSTRACT TRUNCATED AT 250 WORDS)

[Prenatal diagnosis of intracranial teratoma. Apropos of a case]. / Diagnostic anténatal de tératome intracrânien. A propos d'un cas.

The authors report a case of fetal brain teratoma diagnosed at 21 weeks of amenorrhoea and leading to therapeutic termination of pregnancy. After a survey of the general features of intracranial teratomas the literature has been reviewed with a view to separating those elements that can lead to a definite diagnosis and those in a differential diagnosis. This case is unusual because of the diagnosis being made relatively early, thanks to ultrasound. This made it possible to avoid carrying out an unnecessary caesarean operation, which so often has to be done if the diagnosis is made late.

[Neonatal Steinert's disease. Comments on a case and determination of the pregnancy aspects which are predictive of neonatal death]. / Maladie de Steinert néonatale. Réflexions à propos d'un cas et détermination des éléments gravidiques prédictifs de décès néonatal.

The authors report a case of antenatal diagnosis which is original in that a maternal illness was discovered that had not been thought of until then. Steinert's myotonic dystrophy can show up in two types after birth, a congenital type and a lethal type. The antenatal diagnosis at present consists in a combination of hydramnios and lack of fetal movements on ultrasound. The obstetrical complications are the threat of premature labour and, often, breech presentation. The method of delivery will depend on how severely the fetus is affected; which is worked out by looking for features of poor prognosis. In the future it will be possible to make an antenatal diagnosis by villus biopsy with the discovery of the responsible gene.

[Fetal supraventricular tachycardia. Prenatal treatment with a digoxin-amiodarone combination]. / Tachycardie supraventriculaire foetale. Traitement anténatal par l'association digoxine-amiodarone.

The authors present a case history of supra-ventricular tachycardia (SVT) diagnosed in a fetus after 32 weeks of amenorrhoea in a 2-para woman of 29 years. This SVT was discovered after an urgent consultation had been asked for when uterine contractions started after the uterus had been over-distended. The diagnosis that had been suspected when it had been impossible to measure the fetal heart rate by a monitor was confirmed when the rate was found to be 270 beats per minute using TM ultrasound. A complete detailed ultrasound examination showed that there was generalised oedema (anasarca). Searching for a congenital malformation revealed none. Other tests eliminated other causes for the anasarca. Treatment was rapidly instituted by injecting 2 and later 3 ampoules of 0.25 mg of Digoxin in 24 hours. This did not change the fetal heart rate although continued for five days. Adding Amiodarone into a transfusion at the rate of 3 ampoules in 24 hours slowed the fetal heart rate to 220 beats per minute within 24 hours. After 3 days treatment with Amiodarone the heart rate went into sinusal rhythm. A boy weighing 3,410 g was delivered by caesarean section 3 days later after the membranes had ruptured prematurely. The placenta weighed 1,750 g. The newborn infant was transferred into a special care baby unit where it progressed favourably. The child left the unit after six weeks on treatment with Digoxin. Consulting the literature has shown under what circumstances the condition can arise and the ways of diagnosing it and the differential diagnosis of fetal SVT, as well as methods of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[The association of acute polyradiculoneuritis, transitory diabetes insipidus and pregnancy. Apropos of a case and review of the literature]. / Association polyradiculonévrite aiguë, diabéte insipide transitoire et grossesse. A propos d'un cas et revue de la littérature.

This is the first report of the association of transitory diabetes insipidus with acute infective polyneuritis (landry Guillain-Barre Syndrome) occurring in pregnancy. The authors try to establish the inter-relationship between each pathological condition and pregnancy. Polyneuritis in its severe form does not seem to increase the risk of prematurity significantly. The severe forms of more generalised neurological condition as compared with the more limited condition has been noted in the literature but it is not possible to state how pregnancy effects the outcome. Plasma exchange procedures are now possible in pregnant women and the benefits of this treatment have been illustrated in severe forms of polyneuritis. There is difficulty still in selecting what criteria are sufficient to start on a therapy that is not without risk. Finally, the association between transitory diabetes insipidus and pregnancy has been reviewed in the literature and a description is given of the many physiopathological mechanisms associated with it. Diabetes insipidus is rarely found in pregnancy. All authors describe a placental factor with these troubles. The most recent theories suggest that prostaglandins and placental vasopressin are implicated. Treatment is suggested and consists of DDAVP (deamino 8-d-arginine vasopressin), which seems to be the most effective. Close collaboration between the obstetrician, the recovery services and the paediatrician is necessary to get the best results for this very severe pathological condition occurring in pregnancy.

[Placental sulfatase deficiency and sex-linked recessive ichthyosis. Two cases found in two sisters (author's transl)]. / Déficit en sulfatase placentaire et ichthyose récessive liée au sexe. Deux cas observés chez deux soeurs.

The diagnosis of placental sulfatase deficiency was made at the same time in two sisters who were pregnant. This is the first case history reported of two women who were carriers of this abnormality and who were linked by parentage. The inborn error of metabolism was able to be found in its post-natal state in two of the sons of one of the women in the form of retention cutaneous ichthyosis of a sex-linked type.

[Urinary complications of the resectable cancers of the cervix uteri (author's transl)]. / Les complications urinaires des cancers opérables du col utérin.

The authors studied the urinary complications following 721 operations performed between 1960 and 1974 for cervix uterin carcinoma. The surgical method was the one used at the Fondation Curie according to the protocol of treatment. They have noted that: --first, the surgical act as primary treatment (672 cases) was innocuous, as this series showed only 0,6% of the severe complications; in contrast, when the surgery is performed for a recurrence after a total dose irradiation, the severe complications raised to 8%; --secondly, the uretero-hydronephroses following this type of surgery are relatively frequent on the systematic urograms, but most of them are quite asymptomatic and without later sequelae only 0,3% of them required a surgical treatment. The authors analyse the factors influencing the ureteral stenoses, especially the extent of lymphadenectomy and the associated external irradiation. They studied too the ureteral stenoses due to a local recurrence.