Umbilical Cord Prolapse in the Prehospital Setting: A Case Report.

Umbilical cord prolapse is an acute obstetric emergency associated with high fetal morbidity and mortality. To avoid poor outcomes, rapid diagnosis with immediate intervention is required, especially in the prehospital setting where resources are limited. In this case report, we describe a 38-year-old woman with umbilical cord prolapse, with a review of appropriate prehospital maneuvers and treatment.

[Ovarian goiter with hyperthyroidism. A case report]. / Goitre ovarien avec hyperthyroïdie. A propos d'un cas.

We report a case of ovarian goiter associated with hyperthyroidism. We insist upon their rarity and the difficulty of preoperatory diagnosis. Prognosis is good after surgery.

[Cervical ripening with prostaglandin E2 in a scarred uterus during the third trimester of pregnancy. Report of 82 cases]. / La maturation cervicale par prostaglandine E2 sur utérus cicatriciel au troisième trimestre de la grossesse. A propos de 82 cas.

AIM: To study the feasibility, the results and the complications of cervical ripening using PG2 in scarred uterus in the third trimester of pregnancy. METHOD: A retrospective study of 82 cases of which 10 had ruptured membranes. The administration of 0.5 mgs of PG2 by the intracervical route after Beta-mimetic drugs by the intramuscular route. RESULTS: In 78% of the cases it was possible to improve the condition of the cervix so that labour could be induced or that it would start spontaneously. It was possible to deliver the baby vaginally in 67% of cases. There was no case of ruptured uterus. CONCLUSION: It seems possible that when there is a medical indication to induce labour to ripen the cervix using PG2 in a scarred uterus in the third trimester of pregnancy. The administration of beta-mimetic drugs for ripening and the use of tocometry to monitor labour seemed to be important precautions that have to be taken.

[The estimation of fetal weight by measurement of the adipose tissue of the extremities. Use in the diagnosis of hypotrophy]. / Estimation du poids foetal par la mesure de la graisse des membres. Application au diagnostic de l'hypotrophie.

OBJECTIVE: To investigate the accuracy of small for age fetuses diagnosis by a new method of fetal weight estimation, in comparison with some others models. A retrospective study. SUBJECTS AND METHODS: From a 232 fetuses population, whom age is known, ultrasound measurement have been performed (BPD, TBD, FL, AC and thigh circumference). Three physicians collaborated to data collection. All measurement have been done within a 3 days duration between measuring and birth in order to compare actual and calculated weight. There are 39 small fetuses coming from 10th percentile (17.5%), between then 24 from 5th percentile. RESULTS: Positive predictive value (PPV) of small for age diagnosis (from 10th P) by our model is 74% with a 74% sensibility and a 94% specificity. With Warsof estimation model, the PPV is only 47% with a 71% sensibility and a 83% specificity (p = 0.001). COMMENTS: Limbs subcutaneous fat ultrasound measurement improve considerably fetal weight estimation quality (mean error = 6% vs 10% for most of the classical models) and, as an extension, small for age fetuses diagnosis. The cutaneous and subcutaneous circumferences, between which is situated fat tissue have a better individual correlation to actual weight than abdominal circumference, usually considered as the best trophicity parameter. CONCLUSION: High positive predictive value show long term predictive detection possibility. It appears that this diagnosis could be done earlier with a better accuracy that the classical ultrasound biometry.

[Ultrasonic estimation of fetal weight. Value of measuring limb fat]. / Estimation échographique du poids foetal. Intérêt de la mesure de la graisse des membres.

Many ultrasound models for estimating fetal weight have been proposed and for two reasons have not proved to be very successful. First, the weight of the future newborn baby is not necessarily the principal element of neonatal prognosis. Second, the different methods of measurements are so often inaccurate. Many studies dealing with estimates of fetal weight were based on traditional measurements and were therefore not very precise. We suggest a new method based on ultrasound fetal fat measures on a transverse section. This prospective study was made from 274 measurements of which half were used to establish the basic calculation formula and half for the purpose of statistical analysis. The overall accuracy (the median of departure from the means), is 6.3%. This model is particularly good in the case of small foetuses: 6.9% in the 1,000 to 1,500 grams group. Fetal fat seems to be more apt to provide information concerning weight. This measure is inherently a good one for estimating growth and should prove to be particularly interesting in the screening of small for date fetuses.

[Brenner tumor. Apropos of 3 recent cases]. / La tumeur de Brenner. A propos de trois cas récents.

In reference to three recent clinical cases, the authors review the literature regarding Brenner's tumors. It is a rare ovarian tumor (2 p. cent of ovarian tumors), often associated with other utero-adnexal pathological processes. Hormone secretions may be present in 50 p. cent of the cases. Malignant or "borderline" forms are rare. Its histogenesis is discussed.