Leiomyomas in an African Caribbean hysterectomy population considered to be ethnically related to African Americans.

BACKGROUND: Uterine leiomyoma has been reported to be a worse problematic disease for African American than Caucasian women in the US. Data are almost non-existent for other populations of African ancestry. Our aim was to investigate the hypothesis of an equivalent influence of ethnicity on uterine leiomyomas for women of a French African-Caribbean population. BASIC PROCEDURES: Retrospective analysis of hysterectomies performed from 2010 to 2015 at the teaching hospital of Guadeloupe (French West Indies), where most inhabitants are of West African origin, was carried out. Data of the 899 hysterectomies, including those for malignancy, were collected, in particular, uterine weight. MAIN FINDINGS: The indications were leiomyoma in 66.5 % of cases and leiomyomas were found in 91 % of all cases. The mean age and uterine weight were 51.7 years and 464 g for the entire population, 50.2 years and 488 g for the population without malignancies, and 47.0 years and 567 g for the population with leiomyomas. PRINCIPAL CONCLUSIONS: The data were compared to those reported in the literature for several populations, notably African Americans and Caucasians in the US and mainland France. This comparison supports the hypothesis that Guadeloupean women, an African-Caribbean population, have characteristics in terms of uterine leiomyoma that are close to those of African Americans. Although confirmation is required, these results highlight the need for specific research, therapeutic approaches, and improved early management of these populations.

The annual carnival in Guadeloupe (French West Indies) is associated with an increase in the number of conceptions and subsequent births nine months later: 2000 - 2011.

The seasonal patterns of conceptions and births differ between geographic areas. Several potential determinants of this variation have been identified, including biological, environmental and behavioral elements, but festive events are rarely mentioned. We investigated the possible association between the carnival and seasonal fertility variations in the French West Indies. We ran a retrospective registry-based study. The data were extracted from the registry of all births on Guadeloupe between 2000 and 2011 (n = 74,412), and from the Maternity Birth Register of the University Hospital, for all pregnancies of at least 14 completed weeks of gestation (observable conceptions) with an outcome recorded between 2007 and 2010 (n = 8,425). We compared data during and outside the carnival period for each year, including 2009, when there was no carnival due to a 44-day general strike. In all years other than 2009, the weekly number of births was higher for pregnancies initiated during the carnival period than for pregnancies initiated at other times, and the weekly number of observable conceptions was higher during the carnival period than at other times. Our findings support the hypothesis that carnivals in the French West Indies are associated with an increase in the number of conceptions and subsequent births.

Vaginal cesarean section: heir to, but not legacy of Dührssen's incision.

PURPOSE: Vaginal cesarean section is a uterine incision technique derived from Dührssen's incision, with which it is sometimes confused. We report here our experience over 10 years with this technique, with the aim of defining the situations in which it is potentially useful. METHODS: We retrospectively analyzed 24 cases of vaginal cesarean section (i.e. cervico-segmental incision) carried out from 2002 to 2011 in our tertiary maternity unit. This corresponds to an incidence of 1.1 per thousand deliveries. The main outcome measures were the indications and complications of vaginal cesarean section. RESULTS: The study population included 42% nulliparous women. The fetuses concerned had a median gestational age of 24 weeks + 5 days (18 to 34 weeks + 1 day) and a median weight of 595 g (340-1,250 g). The indications for vaginal cesarean section were severe maternal morbidity in 54.2% of cases, failed labor induction in 29.2% and another indication in 16.7%. All but one of the fetuses were dead or nonviable. Surgical complications were observed in three cases: two difficulties achieving hemostatic control and one bladder injury. CONCLUSIONS: Vaginal cesarean section is sometimes considered obsolete, but it has several advantages: technical simplicity, limited tissue dissection, low risk of hemorrhage and no abdominal scar. These features make it particularly suitable for the extraction of medium-sized dead or nonviable fetuses when pharmacological options are ineffective or not rapid enough in cases of poor maternal condition.