[Transuterine migration of intrauterine contraceptive devices]. / Migration transutérine des dispositifs intra-utérins.

UNLABELLED: The intrauterine contraceptive device (IUCD) is frequently used. The use of IUCD can be responsible of serious complications as transuterine migration. In this study, we evaluate the physiopathology, the strategy of diagnosis and treatment of the IUCD translocation. MATERIAL AND METHODS: We conducted a retrospective study of nine cases of IUCD migration having occurred between 2004 and 2009. We discussed the age, the type of IUCD, the risk factors, the mechanisms of migration, the circumstances and methods of diagnosis, the treatment and the evolution of IUCD migration. Mean age of the patients was 35 years. The risk factors were: multiparity, anteversus uterus, scarred uterus, IUCD postpartal insertion, inexperience of the operator. Most patients were asymptomatic. Two patients had urinary symptoms. The diagnosis of an extrauterine device was confirmed by abdominal X-ray and ultrasound results in all patients. The endoscopic treatment was successful in 66% of cases. All patients had an uneventful recovery. Transuterine migration remains one of the least common but most serious complications associated with the use of an IUCD. This complication could be controlled if thorough gynaecological exam was performed, if risk factors were delineated, if the IUCD was technically well inserted and a rigorous surveillance was performed.

[Pulmonary arterial hypertension and porto-caval fistula in a 17 year old patient]. / Hypertension artérielle pulmonaire et fistule porto-cave découverte chez un jeune de 17 ans.

The authors report the case of a 17 year old patient with severe pulmonary arterial hypertension accompanied with a congenital porto-caval shunt. This patient had been admitted with dyspnoea on exertion with signs of pulmonary arterial hypertension on clinical examination. Echocardiography revealed a systolic pulmonary arterial pressure of 80 mmHg with no left heart anomaly or intracardiac shunt. Pulmonary investigations, as well as immunology, clotting, liver function and retroviral serology were all negative. A routine abdominal ultrasound showed a 10 mm proximal porto-caval fistula with no sign of portal hypertension. This case shows that anomalies of the portal system can cause pulmonary arterial hypertension even in the absence of any symptoms suggestive of hepatic disorder.

[Uterine leiomyoma in a patient with Rokitansky-Kuster-Hauser syndrome. Report of a case]. / Léiomyome utérin sur syndrome de Rokitansky-Kuster-Hauser. A propos d'un cas.

We report the discovery of a leiomyoma which developed from a fibrous myometrial band in a woman with Rokitansky-Kuster-Hauser syndrome. This localization is exceptional. The diagnosis was suspected at physical examination and pelvic ultrasonography and laparoscopy. Histology confirmed leiomyoma.

[Pregnancy and delivery in adolescents: characteristics and profile of 311 cases]. / Grossesse et accouchement chez l'adolescente: caractéristiques et profil. A propos de 311 cas.

OBJECTIVE: Adolescent pregnancy is considered to be a high-risk situation in a large part of the world. The aim of this study is to assess the validity of this notion for Moroccan teenagers. MATERIAL AND METHODS: From January 1999 to December 2000, there were 311 teenagers who gave birth in the "Les orangers" maternity hospital in Rabat, Morocco. We compared these adolescents with 155 women aged more than 18 years who delivered during the same period. RESULTS: We were unable to demonstrate a high risk for complications among our adolescent population. The only statistically significant differences found between the two groups concerned use of contraception (22.4% for teenagers vs. 57.6%), traditional practices (6.1% vs. 1.93%), frequency of episiotomy (90% vs. 67.14%), instrumental extraction (37.32% vs. 27.14%), lower birth weight in teenagers (3074 g vs. 3199 g) and a higher rate of low birth weight in unmarried adolescents in comparison with married ones (23.3% vs. 9.6%). CONCLUSION: Adolescent pregnancy in Morocco remains well accepted, particularly within the context of marriage.

[Obstetrical complications of adenomyosis. Literature review and two case reports]. / Les complications obstétricales de l'adénomyose. Revue de la littérature, à propos de 2 observations.

Adenomyosis of the uterus is a frequent disorder often associated with pregnancy. Diagnosis is difficult during pregnancy and usually is made after an obstetrical complication. In a review of the literature from 1904 to 1994, only 31 cases of obstetrical complications related to adenomyosis have been reported. We report two cases revealed by obstetrical complications: one causing spontaneous rupture of the uterus during labor in a primiparous woman and the other with cornual ectopic pregnancy diagnosed, due to an episode of massive intraperitoneal bleeding.

[Pregnancy in patients with Behçet's disease]. / Grossesse chez des patientes ayant une maladie de Behçet.

INTRODUCTION: Behçet's disease is particularly frequent in the Mediterranean countries and in the Far East. Its predominance in men is the reason why its association with pregnancy has rarely been reported in the literature. OBSERVATIONS: Three pregnancies occurred in two patients with Behçet's disease. In the first case the disease was diagnosed post partum. The second pregnancy in a stabilized patient was complicated by depression and abortion at 16 weeks of amenorrhea. The second patient presented with an articular episode after delivery, requiring an increase in dose of corticosteroids. COMMENTS: The interventions between pregnancy and Behçet's disease are obscure. The progression of the disease varies from one women to another and from one pregnancy to the next in the same woman. The observations reported here add to those describing aggravation of Behçet's disease during or after pregnancy.

[Malignant degeneration of benign cystic teratoma of the ovary]. / Tératome cancérisé de l'ovaire.

Malignant transformation of mature cystic teratoma of the ovary is a rare complication occurring preferentially during peri- and post-menopausal period. No clinical nor radiological, nor biological signs are specific to malignant transformation. The treatment is surgical and similar to that of epithelial tumors of the ovary. We report an observation of a squamous cell carcinoma developed on a mature cystic teratoma of the ovary, in a patient aged 46 years.

[Norplant. Experiences at the maternity services of Orangers in Rabat during two years]. / Le Norplant. Expérience de la maternité des Orangers de Rabat sur deux ans.

Norplant is a pure progestative method which couples efficaciousness, reversibility and a period of prolonged action. We have counted 189 insertions since March 1993, the date of the introduction of this contraceptive method in the center of family planning at the university maternity of Orangers. The analytical study of different parameters collected in admission files and preestablished control allowed to draw the epidemiologic profile of the patients as well as acceptability, the tolerance and the efficiency of this method.