[Primary pulmonary arterial hypertension and pregnancy. Case report]. / Hypertension artérielle pulmonaire primitive et grossesse. A propos d'une observation.

Pregnancy is rarely associated with primary pulmonary hypertension (PPH). We are here presenting the case of a 28 year old patient who developed, during her second pregnancy, primary pulmonary hypertension, with fatal results. The autopsy confirmed the diagnosis. The analysis of the case and a review of the literature suggests that patients suffering from PPH are to be advised against pregnancy, or a therapeutic precocious interruption of the pregnancy is to be considered. In case of late discovery of PPH during pregnancy, peridural anesthetics while controlling the pulmonary blood pressure during the delivery seems to be the chosen technique.

[Consumption coagulopathy during pregnancy: a case of afibrinogenemia during the second trimester]. / Coagulopathie de consommation durant la grossesse: un cas d'afibrinogénémie du deuxième trimestre.

We report a case of a membrane disruption at 19 weeks 3 days of gestation complicated by a consumption coagulopathy with clotting tests suggesting primary fibrinogenolysis rather than a disseminated intravascular coagulation usually seen in such cases. A review of the literature revealed 5 cases of coagulopathy during the second trimester of pregnancy among which only two were suspected to be associated with primary fibrinogenolysis. Management of this coagulopathy is discussed.

[Bone metastasis revealing a hepatoma. 13 cases]. / Métastases osseuses révélatrices d'hépatome. 13 cas.

The authors report a series of 13 cases of bony metastases leading to the discovery of a hepatoma. They were subjects of male sex, average age 64 years. Nine were severe alcoholics. The presenting symptoms were in 7 cases neurological, in four cases an isolated bone tumour, finally, one spontaneous fracture, and one case with pain alone. Severe loss of weight was frequent; in 10 cases out of 13 it was greater than 5 kg. Hepatomegaly was found in 8 cases, but in 3 cases there was no sign suggesting liver disease. In 7 cases out of nine, the metastases were already numerous at the time of diagnosis. The diagnosis of metastases from a hepatoma was made on the bone histology 11 times and from the hepatic histology in 6 cases. The histological of the bone metastasis reproduces very well that of the liver. In four cases there was local secretion of bile, in one case the metastatic liver cells underwent steatonecrosis.