[Value of vesical filling for umbilical cord prolapse. Description of a 14-case series at the Befelatanana University hospital center maternity unit (Antananarivo, Madagascar)]. / Intérêt du remplissage vésical au cours des procidences du cordon ombilical pulsatile. A propos de 14 cas observés à la maternité du CHUA de Befelatanana (Antananarivo-Madagascar).

Umbilical cord prolapse occurs when the umbilical cord drops through the open cervix into the vagina ahead of the baby, after spontaneous or artificial rupture of the membrane. It is a severe obstetrical emergency that endangers the life of the baby due to compression of the cord. Since the 1980s, bladder filling has been recommended as a simple and effective technique for reducing foetal mortality even if surgery cannot be undertaken immediately. The purpose of this study was to report experience using the bladder filling technique at the Gynaecology-Obstetrics Unit in Befelatanana (Antananarivo University Hospital Center). These results confirm the reliability and effectiveness as previously reported in the literature. Because of its simplicity and efficacy in reducing the risk for the foetus, bladder filling should be taught and used particularly in countries with limited obstetrical facilities.

[Neglected shoulders reported at the Befelatanana Maternity Hospital (Antananarivo, Madagascar)]. / Les épaules négligées vues à la maternité de Befelatanana à Antananarivo, Madagascar.

We conducted a retrospective study on neglected shoulders during 12 months at the Maternity Hospital of Befelatanana, 31 cases among 4685 deliveries were reported. The majority of the pregnancies are not under medical supervision and no ultrasound is carried out during the third trimester. There were 8 cases of uterine rupture, 2 haemorrhage shocks, 6 syndromes of prerupture, 6 umbilical cord prolapses at the third degree and 6 tears of the cervix. 20 caesarean sections have been performed as well as a turning of foetus in utero in 3 women, 4 hysterectomies, and a conservative suture with uterine tube ligation in the other cases. Often linked to a large multiparity the neglected shoulder remains quite frequent in developing countries such as Madagascar and regular prenatal consultations together with a rigorous clinical exam are highly recommended by the authors to make an early diagnosis and provide a better care management.

[Female genital tuberculosis: about 11 cases treated in Antananarivo (Madagascar)]. / La tuberculose génitale chez la femme: à propos de 11 cas suivis à Antananarivo, Madagascar.

A 5 year prospective study on genital tuberculosis, a rather uncommon localization, has been undertaken in 11 women treated at the DAT-HIS of Antananarivo, Madagascar Clinical diagnosis is problematic, if not unfeasible, due to the polymorphism of genital tuberculosis in women. Only histological and bacteriological examinations are, so far, confirmatory In the future, recourse to polymerase chain reaction will facilitate diagnosis and will allow a more accurate assessment of the incidence of this aspect of tuberculosis infection. Genital tuberculosis compromises women's fertility Even though the tuberculosis is cured, none of the 11 women of our research had carried their pregnancy to delivery, because artificial fertilization is not feasible here in Madagascar Screening of woman genital tuberculosis should be mandatory as regards gynaecological problems such as menstrual cycle disorders, sterility, abdominal pain, cyst of ovary ectopic pregnancy, spontaneous miscarriage in paraclinical investigations, especially in developing countries.

[First description of a case of disseminated peritoneal leiomyomatosis in Madagascar]. / Première description de léiomyomatose péritonéale disséminée à Madagascar.

The authors reported the first case of leiomyomatosis peritonealis disseminata or diffuse peritonealis leiomyomatosis in a patient of 36 years old. The hyalin degeneration of leiomyomatosis with intra and extra peritonealis extension is an uncommon pathology. The right etiology of this complication of leiomyomatosis is unknown. Its detection is a fortuitous event during laparotomy. It is characterized by an extension to the serosa, a break-in of the tissues and unpredictable invasion of the contiguous organs, and it can touch the heart. Despite its rapid evolution, often accompanied by mechanical complications, it remains a benign tumour.