[Value of extemporaneous pathology sections in cone biopsies]. / Intérêt de l'examen anatomopathologique extemporané dans les conisations.

OBJECTIVE: To assess the usefulness of frozen sections in cone biopsies. METHODS: Retrospective study of 60 cases: 26 without frozen section, from January 1985 to December 1988 (group 1); 34 with frozen section of the endocervical upper part of the cone, from January 1989 to December 1992 (group 2). RESULTS: The average height of the cone was 1.48 cm in group 2, and 2.23 cm in group 1. The cone margins were free of disease in 100% of cases in groupe 2, and in 88.5% in group 1. The rate of secondary hemorrage was 2.9%, compared with of 7.6% in group 1. CONCLUSION: Frozen section of endocervical upper part of the cone allows more economic excisions of healthy tissues as well as suppression of cases with involved cone margins. With technical improvement of electro-surgical units, we changed since 1992 from cold knife conization to large loop excision of the transformation zone, in association with frozen sections.

[Pregnancy and adrenal insufficiency. Apropos of a case and reminder of management procedures]. / Grossesse et insuffisance surrénale. A propos d'une observation, rappel de la conduite à tenir.

The authors report a case of pregnancy which proceeded normally in a patient who had Addison's disease. This is not a common condition for obstetricians to meet. Thanks to replacement hormone therapy a patient with Addison's disease can become fertile and pregnancy usually starts in a patient whose chronic adrenal insufficiency (Addison's disease) is known and has been treated. The consequences of this association are reviewed: In the first trimester of pregnancy the hormone state may become more disturbed because of intestinal troubles and can become acutely decompensated because of the "stress" of delivery and its immediate consequences. There are no maternal or fetal repercussions so long as hormone replacement is adequate. The delivery can be by the vaginal route unless there are obstetric contra-indications. These are the particular precautions that have to be undertaken, together with regular supervision of the mother to maintain her hormonal equilibrium: Looking for, prevention and treatment of any condition that may lead to adrenal decompensation: these are particularly intestinal upsets in the first trimester and urinary tract infections. At the end of pregnancy the patient should be hospitalised with resuscitation carried out during and after delivery. These may need to be performed in addition to any surgical procedure that is carried out. The infant does not have any particular treatment and can breast-feed.

[Trophoblastic tumor at the site of placental implantation. Apropos of a new case]. / La tumeur trophoblastique du site d'implantation placentaire. A propos d'un nouveau cas.

The authors report a case in which a trophoblastic tumour developed at the implantation site in a 34-year-old woman in her second pregnancy. She had previously had trophoblastic disease that had persisted after a molar pregnancy. Using monoclonal anti-beta-hCG antibodies in order to localise the tumour by clinical radio immunodetection made it possible to cure the patient. The tumour was a secretory tumour and hysterectomy was the cure.