[Abdominal necrotizing fasciitis after caesarean delivery]. / Fasciite nécrosante de la paroi abdominale post-césarienne.

Necrotizing fasciitis (NF) is a rare infection (0,2 to 0,4/100,000 adults) of the dermis and hypodermis extending along muscular fascia1. The absence of pathognomonic symptoms makes its diagnosis difficult. Rapidly progressive, it is a life-threatening emergency whose prognosis is letal in 30 % of cases. Treatment of necrotizing fasciitis is mixed and involves aggressive surgical debridement and medical treatment with antibiotics and supportive agents. This article is presenting the case of a young woman who developed abdominal necrotizing fasciitis following a caesarean section. In forty-eight hours, the patient developed septic shock with an extensive and rapid destruction of her abdominal wall. After hysterectomy and multiple surgical debridements, evolution was favorable. After one month, a reconstruction of the abdominal wall could be performed.

La fasciite nécrosante (NF) est une infection rare (0,2 à 0,4/100.000 adultes) caractérisée par une dermo-hypodermite nécrosante s'étendant le long des fascias sous-cutanés. L'absence de symptôme pathognomonique rend son diagnostic difficile. D'évolution rapidement progressive, il s'agit d'une urgence vitale dont le pronostic est fatal dans 30 % des cas. Le traitement est mixte et associe un débridement chirurgical agressif à un traitement médical à base d'antibiotiques et d'agents supportifs. Cet article reprend le cas d'une jeune femme ayant développé une fasciite nécrosante abdominale suite à une césarienne. En quarante-huit heures, la patiente a présenté un choc septique avec une destruction extensive et rapide de sa paroi abdominale. Une hystérectomie et de multiples débridements chirurgicaux ont permis une évolution favorable. Après un mois, une reconstruction de sa paroi abdominale a pu être effectuée.

[The evaluation of the risk of spontaneous abortion at various stages of pregnancy. Study of overall risk and of normal ultrasound pregnancy]. / Evaluation à diverses périodes gestationnelles des risques d'avortements spontanés. Etude du risque global et des grossesses à échographie normale.

The authors have studied a series of 2,292 pregnancies that were unselected and have calculated from this the risks of spontaneous abortion before the 28th week of the pregnancy that patients have when they come for ultrasonography for the first time in the pregnancy. They have been able to work out the risks of spontaneous abortion even when the ultrasound was normal for the time of pregnancy. The risks diminish as the pregnancy progresses and rise with the mother's age.

Ultrasonic measurement of aortic and umbilical blood flow in the human fetus.

The study reports blood velocity and blood flow in the descending aorta and the umbilical vein of 20 normal human fetuses by application of combined B-mode ultrasound and pulsed Doppler technique. All pregnancies and newborns were clinically normal. The echographic examination was performed between 37 and 40 weeks' gestation by an ADR real-time linear scanner 2130 coupled with the Kranzb uhler pulsed Doppler system 8105. The diameter of the vessels was measured by B-mode echogram, and the Doppler beam was directed to form an incident angle between 30 and 65 degrees with the axis of the vessel. The Doppler shift frequency was measured electronically with a spectrum analyzer 8106. Fetal blood velocity waveforms were calculated following the Doppler equation. In the descending aorta, the calculated velocity was 27.7 +/- 6.7 cm/second (mean +/- SD) and the blood flow was 679 +/- 106 ml/minute or 216 ml/kg/minute. In the umbilical vein, the same parameters were 18.3 +/- 4.0 cm/second, 366 +/- 65 ml/minute, and 117 +/- 16 ml/kg/minute, respectively. The average umbilical flow: aortic flow ratio was 0.54 +/- 0.07.

[The placenta in trisomy in the last trimester of pregnancy]. / Le placenta des trisomies dans le dernier trimestre de la gestation.

18 cases of trisomies 13, 18, or 21 were diagnosed either by examining the caryotype or on clinical criteria. When the placenta was examined in 60% of cases there was a marked retardation of villous maturation with frequent persistence of embryonic forms of villi. The authors suggest that the failure of the villi to mature was often a reflection of pathology in the oocyte which started to show itself at the beginning of the pregnancy.