[Eclampsia: epidemiological aspects and management of 28 patients]. / Eclampsie: profil épidémiologique et prise en charge a propos de 28 cas.

AIM: To ascertain the characteristics, clinical features, and maternal fetal outcome in eclampsia in a tertiary referral center (Service A, CMNT). METHODS: 28 case notes were retrieved retrospectively and data was analyzed descriptively. RESULTS: Twenty eight pregnancies complicated by eclampsia were identified. 14.8% of the women were nulliparous and 50% were primiparous. The mean age was 32.5 years. Mean gestational age at the time of seizures was 33.4 weeks' gestation. Twenty-two women had antepartum seizures (78.57%); 8 of the 22 had seizures at home. 6 women had postpartum seizures (21.42%). Headache preceded seizures in 17 cases (60%) hyperreflexia preceded seizures in 16 cases. 50% of women presented with systolic blood pressure (SBP) > 160 mmHg and 42.85% presented with diastolic blood pressure (DBP) > 110 mmHg. One case of maternal mortality are noted. There were 12 perinatal deaths. Three patients had intrauterine fetal deaths. CONCLUSION: Eclampsia increased maternal and perinatal morbidity and mortality. She was not found to be a progression from severe preeclampsia. There is a need to develop new methods to identify this group of patients in an effort to further reduce the prevalence of this dangerous condition.

[Place of the sulprostone in therapeutic interruptions of the pregnancy]. / Place du sulprostone dans les interruptions therapeutiques de la grossesse.

BACKGROUND: Therapeutic interruption of the pregnancies of the 2nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone (Nalador) is a big contribution. AIM: The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use. METHODS: It is about a forward-looking study opened from the 01-07-02 led in the service "A" of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone. RESULTS: The average age was of 27 years with extremes from 18 to 39 years 50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2.25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol (cytotec *), the Probe extra amniotic dries and the wet Probe. CONCLUSION: The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90 %.

[Maternal benefit of postpartum corticosteroid therapy in patients with HELLP (hemolysis elevated liver enzymes low platelets count) syndrome]. / Intérêt de la corticothérapie en post partum dans le HELLP (hemolysis elevated liver enzymes low platelets count) syndrome.

Our purpose was to assess the effects of corticotherapy prescribed after delivery on the kinetic of biological parameters of HELLP syndrome (hemolysis elevated liver enzymes low platelets count). Twenty patients in whom pregnancy was complicated by antepartum or postpartum Hellp Syndrome, were randomised to receive, after delivery, either 12 mg of Dexamethasone every 12 hours for two doses (Group C, n=10), or a placebo (Group T, n=10). Biological parameters of the Hellp syndrome were analysed just before the first bolus of either treatment (H0), then after 24, 36, 48 and 72 hours. The corticotherapy was more efficient than placebo, in the correction of the biological parameters of the hellp syndrome. It permitted a rapid correction of the thrombopenia (from the 24th hour) but its effect on hemolysis marker was later (from the 36th hour). The kinetic of the hepatic cytolysis marker was not modified by corticotherapy. Finally, the administration of corticosteroids does not reduce maternal morbidity related to HELLP Syndrome.

[Sulprostone in the treatment of uterine inertia. Report of 60 cases]. / Place du sulprostone dans la prise en charge des inerties uterines. A propos de 60 cas.

The serious haemorrhages of the delivery still one of the first causes of maternal mortality. We report an analytical study over a period of 18 months and gathering 60 cases of haemorrhage of the delivery by uterine inertia having imposed the recourse to the sulprostone. The average age of the patients was 31 years, the average parity wasv1.9, the rate of childbirth per Caesarean was 65%. The uterine surdistension was the principal etiology of the uterine inertia. The average time of administration of the sulprostone was 10 mn. No complication related to the product was noted. The effectiveness of the treatment was observed in 93.3% of the cases, with 4 cases of failure.