[Blind hemivagina: diagnostic method and problems of treatment]. / L'hemivagin borgne: methode diagnostique et problemes therapeutiques.

Blind hemivagina with duplex uterus and agenesis of the homolateral urinary tract is a rare malformation. For this reason, diagnosis may be not found. We report one case of duplex uterus with blind hemivagina in a fourteen-year-old adolescent girl. From this case, clinical signs, principal diagnosis criteria, complications and treatment are discussed, transvaginal resection of the hemivaginal septus is the best method of treatment but resulting hymeneal rupture may constitute a real problem of treatment in some social environments. So we propose to evaluate endoscopic septotomy.

[The delivery of macrosomic infants weighing 4500 g and more. A report of 61 cases]. / L'accouchement du macrosome de 4500 g et plus. A propos de 61 cas.

UNLABELLED: The objective of this study is to review the difficulties in prediction of great macrosomia, to assess trial of labor results, and to confirm the increased risk of perinatal complications. MATERIAL AND METHOD: in this retrospective study we analyzed 61 deliveries of infants with birth weights > 4500 g in one year period. This group was compared with a group of infants weighing between 4000 and 4500 g (339 cases) born during the same period. Elective cesarean delivery was performed for 3 cases of the second group because of overestimation of fetal weight. 38 cases of the first group (62.3%) were delivered vaginally after underestimation of fetal weight. Incidence of shoulder dystocia in vaginal delivery was 13.5% in the first group and 5.32% in the second one, but difference was not statistically significant (p = 0.07). Difference between incidence of hypoglycemia in the first group (18.03%) and in the second one (2.06%) was highly significant (p = 0.00006) There is no reliable method for prediction of fetal weight > than 4500 g. With literature review, we confirm the increased risk of shoulder dystocia, birth asphyxia and hypoglycemia for these infants. So, we believe that cesarean delivery is justified in all cases of fetal weight estimation > 4500g.

[Sonographic estimation of fetal weight at term: a proposal of a predictive score of a weight more than 4500 g]. / L'estimation echographique du poids foetal a terme: proposition d'un score predictif d'un poids supérieur à 4500 g.

UNLABELLED: Estimation of fetal weight at term is essential because of risks of macrosomic infant delivery. The purpose of this study is to assess sonographic prediction of macrosomia and especially in fetal weight (o) > 4500 g. MATERIAL AND METHOD: In a retrospective study on one year period, we analyzed sonography of 214 pregnant women at term having delivered macrosomic infants. From sensitivity, specificity and VPP found for each fetal measurement (abdominal transverse diameter: ATD, femur length: FL, and biparietal diameter :BPD) we tried to determine the best thresholds values that permit to suspect fetal weight more than 4500 g. RESULTS: Sensitivity of ATD (o) > 100 mm, FL (o) > 76 mm and BPD (o) > 94 mm in prediction of macrosomia were: 70.5%, 56% and 58.9% respectively. The most reliable and predictive thresholds for macrosomia more than 4500 g were: 105 mm, 78 mm and 98 mm respectively for ATD, FL and BPD. In an other study, we have found that fundal height (o) > 37 cm is also predictive of such a macrosomia. So we have proposed a predictive score of fetal weight more than 4500 g, based on the best thresholds found for fundal height, ATD, FL and BPD.

[Clinical fetal weight estimation and prediction of macrosomia]. / Estimation clinique du poids foetal: interet dans la prediction de la macrosomie.

The purpose of this study is to assess symphysis fundal height measurement in prediction of fetal macrosomia and to search for the error causes. A retrospective study concerning 400 macrosomic newborns was performed. For each pregnant woman before delivery, we have reviewed fundal height, weight, height and newborn weight. Influence of obesity and maternal height were especially studied. Fundal height measurement is not reliable in prediction of fetal macrosomia. Patient body mass and height may be error causes.

[Peripartum pubic symphysis separation. A report of three cases and review of the literature]. / La disjonction symphysaire du peripartum. A propos de trois cas et revue de la littérature.

Peripartum pubic symphysis separation is a rare complication of delivery, but the incidence seems to be under-estimated. We report three cases of pubic syphysis separation identified in a two-year period. All cases occurred following spontaneous non operative vaginal deliveries. The underlying etiology and pathophysiology has not been fully elucidated. Thus, prevention is difficult. Conservative therapy usually results in a complete recovery within many weeks.

[Ovarian pregnancy: the situation in 2003. A report of four cases and literature review]. / La grossesse ovarienne: le point en 2003. A propos de 4 cas et revue de la littérature.

Ovarian pregnancy remains a rare form of extracitérine pregnancy. It's incidence is estimated at 1 to 6% of ectopic pregnancies. We report 4 cases of ovarian pregnancies diagnosed at the obstetric and gynecology department of Nabeul Hôspital (Tunisia) during a 4 year period. An update on ovarian pregnancy based on these 4 cases and a literature review is provided. In contrast to tubal pregnancy, ovarian pregnancy occurs as a single event in an otherwise healthy woman. There is no specific clinical, laboratory test or ultrasonographic signs for differentiating ovarian from tubal pregnancy. At laparoscopy, it frequently suggest haemorrhage from the corpus luteum or a rupture of ovarian cyst. Histology is the only means of establishing the diagnosés. Ovarian pregnancy rupture is often more dangerous than tubal pregnancy, but conservative treatment is often possible. Recurrency is exceptional and future fertility usually is unmodified.