[Extrauterine pregnancies in patients with intrauterine devices (apropos of 9 cases)]. / Grossesses extra-utérines sur dispositifs intra-utérins (à propos de neuf observations).

PIP: The published literature reports an increase of ectopic pregnancies in patients wearing an IUD. Over the total number of pregnancies with IUD in situ, ectopic pregnancies account for about 10-17%. The incidence is lower for the first 6 months after insertion, and higher after that. The mechanism responsible for extrauterine pregnancies can be the appearance of infectious lesions in the genital tract, or the slow and continuous secretion of prostaglandin promoted by the presence of the IUD. Diagnosis of ectopic pregnancy is not always easy, and it usually follows episodes of pelvic pain and metrorrhagia.^ieng

[Tolerance of Plasti-Pore prostheses in ear surgery]. / Tolérance des prothèses en plasti-pore en chirurgie otologique.

The authors describe the tolerance of Plasti-Pore prosthetic ossicles in reconstructive surgery of the middle ear. Tolerance is excellent where cartilage is interposed between the prosthesis and the tympanic graft (0% failure). Without such insertion of cartilage, the authors note a protrusion by the prosthesis with tympanic perforation in 19.3% of cases, except in those where the tympanic graft is a homograft (0% failure). In the case of a tympanic graft using temporal aponeurosis it is therefore advisable to interpose a fragment of cartilage. This insertion of cartilage does not appear necessary in the case of a tympanic homograft.

[Pregnancy in obese women who have had jejuno-ileal short-circuit operations (author's transl)]. / La grossesse chez les obèses ayant subi une dérivation jéjuno-iléale.

The authors report two cases of obese women who had had intestinal short-circuit operations for obesity 18 months and 24 months previously. They review the indications for this type of operations and the effects the operation has on the body. It has been possible to find 85 other cases in the literature. In general the pregnancy proceeds well but it is important to carry out very strict supervision of the electrolyte balance, of the hypoprotinaemia and of the blood count. Mechanical complications of the short-circuit operation are rare. While abortions and premature labours are not more frequent in these than in other cases the child is often moderately small-for-dates. Congenital malformations can be raised and are of the order of 7 per cent. These fetal abnormalities, as well as maternal digestive troubles, are definitely more frequent if the interval between the operation and the pregnancy is short. It is therefore preferable to wait for two years before allowing a woman who has had a short-circuit type of operation to become pregnant.