[Advantages and risk of a trial of vaginal delivery in the scarred uterus]. / Avantages et risques de la tentative de la voie basse sur utérus cicatriciel.

We present a retrospective study of 1235 deliveries in scarred uterus. The aim of this study is to analyse the materno-fetal mortality and morbidity after caesarean section and a trial vaginal delivery. Uterine challenge has been tried is 578 cases with success in 12.14%. The global rate of real uterine rupture is 1.3% and of scare opening is 3.16%. The trial vaginal birth was complicated by uterine rupture in 5.9% versus 2.89% in planned caesarean section. (P = 0.00967). The length of hospitalization, the number of blood transfusion and the rate of puerperal infections are lower in the vaginal delivery trial group. The rate of new-born with Apgar < 7 in the 5th minute is in a significative way, lower in the iterative caesarean section group. (2.58% versus 4.67%), (P = 0.048). In the other hand, uterine rupture rate as well as fetal distress rate are higher in case of failure of the vaginal delivery. Maternal and fetal complications are rare and seem to be more frequent in case of failure of the uterine challenge. Accurate analysis of different obstetrical situations is necessary in order to predict the success or the failure of the vaginal delivery trial. It may lessen the maternal and fetal morbidity.

[Acute gravidic steatosis: review and management]. / La steatose aigue gravidique: revue et mise au point.

The acute gravidic steatosis is a specific hepatopaty of pregnancy that has a low frequency witch often very serious. On the light of a gravidic steatosis case histological proved progenitors analyse the clinical criteria of positive diagnosis. The coexistence of an hepatic anomaly that is of an hyperuricemia with a normotensive woman is too suggestive of the diagnosis. The maternal mortality exceeded 92% before 1970, now it has reached 10%. his amelioration is mainly due the obstetric attitude of evacuation and the progress of reanimation.

[The association between Takayasu's arteritis and pregnancy]. / A propos de l'association arterite de TAKAYASU et grossesse.

We present about three observations of patients suffering from TAKAYASU's arteritis two of home have necessitated one carotidien's angioplasties. From these three cases and from a review of literature, we analyse the different materno-foetal risks of the association TAKAYASU'S arteritis and pregnancy. The high arterial pressure and the pre-eclampsia constitute the aim maternal complication. The vascular accident and the cardiac decompensation can be seen in five percent (5%) of cases. The back wordiness of the intrauterine growth the major foetal complication. Eventually, we suggest the behaviour to hold in order to improve the materno-foetal prognostic.