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1.
J Gynecol Obstet Biol Reprod (Paris) ; 45(8): 985-989, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-27496570

RESUMO

Endometriosis is a common condition in women, whose main repercussions are painful symptoms. In addition, it was shown that endometriosis was a major cause of infertility and various obstetric complications could be related to this pathology. Uterine rupture is a rare but serious complication whose incidence tends to decrease with the screening of women at risk, however, its fetal, maternal morbidity and mortality causes remains important. We were confronted with a case of posterior uterine rupture in a patient of 36 years, primipare term exceeded in immediate postpartum period. The patient's primary antecedent of uterine surgery torus was responsible for infertility endometriosis. The outcome was favorable for the mother, after a surgical treatment by laparotomy, and for the child. In the literature, two cases have been reported of uterine rupture after endometriosis surgery, which is why we found it interesting to report this rare case. Given the increase in surgical management of this disease, it seems relevant to ask whether, in the future, we should be more vigilant in monitoring pregnancy for these women.


Assuntos
Endometriose/cirurgia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Doenças Retais/cirurgia , Ruptura Uterina/etiologia , Doenças Vaginais/cirurgia , Adulto , Feminino , Humanos , Gravidez
2.
J Gynecol Obstet Biol Reprod (Paris) ; 44(8): 740-51, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26139036

RESUMO

OBJECTIVE OF THE REVIEW: To identify predictors of preterm delivery in the context of threatened preterm labour. MAIN POINTS: Tobacco use and previous history of preterm delivery are the main anamnestic elements to predict preterm birth. High positive predictive value of vaginal examination is restricted to cases with strong cervical alterations like dilatation over 4 cm. In case of discrete cervical alterations, literature confirms the great interest for cervical length ultrasonographic measurement as it reduces false positive cases. Absence of fetal respiratory movements appears to be as sensitive as cervical length and could be more specific but its clinical use remains rare. Vaginal detection of fetal fibronectin is the most useful biomarker with high negative predictive value (>90%). Fibronectin quantitative test seems to enhance the positive predictive value. No other biomarker is currently used in clinical practice. Electromyography and elastography of the cervix appear to be promising approaches.


Assuntos
Colo do Útero/diagnóstico por imagem , Fibronectinas/análise , Nascimento Prematuro/diagnóstico , Diagnóstico Pré-Natal/métodos , Colo do Útero/fisiopatologia , Feminino , Humanos , Gravidez , Ultrassonografia
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