[Cesarean scar pregnancy: a case report of conservative management]. / Grossesse sur cicatrice de césarienne : un cas clinique de traitement conservateur.

A caesarean scar pregnancy is a rare type of ectopic pregnancy which engages the vital prognosis either by hemorrhage or by early uterine rupture. We report the case of a 38-years-old patient who presented an ectopic pregnancy developed inside a previous caesarean section scar. The diagnosis was made at eight weeks of gestation by ultra-sound and allowed a fast management. We chose a conservative medical treatment by methotrexate both systemic and in situ. A hemorrhagic complication occured in two months of the initial treatment, requiring an endovascular therapy as well.

[Obstetrical management of women with previous caesarean section]. / Prise en charge de l'accouchement des patientes ayant un antécédent de césarienne.

The authors announce their own experience and data of the literature to clarify their policy in cases of pregnancy after a previous caesarean section. For obstetricians, the question is to accept a trial of labor for vaginal birth or to decide an elective caesarean section. We particularly explain our conclusions in cases of breech deliveries, twin pregnancies, fetal pelvic disproportion, maternal diabetes, and labor inductions. In cases of previous caesarean, a trial of labor can be successfully tempted in numerous situations. Nevertheless, there are some limits not to be crossed.

[Acute pancreatitis induced by major hypertriglyceridemia during pregnancy. A case report]. / Pancréatite aiguë secondaire à une hypertriglycéridémie majeure au cours de la grossesse. A propos d'un cas.

A parturient in the 37th week of gestation is referred to the obstetrical emergency ward for an acute abdominal pain with vomiting and fever. Few hours after her admission, a caesarean section is performed for acute fetal distress. It gave birth to a 3940 g healthy newborn. An abundant and milky peritoneal fluid is noted during the C-section related to a major hypertriglyceridemia (84,47 g/L) which induced an acute pancreatitis explaining the early symptoms. The patient is then hospitalized in surgical reanimation: heparin and a low fat diet led to a quick decrease of triglyceridemia and the healing of the acute pancreatitis. We review the most recent literature about acute pancreatitis during pregnancy, especially induced by hypertriglyceridemia, and the different management option: heparin, parenteral nutrition or plasmapheresis.