[General practitioners' management of childhood asthma in Sfax, Tunisia]. / Prise en charge de l'asthme de l'enfant par le médecin de première ligne au Gouvernorat de Sfax, Tunisie.

AIMS: To study primary care physicians' attitudes toward childhood asthma management and their adherence to international guidelines. METHODS: Cross-sectional, descriptive and analytical survey conducted among 400 primary care physicians practicing in the governorate of Sfax. Data collection was done through a self-administered questionnaire with 36 questions. RESULTS: the participation rate was 53.75%. The average age was 49.72years and the sex ratio=1.52. 56.3% reported that they assisted in childhood asthma medical education between 2019 and 2020. Poor knowledge was found in 53.3% of practitioners. It concerns in 60.5% of cases the long-term asthma treatment. We found that 49.8% of doctors did not use the GINA guidelines in their daily practice. These guidelines were considered too complex by 45.8%. Oral salbutamol was prescribed by 10.2% of physicians in childhood asthma exacerbation and 64.2% antibiotics as therapy for childhood febrile asthma exacerbation. The practice of prescribing antihistamines as long-term therapy is still present in 28.8% of physicians. In front of exercise-induced asthma, sports exemptions were given by 33% of participants. Adherence to asthma guidelines was found in 34,41%. Physicians who are aged between 35 and 45years and who used GINA guidelines had better childhood asthma management score than other physicians. CONCLUSION: Despite guidelines, childhood asthma is still underdiagnosis and undertreated. Our study revealed difficulties faced by primary care physicians in the management of childhood asthma.

[Post-traumatic stress disorder, depression and anxiety in parents of children with epilepsy]. / Trouble stress post traumatique, dépression et anxiété chez les parents d'enfant(s) atteint(s) d'épilepsie.

INTRODUCTION: Post-traumatic Stress Disorder (PTSD), depression and anxiety are the most common psychiatric consequences among parents of children with epilepsy. OBJECTIVES: We aimed to investigate the prevalence and predictors of PTSD, depression and anxiety in a sample of parents of children with epilepsy. METHODS: A survey of 135 parents of children with epilepsy, treated in the pediatric neurology department at the Sfax Teaching Hospital in Tunisia, was conducted in the last quarter of 2019. The PTSD Checklist for DSM-5 and the Hospital Anxiety and Depression Scale (HADS) were used to assess, respectively, PTSD, depression and anxiety in parents. Associations with clinical and demographic variables with PTSD, depression and anxiety were evaluated in a logistic regression model. RESULTS: Results revealed PTSD rates of 20.7%, depression rates of 28.9% and anxiety rates of 55.6%. The main factors associated with PTSD on multivariable analysis were female gender (P=0.026, ORa=13.1), insufficient involvement of partner in disease management (P<10-3, ORa=12.1) and duration of epilepsy less than 12 months (P=0.001; ORa=0.1). Female gender (P=0.006, ORa=18.1) and restriction of social life (P=0.006, ORa=4.1) were associated with depression. Factors associated with anxiety were insufficient involvement of partner in disease management (P=0.03, ORa=4.6) and PTSD (P=0.005, ORa=9.1). CONCLUSION: These findings suggest that clinicians should pay more attention to psychological health of parents of children with epilepsy and help healthcare providers to develop preventive and intervention strategies for parents of such children.

Impact of a training intervention on knowledge and practices of health-care workers about reprocessing reusable medical devices in a South-Tunisian University Hospital.

INTRODUCTION: Reprocessing of reusable medical devices (RMD) play an important role in the prevention of health-care associated infections. In this perspective, this study aimed to evaluate the impact of a training program intervention on health-care workers' (HCWs) knowledge and hospital practices about the reprocessing of RMD as a main strategic axis of infection control. METHOD: We led a pre-post quasi-experimental study to evaluate knowledge of HCWs and to assess hospital practices in reprocessing RMD before and after a training intervention from May to November 2020 in Hedi Chaker University Hospital. A self-administrated questionnaire was distributed for each participant to assess knowledge. To evaluate practical skills, an audit grid was used. RESULTS: Overall, 30 participants were included. All HCWs had a fair level of knowledge before training. The knowledge score (KS) has significantly risen from pre to post-training (64/100 vs. 80/100; P<0.001). When stratified by RMD type, a significant increase was noted on post intervention in KS about thermo-sensitive RMD reprocessing (P=0.044) and sterilization of thermo-resistant RMD (P=0.004). As for practice assessment, 5 (62.5%) departments had a fair level of practice. The conformity score (CS) did not significantly change from baseline to post-follow-up (53.5 vs. 56.2; P=0.06). According to the audit sections, we did not find a significant change in the pre- and post-intervention CS in sterilization process (70 vs. 80; P=0.06) and in the cleaning and decontamination steps (66.7 vs. 67; P=0.18). CONCLUSION: As opposed to practical skills, positive impact of the training intervention on HCWs knowledge was noted, which underlined the gap between theory and practice.

Validation of the Hamilton Depression Rating Scale (HDRS) in the Tunisian dialect.

OBJECTIVES: The Hamilton Depression Rating Scale (HDRS) is one of the most frequently used depression assessment scales. In Tunisia, psychiatrists commonly use this scale in a Tunisian dialect. However, to the best of our knowledge, this scale has never been validated in Tunisia. This study aims to investigate the reliability and the validity of the HDRS among Tunisian patients who have been hospitalised for a suicide attempt. A secondary objective is to describe the sociodemographic characteristics of the study population. STUDY DESIGN: This is a cross-sectional study performed in the emergency department. METHODS: Patients who were hospitalised for a suicide attempt were eligible for inclusion in this study. The Tunisian version of the HDRS was developed using a forward-backward translation procedure. Psychometric properties of the Tunisian version of the HDRS were tested, including (i) construct validity with a confirmatory one-factor analysis; (ii) internal validity with Pearson correlations and Cronbach alpha coefficients; and (iii) external validity by correlations with the Patient Health Quality-9 (PHQ-9) scale. We used the Receiver-Operating Characteristic (ROC) curve to analyse the correlation between the total HDRS score and the presence of depression according to the PHQ-9. RESULTS: In total, 101 participants were enrolled in this study. The principal component analysis (PCA) type factor analysis with varimax rotation found a high-grade correlation between HDRS individual items and the total score. The total variance, explained by five factors, was 64.4%. Cronbach's standardised alpha coefficient was 0.86 for the overall scale. Correlations between the total HDRS score and the PHQ-9 score, and its various items, were significant. The ROC curve analysis showed good sensitivity (80.8%) and specificity (91.1%). CONCLUSION: The Tunisian version of the HDRS is an acceptable instrument to screen depression in individuals who have attempted suicide.

Prevalence and predictors of hypertension self-care practice in primary health-care facilities in Southern Tunisia.

BACKGROUND: Unmanaged hypertension (HTN) is usually accompanied with complications leading to disability in older adults. It has been demonstrated that self-care practice is essential for blood pressure control and reduction of HTN complications. OBJECTIVE OF THE STUDY: This study aimed to estimate the level of implementation of HTN self-care practice and to identify their associated factors. STUDY DESIGN: It was a cross-sectional study conducted in Sfax, Southern Tunisia in April 2020. MATERIALS AND METHODS: A total of 6 primary health-care facilities were approached for the study participants according to a single-stage cluster sample, by selecting six grapes randomly. A total of 270 participants were recruited, among whom 250 cases (92.6%) completed the questionnaire. RESULTS: A total of 250 hypertensive patients were included in the study, giving a male to female ratio of 0.77. There were 125 participants (50%) aged over 65years. Overall, 137 cases (54.8%) had a high total self-care practice score. The independent factors of good HTN self-care practice were≥65years [Adjusted odds ratio (AOR)=9.5; P<0.001], university educational level of the participants (AOR=21.2; P<0.001), as well as receiving a health education, by health-care providers (AOR=2.5; P=0.012) and family members (AOR=4.36; P=0.004). Advanced hypertension stage (II and III) (AOR=0.45; P=0.032) and chronic pulmonary diseases, including asthma (AOR=0.42; P=0.027) and chronic obstructive pulmonary diseases (AOR=0.27; P=0.016) were independently associated with poor HTN self-care practice. CONCLUSION: Advanced hypertension stage, pulmonary co-morbidities, education level and lack of self-care education were predictive factors of poor self-care practice. These findings suggested that such factors should be considered when planning HTN self-care education.

The ongoing challenge of Pulmonary Tuberculosis in Southern Tunisia: A review of a 22-year period.

BACKGROUND: Despite the wide use of anti-tuberculosis drugs, pulmonary tuberculosis (PTB) remains one of the most important causes of mortality and morbidity, particularly in developing countries. Therefore, combining clinical and epidemiological approach would be of a great benefit. Our study aimed to describe the epidemiological and clinical specificities of PTB and its recent chronological trends. METHODS: We conducted a retrospective study of all PTB new cases of any age diagnosed between 1995 and 2016 in Southern Tunisia. We applied the direct method of age-standardization using the World Standard Population to compute the age standardized incidence rate (ASIR) and the age standardized mortality rate (ASMR) per 100 000 inhabitants. RESULTS: We recorded 1121 new cases with PTB among 2771 new cases of tuberculosis (40.5%). The ASIR of PTB was 5.3/100 000 inhabitants/year and didn't change over the study period (rho=0.3; P=0.2). Patients with PTB were mainly aged between 15 and 59 years (n=861; 76.8%) and came from urban areas (n=600; 55%). The median duration of treatment was 7.6 months (IQR=[6-8 months]). Successful outcome was notified in 1075 cases (95.9%). Forty-one patients died yielding an ASMR of 0.18/100 000 inhabitants/year. Factors statistically associated with unsuccessful outcome included age≥60 years (OR=5; P<0.001) and shorter treatment duration (6.15 months vs 7.76 months; P<0.001). CONCLUSION: In contrast to the decline in the global PTB incidence reported worldwide and in the neighboring countries, our study revealed no significant change in the PTB rates from 1995 to 2016. Therefore, tools and strategies used to manage PTB should be strengthened by a substantial effort in both basic science and epidemiology to have better incidence curves.

A new combined predicting model using a non-invasive score for the assessment of liver fibrosis in patients presenting with chronic hepatitis B virus infection.

OBJECTIVES: Several non-invasive markers have recently been proposed to predict liver fibrosis without percutaneous liver biopsy (PLB). We aimed to evaluate the performance of non-invasive scores and to highlight the value of a new combined score in the prediction of liver fibrosis in chronic hepatitis B (CHB) patients. PATIENTS AND METHODS: We performed a retrospective study of patients presenting with CHB who underwent PLB between 2008 and 2016. We calculated ASAT/Platelet Ratio Index (APRI), Fibrosis-4 Score (FIB4), GGT-to-platelet ratio (GPR), and ASAT/ALAT Ratio (AAR). Then, we combined APRI and FIB-4 scores into a new combined score. We assessed their performance in predicting liver fibrosis according to the Metavir score. RESULTS: A total of 179 patients presenting with CHB were included. Multivariate analysis showed that the APRI score was the only independent factor of significant fibrosis (OR=3.78; P=0.02), whereas the FIB-4 score was the only independent factor for severe fibrosis (OR=2.85; P<0.001) and cirrhosis (OR=2.5; P=0.001). At a threshold of severe fibrosis, APRI had the best specificity (75%) and FIB-4 had the greatest sensitivity (74%). Using the combined score, we improved the diagnostic performance of APRI and FIB-4 scores at the three thresholds of liver fibrosis. With this combined score, maximum 25.1% of patients presenting with CHB would undergo PLB. CONCLUSION: APRI, FIB-4, and GPR scores were well performing to predict liver fibrosis during CHB. The new combined score using APRI and FIB-4 was more accurate at the three-fibrosis thresholds.

[Active smoking: A major risk factor for human non-communicable diseases in a hospital survey]. / Le tabagisme actif : un facteur de risque majeur des maladies non transmissibles humaines dans une enquête hospitalière.

INTRODUCTION: Tobacco is the main preventable cause of death worldwide. Our study aimed to determine the role of tobacco in the occurrence of non-communicable diseases (NCDs). METHODS: We conducted a retrospective study including all NCDs patients during 2015-2016. NCDs include cardiovascular diseases (CVD), chronic respiratory diseases (CRD), cancers (CS) and diabetes mellitus (DM). RESULTS: We identified 3643 cases of NCDs (43%) among 8478 hospitalizations, all diseases combined. Active smoking was found in 1076 cases (29.5%). Among the NCDs groups, CVD was the most common (65%). Tobacco was significantly associated with CVD (P<0.001), CRD (P=0.002), bronchopulmonary CS (P<0.001), haematological malignancy (P=0.023), and DM (P<0.001). Multivariate analysis performing binary logistic regression revealed that tobacco was an independent factor associated with CVD (OR=2.6, P<0.001), CRD (OR=1.5, P<0.001), bronchopulmonary CS (OR=1.8, P=0.013) and DM (OR=3.6, P<0.001). CONCLUSION: Active smoking was a major risk factor in the occurrence of NCDs. Thus, smoking cessation represents the cornerstone for preventing the spread of these diseases, especially in countries with limited resources.

[Psychiatric comorbidity related to children with attention deficit hyperactivity disorder at schools in Sfax, Tunisia]. / Comorbidité psychiatrique au trouble déficit de l'attention/hyperactivité en population scolaire dans la région de Sfax. Tunisie : étude transversale.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a prevalent behavioral disorder particularly noticed among school children. It is often associated with other psychological troubles at the origin of an additional difficulty that has to be overcome. OBJECTIVE: Our research's aim was to study the comorbidity of school-aged children diagnosed with ADHD in Sfax, Tunisia. SUBJECTS AND METHODS: A cross-sectional descriptive study was carried out from 1st April 2008 to 1st October 2008. Five hundred and thirteen pupils aged between 6 and 12, from primary arbitrarily chosen schools from Sfax were subjected to this study. Measurements were carried out in two steps: parents and teachers of each child filled in separately Conners questionnaire, then children with a score in subscales inattention, hyperactivity impulsivity higher than 70 were selected for psychiatric interview that was intended to confirm or to invalidate the ADHD diagnosis and the possible comorbid diagnosis. The diagnoses were made according to DSM-IV-TR. RESULTS: We have noticed that 109 pupils exhibited at least one pathological score on the Conners questionnaire. After interviewing these 109 pupils, the results have shown that 51 among them fulfilled criteria of ADHD. Prevalence of ADHD was found to be 9.94 %. About 72.54 % of children with ADHD had one or more comorbid disorder: learning disabilities (23.52 % of cases), anxiety disorder (31.37 % of cases), oppositional defiant disorder in (15.68 % of cases), mood disorder (3.92 % of cases), enuresis (13.72 % of cases) and slight mental retardation (1.95 % of cases). CONCLUSION: We can say that this study has shown that ADHD school children's psychiatric comorbidity is similar to any other previous study.

Translation in Arabic, adaptation and validation of the SF-36 Health Survey for use in Tunisia.

OBJECTIVE: To translate into Arabic and validate the SF-36 quality of life index in a Tunisian Arabic population. BACKGROUND: No validated Arabic quality of life index is published. DESIGN: Arabic translation of the SF-36 scale was obtained by the "forward/backward translation" method. Adaptations were made after a pilot study involving 22 subjects from general population. Inter-rater reliability was assessed by use of intraclass correlation coefficient (ICC) and Bland and Altman method. Construct validity was assessed by Spearman rank correlation coefficient (convergent and divergent validity), and factor analysis with Varimax rotation. Internal consistency was assessed by Cronbach alpha coefficient. RESULTS: We note that 130 Tunisian subjects were included in the validation study. No items were excluded. Inter-rater reliability was excellent (ICC=0.98). Cronbach alpha coefficient was 0.94 conferring to translated index a good internal consistency. Expected divergent and convergent validity results suggested good construct validity. Two main factors were extracted by factor analysis and explained 62.3% of the cumulative variance: the first factor represented mental component, the second physical component. The Cronbach alpha coefficient was 0.88 and 0.91 respectively for factor 1 and factor 2. CONCLUSION: We translated into Arabic language and adapted the SF-36 scale for use in Tunisian population. The Arabic version is reliable and valid. Although the scale was validated in a Tunisian population, we expect that it is suitable for other Arab populations, especially North Africans. Further studies are needed to confirm such a hypothesis.

Are there any predictive factors of metachronous inguinal hernias in children with unilateral inguinal hernia?

PURPOSE: This study was done to identify risk factors for metachronous manifestation of contralateral inguinal hernia in children with unilateral inguinal hernia. METHODS: This is a retrospective study of 565 patients with inguinal hernia during a nine-year period at a single institution. Age, sex, and side of the hernia at presentation were recorded. The incidence of metachronous inguinal hernia and its risk factors were analyzed. RESULTS: Of 565 children, 62 (11%) were presented with synchronous bilateral hernias. Of the remaining 503, a metachronous contralateral hernia developed in 22 (4.4%). The age at hernia repair of the patients with contralateral manifestation (18 ± 3.67 months; mean ± SD), was significantly younger than observed in the control patients (34 ± 1.34 months; p = 0.000). There was no significant difference between the groups in other factors such as the age at hernia presentation, the initial side of the hernia, birth weight. and the percentage of patients who had experienced incarceration. CONCLUSION: We believe that the incidence is still too low to recommend routine contralateral exploration. Therefore, infants younger than 18 months appear to be a higher-risk subpopulation and should receive closer follow-up over this time period.

[Bacteriology of community acquired meningitis in Sfax, Tunisia (1993-2001)]. / Bactériologie des méningites communautaires dans la région de Sfax, Tunisie (1993-2001).

OBJECTIVE: The aim of this study was to analyze the distribution of bacteria responsible for community-acquired meningitis and the pattern of resistance of common species. DESIGN: All bacteriologically confirmed cases of community-acquired meningitis were recorded between 1993 and 2001. RESULTS: Two hundred twenty-four cases of bacterial meningitis were recorded. The most frequent species were Haemophilus influenzae and Streptococcus pneumoniae followed by Neisseria meningitidis with respectively 37.1%, 32.1%, and 10.7% of cases. The yearly distribution of these bacteria did not show any epidemic peak. Enterobacteria and group B Streptococcus were the most frequently identified pathogens in neonatal meningitis. H. influenzae was the predominant microorganism in children between one month and five years of age, (66.4%) followed by S. pneumoniae (23.5%). S. pneumoniae was the predominant bacteria responsible fore more than half of the cases over five years of age. 28.8% of H. influenzae strains produced beta-lactamase. 27.2% of S. pneumoniae strains were less susceptible to penicillin. Resistance rates for amoxicillin and cefotaxime were respectively 10.6% and 7.5%. Only one strain of N. meningitidis (4.2%) presented with a decreased susceptibility to penicillin. CONCLUSIONS: In our study, H. influenzae and S. pneumoniae were the main microorganisms responsible for community-acquired meningitis. High resistance rates were found for these bacteria: 28.8% of H. influenzae to ampicillin and 27.2% of S. pneumoniae to penicillin.

Sperm oxidative stress and the effect of an oral vitamin E and selenium supplement on semen quality in infertile men.

Numerous studies have reported beneficial effects of antioxidant drugs on semen quality, but there is no well-defined therapeutical protocol in male infertility. This study aimed to test the effects of vitamin E and selenium supplementation on lipid peroxidation and on sperm parameters. The study included 54 voluntary and infertile men who produced semen samples for spermiogram and for spectrophotometric measurement of a lipid peroxidation marker, the malondialdehyde (MDA), and produced blood samples for high-performance liquid chromatography assessment of serum vitamin E level. The trial was randomized and open. Twenty-eight men were supplemented daily by vitamin E (400 mg) and selenium (225 microg), during 3 months. The remaining 26 patients received vitamin B (4,5 g/day) for the same duration. Only 20 patients achieved their treatment and returned for control analysis. MDA concentrations in sperm were much less than in seminal plasma and motility and viability were inversely correlated with semen MDA levels. In contrast to vitamin B supplementation, vitamin E and selenium supplementation produced a significant decrease in MDA concentrations and an improvement of sperm motility. The results confirm the protective and beneficial effects of vitamin E and selenium on semen quality and advocate their use in male infertility treatment.

[Quality control in tumor marker values: methology, results and potential problems]. / Le controle de qualite dans le dosage des marqueurs tumoraux: methodologie, resultats et problemes poses.

Ensuring the quality is one of the first preoccupations of every biologist. However, measuring the circulating tumor markers could be more vital especially that the result is decisive for the diagnostic and the therapeutic attitude. In this study, we report methods used for an internal and external < or = quality control < or = program applied in the immunology laboratory of Sfax university hospital for the dosage of tumor markers AFP, CEA and CA15-3. The results obtained are analysed comparatively with those reported in literature. Factors causing discrepancies in the results of tumor marker measurements are recalled.

[Ultrasonography in the diagnostic approach of septic arthritis]. / L'échographie dans l'approache diagnostique des arthrites septiques.

PURPOSE OF THE STUDY: Septic arthritis is frequent in Tunisia and is responsible for orthopedic sequela. The purpose of this study was to establish the indication and the viability of ultrasound scanning in the early diagnosis of septic arthritis. MATERIAL AND METHODS: 82 patients were explored by ultrasonography for suspected septic arthritis. Mean age was 7 years (range 2 months to 37 years). All sonographic studies were performed using a 7.5 MHZ transducer. 52 patients were surgically treated or had joint aspiration. Only 39 patients had septic arthritis. The hip and the knee were the most frequent localisation (respectively 20 and 12 cases). RESULTS: Statistical analysis showed that the ultrasound scanning in the diagnosis of joint effusion had a sensitivity of 93.4 per cent and a specificity of 100 per cent. Matter floating within the joint effusion was noted in 50 per cent of septic arthritis. These changes were not found in other arthritis. The thickness of synovialis and joint capsule was not specific of septic arthritis. In hip septic arthritis (51 per cent of localisation) the mean width of the anterior synovial recess was 11.7 mm (5-20 mm). In the asymptomatic opposite hip, the mean width was 3.6 mm (2.6-5 mm). Cortical irregularities had suggested osteomyelitis of femoral neck in osteoarthritis of the hip in 4 cases. Subperiosteal abscess of the femoral neck was directly visualized in another patient. DISCUSSION AND CONCLUSION: Our expense highlights that sonography may be a useful tool in the management of patient with suspect septic arthritis. Sonography allows early diagnosis of joint effusion with high accuracy. Hyperechoic or mixed aspects of the fluid joint suggest septic origin.

[In vitro study of the sensitivity to antibiotics of 213 Pseudomonas aeruginosa strains isolated in an intensive care unit of the Sfax Hospital (Tunisia)]. / Etude in vitro de la sensibilité aux antibiotiques de 213 souches de Pseudomonas aeruginosa isolées au service de réanimation du CHU de Sfax (Tunisie).

Susceptibility of 213 strains of Pseudomonas aeruginosa isolated in a general intensive care unit during two years 1989 and 1990 was tested against 11 antibiotics: ticarcillin (TIC), ticarcillin+clavulanic acid (TCC), cefsulodin (CFS), ceftazidime (CAZ), imipenem (IMP), gentamicin (G), tobramycin (TOB), amikacin (AN), ofloxacin (OFX), norfloxacin (NOR) and ciprofloxacin (CIP). Antibiotic susceptibility testing was performed by disk agar diffusion test and by measuring minimum inhibitory concentrations (MICS using test agar dilution. 65% of strains were isolated from respiratory tract infections. Resistance frequency of this antibiotics was: TIC: 41.3%, TCC: 33.8%, CFS: 26.5%, CAZ: 23.2%, IMP: 11.6%, G: 72.5%, TOB: 46.5%, AN: 12.6%, OFX: 29.3%, NOR: 21.3%, CIP: 17.6%. We observed by measuring CMI that imipenem and amikacin were the most active antibiotics. From 1989 et 1990, the increase number of strains resistant to imipenem, amikacin and fluoroquinolones could be explained by massive use of those antibiotics. Besides their high level of resistance, strains isolated in intensive care unit ere characterized by their multiresistance: 24 strains were resistant to 8 of 11 antibiotics tested; four of them showed resistance to all antibiotics the multiresistance of those strains suggest strongly that decreased permeability could be the cause.

[Prevention of complications of severe arterial hypertension in pregnancy using platelet antiaggregants]. / Prévention des complications de l'hypertension artérielle gravidique par les antiagrégants plaquettaires.

A prospective study conducted between January, 1985 and September, 1987 involved 60 pregnant women who had previously suffered from hypertension in pregnancy with or without foetal and maternal complications. Thirty women received aspirin 250 mg every other day and dipyridamole 300 mg per day, starting from the 3rd month of pregnancy (group I); 30 women were examined regularly from the onset of pregnancy and received the conventional symptomatic treatment of complications that occurred (group II). Women in these two groups were similar in age, parity and previous obstetrical complications. Twenty-five women of group I had a perfectly normal pregnancy, as against 5 women of group II (P less than 0.001). Hypertension and/or proteinuria were observed in 5 women of group I and 15 of group II (NS). The 13 severe complications recorded (foetal death, eclampsia, retroplacental haematoma) occurred exclusively in women of group II. The duration of pregnancy and weight of the newborn were significantly greater in group I than in group II. Thus, antiplatelets appear to have an uncertain preventive effect on hypertension of pregnancy and a much more obvious prophylactic effect on major foetal and maternal complications.