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2.
Tunis Med ; 84(8): 517-9, 2006 Aug.
Artigo em Francês | MEDLINE | ID: mdl-17175697

RESUMO

Placenta percreta is characterized by the penetration of trophoblast through the myometrium and peritoneum. This invasion may also involve adjacent structures. This condition is the most serious of placental implantation anomalies. It is a rare but life-threatening complication of pregnancy. We present a case of placenta praevia percreta with involvement of the bladder, discuss the particularities of the diagnosis and management, and review the literature.


Assuntos
Placenta Acreta/diagnóstico , Doenças da Bexiga Urinária/etiologia , Adulto , Feminino , Humanos , Histerectomia , Gravidez , Doenças da Bexiga Urinária/cirurgia
3.
Tunis Med ; 84(7): 458-61, 2006 Jul.
Artigo em Francês | MEDLINE | ID: mdl-17039740

RESUMO

Prune Belly syndrome is characterized by a combination of megacystis, anterior abdominal wall distension with deficiency of the abdominal wall musculature, and bilateral cryptorchidism. Diagnosis is easy after 15 weeks of gestation, but may be difficult at the end of the first term. Authors report 2 cases of Prune Belly syndrome diagnosed at 11 and 14 weeks of gestation respectively. After literature review, diagnosis and prognosis particularities of this syndrome are discussed.


Assuntos
Doenças Fetais/diagnóstico por imagem , Diagnóstico Pré-Natal , Síndrome do Abdome em Ameixa Seca/diagnóstico por imagem , Aborto Induzido , Adulto , Diagnóstico Precoce , Feminino , Doenças Fetais/diagnóstico , Humanos , Masculino , Gravidez , Primeiro Trimestre da Gravidez , Síndrome do Abdome em Ameixa Seca/diagnóstico , Ultrassonografia Pré-Natal
4.
Tunis Med ; 84(1): 16-20, 2006 Jan.
Artigo em Francês | MEDLINE | ID: mdl-16634207

RESUMO

The purpose of this study is to determine predictive factors of successful vaginal delivery after cesarean section, and to estimate the risks of this trial of labor (TOL). A retrospective study about 352 women undergoing a TOL after cesarean section was carried out. Different variables stratified by the termination of the TOL were analysed with statistic tests. TOL success rate was 76.1%. Parity > or = 3. prior vaginal delivery following cesarean section, body mass index < 30, fundal height < 34 cm, and low fetal head level at the beginning of labor increased significantly the probability of success. Uterine rupture rate is 1.1%. Failure of TOL was associated with a higher risk of uterine scar dehiscence and rupture, and higher fetal morbidity. A predictive score of successful vaginal delivery after cesarean section is proposed.


Assuntos
Prova de Trabalho de Parto , Ruptura Uterina/etiologia , Nascimento Vaginal Após Cesárea , Adulto , Feminino , Humanos , Morbidade , Paridade , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez , Prognóstico , Estudos Retrospectivos , Fatores de Risco
5.
Tunis Med ; 82(6): 526-30, 2004 Jun.
Artigo em Francês | MEDLINE | ID: mdl-15517951

RESUMO

UNLABELLED: Estimation of fetal weight at term is essential because of risks of macrosomic infant delivery. The purpose of this study is to assess sonographic prediction of macrosomia and especially in fetal weight (o) > 4500 g. MATERIAL AND METHOD: In a retrospective study on one year period, we analyzed sonography of 214 pregnant women at term having delivered macrosomic infants. From sensitivity, specificity and VPP found for each fetal measurement (abdominal transverse diameter: ATD, femur length: FL, and biparietal diameter :BPD) we tried to determine the best thresholds values that permit to suspect fetal weight more than 4500 g. RESULTS: Sensitivity of ATD (o) > 100 mm, FL (o) > 76 mm and BPD (o) > 94 mm in prediction of macrosomia were: 70.5%, 56% and 58.9% respectively. The most reliable and predictive thresholds for macrosomia more than 4500 g were: 105 mm, 78 mm and 98 mm respectively for ATD, FL and BPD. In an other study, we have found that fundal height (o) > 37 cm is also predictive of such a macrosomia. So we have proposed a predictive score of fetal weight more than 4500 g, based on the best thresholds found for fundal height, ATD, FL and BPD.


Assuntos
Peso ao Nascer , Feto/anatomia & histologia , Ultrassonografia Pré-Natal , Feminino , Humanos , Recém-Nascido , Valor Preditivo dos Testes , Gravidez , Estudos Retrospectivos
6.
Tunis Med ; 82(7): 656-61, 2004 Jul.
Artigo em Francês | MEDLINE | ID: mdl-15552023

RESUMO

UNLABELLED: The objective of this study is to review the difficulties in prediction of great macrosomia, to assess trial of labor results, and to confirm the increased risk of perinatal complications. MATERIAL AND METHOD: in this retrospective study we analyzed 61 deliveries of infants with birth weights > 4500 g in one year period. This group was compared with a group of infants weighing between 4000 and 4500 g (339 cases) born during the same period. Elective cesarean delivery was performed for 3 cases of the second group because of overestimation of fetal weight. 38 cases of the first group (62.3%) were delivered vaginally after underestimation of fetal weight. Incidence of shoulder dystocia in vaginal delivery was 13.5% in the first group and 5.32% in the second one, but difference was not statistically significant (p = 0.07). Difference between incidence of hypoglycemia in the first group (18.03%) and in the second one (2.06%) was highly significant (p = 0.00006) There is no reliable method for prediction of fetal weight > than 4500 g. With literature review, we confirm the increased risk of shoulder dystocia, birth asphyxia and hypoglycemia for these infants. So, we believe that cesarean delivery is justified in all cases of fetal weight estimation > 4500g.


Assuntos
Parto Obstétrico , Macrossomia Fetal , Peso ao Nascer , Parto Obstétrico/métodos , Macrossomia Fetal/diagnóstico , Humanos , Recém-Nascido , Estudos Retrospectivos
7.
Tunis Med ; 82(3): 271-5, 2004 Mar.
Artigo em Francês | MEDLINE | ID: mdl-15382461

RESUMO

The purpose of this study is to assess symphysis fundal height measurement in prediction of fetal macrosomia and to search for the error causes. A retrospective study concerning 400 macrosomic newborns was performed. For each pregnant woman before delivery, we have reviewed fundal height, weight, height and newborn weight. Influence of obesity and maternal height were especially studied. Fundal height measurement is not reliable in prediction of fetal macrosomia. Patient body mass and height may be error causes.


Assuntos
Macrossomia Fetal/diagnóstico , Peso Fetal , Adulto , Peso ao Nascer , Estatura , Peso Corporal , Feminino , Previsões , Humanos , Recém-Nascido , Mães , Obesidade , Razão de Chances , Gravidez , Complicações na Gravidez , Estudos Retrospectivos
8.
Tunis Med ; 82(9): 858-66, 2004 Sep.
Artigo em Francês | MEDLINE | ID: mdl-15693480

RESUMO

Ovarian pregnancy remains a rare form of extracitérine pregnancy. It's incidence is estimated at 1 to 6% of ectopic pregnancies. We report 4 cases of ovarian pregnancies diagnosed at the obstetric and gynecology department of Nabeul Hôspital (Tunisia) during a 4 year period. An update on ovarian pregnancy based on these 4 cases and a literature review is provided. In contrast to tubal pregnancy, ovarian pregnancy occurs as a single event in an otherwise healthy woman. There is no specific clinical, laboratory test or ultrasonographic signs for differentiating ovarian from tubal pregnancy. At laparoscopy, it frequently suggest haemorrhage from the corpus luteum or a rupture of ovarian cyst. Histology is the only means of establishing the diagnosés. Ovarian pregnancy rupture is often more dangerous than tubal pregnancy, but conservative treatment is often possible. Recurrency is exceptional and future fertility usually is unmodified.


Assuntos
Gravidez Ectópica , Adulto , Diagnóstico Diferencial , Emergências , Feminino , Humanos , Laparoscopia , Laparotomia , Ovariectomia , Gravidez , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/patologia , Gravidez Ectópica/cirurgia
9.
Tunis Med ; 82(12): 1116-20, 2004 Dec.
Artigo em Francês | MEDLINE | ID: mdl-15822515

RESUMO

Peripartum pubic symphysis separation is a rare complication of delivery, but the incidence seems to be under-estimated. We report three cases of pubic syphysis separation identified in a two-year period. All cases occurred following spontaneous non operative vaginal deliveries. The underlying etiology and pathophysiology has not been fully elucidated. Thus, prevention is difficult. Conservative therapy usually results in a complete recovery within many weeks.


Assuntos
Complicações do Trabalho de Parto , Sínfise Pubiana/lesões , Adulto , Repouso em Cama , Fixadores Externos , Feminino , Seguimentos , Humanos , Recém-Nascido , Dor/etiologia , Gravidez , Fatores de Tempo , Caminhada
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