Antepartum detection of macrosomic fetus: the effect of misdiagnosis.

AIM: To determine the effect of misdiagnosis of macrosomia on maternal and perinatal outcomes. METHODS: We conducted a retrospective study ,between January 2007 and December 2008 of women (n = 464) who delivered singleton neonates with actual birth weight over 4000g and in whom fetal weight was estimated, by both methods :sonographic and clinical, up to 3 days before delivery.Statistical comparisons were made between patients in whom fetal macrosomia was predicted : «prediction ¼ group (n=336)and those in whom it was not « non prediction ¼group (n=128) for outcome variables. RESULTS: The cesarean delivery was performed in 35.9% in « non predicted ¼ group, and in 35.7% in the « predicted ¼ group.The difference was not statistically significant. Failure to detect macrosomia was associated with higher rates of maternal and fetal complications in the group « non predicted ¼ compared with the group « predicted ¼ :perineal trauma,post partum hemorrhage, 5- minute Apgar scores less than 7, and shoulder dystocia, mostly related to the higher rate of surgical vaginal deliveries. CONCLUSIONS: The misdiagnosis of fetal macrosomia substantially did not modify the cesarean section rate but leads to increase the maternal and neonatal complications.

[Paraneoplastic cerebellar degeneration as the presenting manifestation of breast carcinoma: a case report]. / Dégénérescence cérébelleuse paranéoplasique révélant un cancer du sein : à propos d'un cas.

INTRODUCTION: Paraneoplastic cerebellar degeneration may be a manifestation indicative of lung, gynecological or breast cancer. Nevertheless, breast cancer is rarely revealed by the occurrence of a paraneoplastic syndrome. CASE REPORT: We report a 38-year-old patient who presented a paraneoplastic cerebellar degeneration with anti-Yo antibodies as the presenting manifestation of a breast cancer. CONCLUSION: The diagnosis of a paraneoplastic neurological syndrome (PNS) should lead to urgent and comprehensive screening for cancer oriented by the type of PNS and the nature of the anti-neuronal antibody.

[Sexuality of the couple during pregnancy stemming from a medically assisted procreation]. / Sexualité du couple lors de grossesse issue d'une procréation médicalement assistée.

OBJECTIVE: We studied the impact of pregnancy stemming from a medically assisted procreation on the sexuality of the couple. PATIENTS AND METHODS: Our study was forward-looking realized in the maternity of Sfax on duration of nine months. Its methodology is based on a questionnaire distributed to 40 women and on a review of the literature. RESULTS: Our patients continued to have a sexual activity during their pregnancy in the majority of the cases (at least 65% of the cases) but with a decrease of libido in 80% of the cases as well as a net decrease of the frequency of the sexual intercourse. DISCUSSION AND CONCLUSION: In front of these difficulties of the consequent sexual life noticed also in the literature, a psychological support of these couples is so recommended that a sexologic care adapted to the particular context of the medically assisted procreation countered justified.