[Gestational trophoblastic diseases: a retrospective study from 1997 to 2003]. / Maladies trophoblastiques gestationnelles: étude rétrospective de 1997 a 2003.

BACKGROUND: Trophoblastic diseases correspond to a very heterogeneous group of rare pathology in young women which fertility should be preserved. PATIENT AND METHODS: We conducted a retrospective study from 1997 to 2003, including all patients with molar pregnancy or trophoblatic tumor in our department of Obstetrics and Gynecology. RESULTS: Fifteen patients were identified with 9 molar pregnancies, 5 trophoblastic tumors and 1 placental tumor of implantation site. The outcome was favorable for 14, and one patient died from her metastatic disease. For 4 patients we asked our university colleague for the optimal approach. DISCUSSION: Management of molar pregnancies is well established. Persistent gestational disease is more rare and problematic with potential metastatic dissemination. Multidisciplinary care is often needed. CONCLUSION: Persistent gestational disease should be managed in a highly specialized centre, as developed in the Lyon University Hospital.

[Amniotic fluid leakage and premature rupture of membranes after amniocentesis. A review of the literature]. / Perte de liquide amniotique et rupture des membranes après amniocentèse. Revue de la littérature.

BACKGROUND: Amniotic fluid leakage and premature rupture of membranes following amniocentesis is uncommon. MATERIAL AND METHODS: We reviewed the literature. Thirteen recent studies including 17 186 amniocenteses and 280 cases of amniotic fluid leakage were analyzed. RESULTS AND DISCUSSION: Risk increases when early amniocentesis is performed prior to 15 weeks gestation and when the needle is inserted far from the placenta. Significant loss of amniotic fluid compromises pregnancy. Conservative management with bed rest seems to give good results. When amniotic leakage persists for more than two weeks, there is little spontaneous resolution. The risk of pursuing the pregnancy should be discussed with the couple in this case. Risks include respiratory disorders, skeletal malformations and premature birth. CONCLUSION: New techniques such as 'amniopatch' may play an important role in the near future.