RESUMO
BACKGROUND: Therapeutic interruption of the pregnancies of the 2nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone (Nalador) is a big contribution. AIM: The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use. METHODS: It is about a forward-looking study opened from the 01-07-02 led in the service "A" of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone. RESULTS: The average age was of 27 years with extremes from 18 to 39 years 50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2.25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol (cytotec *), the Probe extra amniotic dries and the wet Probe. CONCLUSION: The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90 %.
Assuntos
Abortivos não Esteroides , Aborto Terapêutico , Dinoprostona/análogos & derivados , Abortivos não Esteroides/administração & dosagem , Abortivos não Esteroides/efeitos adversos , Aborto Terapêutico/instrumentação , Adolescente , Adulto , Anormalidades Congênitas , Diarreia/induzido quimicamente , Dinoprostona/administração & dosagem , Dinoprostona/efeitos adversos , Feminino , Morte Fetal , Idade Gestacional , Humanos , Misoprostol/administração & dosagem , Paridade , Dor Pélvica/etiologia , Gravidez , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Vômito/induzido quimicamenteRESUMO
To establish the epidemiological profile, of patients who presented a uterine rupture, as well as the obstetrical follow up, the neonatal outcome and the prognosis factors. A retrospective study of 41 cases of uterine rupture treated in the maternity center of Tunis during a 5-year period. The frequency of uterine rupture was 1.38%@1000 of births. Rupture in scarred uterus was found in 58.5% of the cases against 41.5% in sain uterus. Three risk factors were statistically significant in our series: cesarian section, multiparity and high fetal weight. Uterine rupture is a medico-surgical emergency causing materno-fetal morbidity and mortality.
Assuntos
Complicações na Gravidez/etiologia , Ruptura Uterina/etiologia , Adulto , Peso ao Nascer , Cesárea , Feminino , Humanos , Incidência , Paridade , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/patologia , Estudos Retrospectivos , Fatores de Risco , Ruptura Uterina/epidemiologia , Ruptura Uterina/patologiaRESUMO
The serious haemorrhages of the delivery still one of the first causes of maternal mortality. We report an analytical study over a period of 18 months and gathering 60 cases of haemorrhage of the delivery by uterine inertia having imposed the recourse to the sulprostone. The average age of the patients was 31 years, the average parity wasv1.9, the rate of childbirth per Caesarean was 65%. The uterine surdistension was the principal etiology of the uterine inertia. The average time of administration of the sulprostone was 10 mn. No complication related to the product was noted. The effectiveness of the treatment was observed in 93.3% of the cases, with 4 cases of failure.