[Medical information and patients' choices. Influences on term singleton breech deliveries]. / Information médicale et choix des patientes. Influences sur la pratique de l'accouchement du siège à terme par voie basse.

OBJECTIVE: The mode of delivery of term singleton breech presentation has been argued for decades. Many elements are responsible for the current increase in the rate of elective cesarean delivery. Among these elements, the influence of medical information and patients' choices are unknown. PATIENTS AND METHODS: We studied retrospectively, between January 1996 and December 2005, the mode of term breech delivery in a French maternity. RESULTS: Medical information relates primarily to the complications of vaginal birth. Patient's request for an elective Cesarean has been in constant increase since 1996. DISCUSSION AND CONCLUSION: Medical information and patients' choices strongly influence the practice of breech delivery.

[Repeated thromboembolism during pregnancy with constitutional antithrombin deficiency]. / Thromboses récidivantes gravidiques et déficit en antithrombine.

We report the case of a twenty-three-year old woman with constitutional antithrombin deficiency, who had oral anticoagulation since she was four years old. During her first pregnancy, after the introduction of unfractionated heparin prophylactic therapy, she presented a first venous thromboembolism at nine weeks, and a second one with low-molecular-weight heparin therapy at nineteen weeks. Because of a severe antithombin deficiency, regular infusions of antithrombin concentrates were necessary until delivery to ensure effective anticoagulation by heparin. Patients with antithrombin deficiency have a very high risk of venous thromboses during the pregnancy and post-partum. We discuss the significant points of management for this period.