[Ultrasound diagnosis of ectopic pregnancy: prospective study about 200 cases]

The ectopic pregnancy is responsible for 10% of maternal mortality in the first quarter. Progress in transvaginal ultrasound; have revolutionized the diagnosis of ectopic pregnancy, allowing her diagnosis earlier. To evaluate the contribution of ultrasonography in the diagnosis of ectopic pregnancy. A prospective study about 200 patients hospitalized for ectopic pregnancy between July 2009 and July 2011. All patients underwent a transvaginal ultrasound. The average age was 25.4 years. The study of the endometrium showed an endometrial thickness of 10.1mm in 152 cases. An haematosalpinx was observed in 71% of cases. The average size was 30.5mm. Hemoperitoneum was observed in 64.5% of cases. An ectopic gestational sac with embryo was found in 9 cases [4.5%]. In 51 cases no pathological sonographic signs were noted. The transvaginal ultrasound is the method of choice in the diagnosis of ectopic pregnancy. However the use of BHCG is still necessary

[Cervical incompetence: diagnosis ; indications and strapping outcome]

Cervical incompetence, a major cause of late abortions and preterm delivery is a diagnosis increasingly easy to establish.Strapping is deemed effective to prevent recurrence of such accidents midwifery. To evaluate the relevance of the diagnosis of cervical incompetence, check the main indications of banding and study the outcome of rimmed pregnancies. A retrospective study about 103 rimmed pregnancies collected in the service of Motherhood Hospital Mahmoud El Matri Ariana to the period of January 2001 until December 2008. The diagnosis of cervical incompetence is suspected in a body of evidence linking ATCD of late abortions or premature births found in respectively 46.2% and 31.1% of our patients in our series, 16.98% are carriers of known uterine defects. 8.49% are classified as high risk front of 3-ATCD of late abortions or preterm delivery and were circled systematically. 2.83% are rimmed after confirmation the incompetent cervix by calibration of the cervix and 55.99% because of clinically short cervix. The strapping has reduced the rate of late abortion which decreased from 46.6% before strapping to 7.6% after. As for preterm delivery, it is reduced from 31.1% before strapping to 18.5% after. This difference is statistically significant. The average term of confinement in our series is 36SA six days. 68 cases were delivered at term. Among patients in whom we have accepted the vaginal delivery, 74.2% had spontaneous labor. One case of rupture of the anterior lip of the cervix was noted. The indication of a cervical strapping needs a well established diagnosis involving data from history, clinical examination and possibly endo-vaginal ultrasound to confirm the high-risk of cervical incompetence. The strapping participates significantly to prolong the duration of pregnancy, to lower rates of early major premature and to improve the chance of viability and prognosis of fetuses without serious repercussions on the workflow

First trimester diagnosis of Pallister-Killian syndrome in a fetus with suggestive abnormalities

Pallister-Killian Syndrome is a rare, sporadic chromosomal disorder characterized by a tetrasomy 12p often in mosaic. It is only in 2000 that the first case of PKS was diagnosed in the first trimester further to an increased nuchal translucency. Report a new case. To our knowledge, we present the first case of early prenatal diagnosis of Pallister Killian Syndrome due to the presence of an increased nuchal translucency, a diaphragmatic hernia, a typical facial dysmorphism and a micromelia of a predominantly rhizomelic type. A chorionic cells biopsy showed a normal karyotype. The diagnosis was revealed on cytogenetic analysis of amniotic fluid sampling. The main ultrasound indicators of PKS seem to be: Hydramnios, congenital diaphragmatic hernia [CDH] and a micromelia of a rhizomelic type. The hydrops fetalis, hygroma coli or increased nuchal translucency [INT], fetal overgrowth, ventriculomegaly and presence of a sacral appendix are less common. The amniocentesis with the study of the karyotype on amniotic cells is considered to be the gold standard for the diagnosis of PKS. A good morphological study during the first trimester in search of ultrasound abnormalities highly suggestive of PKS is able to direct the cytogenetic study