[ kuster Rokitansky Hauser syndrome]

The Mayer-Rokitansky-Kuster-Hauser syndrome is a congenital abnormality characterized by primary amenorrhea, vaginal hypoplasia, rudimentary uterus and normal ovaries. Surgical treatment may be proposed to allow normal sexual function. We report two cases of Rokitansky syndrome and we identify the characteristics of this syndrome and anlayse modalities of its management

[Postmenopausal uterine bleeding. Analytic study about 65 cases]

Postmenopausal uterine bleeding is frequent in gynecology. This symptom can reveal benign causes as well as cancers. So it's essential to rule out organic pathology. We propose a retrospective study of 65 postmenopausal women who had uterine bleeding for two years. To study the relative frequency of different causes of post-menopausal uterine bleeding.- To evaluate the different investigation procedures. In 65 cases of postmenopausal bleeding, we found:- 6 cases of cancer [9.2%]: 4 cases of cancer of uterine corpus and 2 cases of cancer of uterine cervix.- Benign pathology was more frequent [59 cases: 90.8%], essentially represented by endometrial atrophy [37 cases] and hyperplasia [11 cases].- Hysteroscopic aspect in the 4 cases of endometrial cancer:- Polypoid hypertrophy: 2 cases.- Simple hyperplasia: 2 cases. Despite the fact that benign pathology is more frequent than malignancy as a cause postmenopausal uterine bleeding, we must always rule out a cancer by oriented biopsy

[ obstetrical advantages of epidural analgesia in trial of labour]

Two series of labour trial were compared in a forward-looking study. The first series of 24 parturient women [series I] to whom the labour trial took place under peridural analgesy. The second series of 80 parturient women [series II] to whom the labour trial took place without peridural analgesy. The rate of caesarean section is significantly less important in the series 1 [33.3% versus 58 %] P=0.37. The average duration of the labour trial is significantly prolonged under peridural analgesy but without bard effects for the newborn children. The authors consider that the peridural analgesy is the method that brings ideal conditions for a real test allowing to eliminate dynamic dystocya and maternal restlessness in order to have an accurate cephalo-pelvic confrontation

[Breech presentation vaginal delivery or planned caesarean section?]

Breech delivery is a high risk situation because of its numerous dystocies. The most serious is the last head retention. The authors realized a retrospective study concerning 347 patients who had given birth to a newborn child in breech presentation during a period of 4 years

Results: The vaginal delivery was associated in a significant way to an excess of obstetric traumatisms [5.5%] versus caesarean section [0.5%] and this even after strict selection of vaginal delivery's conditions [P= 0.00453]. The rate of the newborn child having Apgar's score < 7 in 5 min was higherin case of vaginal delivery [17.39%] than caesarean section's birth [3.48%]. Corrected neonatal mortality is higher in the group of vaginal delivery than caesarean section's group [34% versus 0.49%, P= 0.02553] There is no significant difference of maternal morbidity between caesarean section and vaginal delivery group [P=4.65]. Vaginal delivery is associated to an excess of morbidity and neonatal mortality even after strict selection of the candidates of the vaginal delivery