[Safety of magnesium sulfate in severe preeclampsia]

Several observational studies and randomized trials have described the use of various regimens of magnesium sulfate to prevent or reduce the rate of seizures and complications in women with severe preeclampsia. To assess the validity of a service protocol in the management of severe pre-eclampsia all specifying the benefits, complications and side effects of magnesium sulfate. We have performed a retrospective descriptive study over two years [2009-2010] concerning 150 patients affected with severe preeclampsia in the department "B" of gynecology and obstetrics of the "Rabta" at the Centre of Maternity and Neonatology of Tunis [third level maternity]. The protocol consisted in the administration of 3 grammes of magnesium sulfate followed by intravenous dose of 1 g/hour associated with an anti-hypertensive treatment. One hundred and forty patients [93%] had 2 or more criteria of severity associated. Seventy-eight [52%] patients with severe preeclampsia have profited an anti-hypertensive treatment based on nicardipine associated with magnesium sulfate without notable secondary effects. In two cases [1.3%] an eclampsia was noted with magnesium sulfate, 27.4% of severe preeclampsia was noted at a term within 34 week of amenorrhea. Only one case of surdosage was noted in post partum. The use of magnesium sulfate in practice does not appear to increase the risk of complications or major side effects in the mother and fetus

[Hemorrhage delivery: about 65 cases]

The delivery haemorrhage is actually a problem of public health. It is responsible of 31.5% of the maternal death in Tunisia. The goal of this work is to study the frequency of this complication, its gravity, its risk factors, its etiologists and its methods of treatment. It is a retrospective study, of 65 cases of delivery haemorrhage recorded to the obstetric gynaecology service < C > of the centre of motherhood and neonatology of Tunis during 4 years. The frequency of the delivery haemorrhage in our study is 1.19%. The middle age of the patient is of 31 years. Their middle parity is 2.4. Factors of risk taking out again our set are: gestational toxemia [35.4%]. primiparity [33.8%], advanced maternal age [30.7%]. pre-existent anaemia [24.6%]. the uterine surdistension [21.3%], an abnormal middle length of labour [69.6%]. use of oxytocin during labour [34%]. induction [21.5%]. Etiologists in our set are atone in 63% of cases, retained placenta in 31.2% des cases, coagulopathie [9.2%], placenta previa [1.5%], uterine inversion [1.5%]. The hold must be in charge multidisciplinary, systematized, precocious and dynamic

Prise en charge en reanimation des pathologies obstetricales graves

We report a retrospective study over a period of 4 years and half and bearing on 59 patients that require an intensive care. The number of childbirth during this period was 22237 with 8.97% of Caesareans. The main obstetrical diseases were: gravidic toxaemia 75.5%, uterine inertia 7%, cardiopathy 5% of the cases. The reasons for the transfer were: eclamptic state in 27% of the cases, hemostasis disorder 22% of the cases, and acute pulmonary oedema 18.6% of the cases. Average duration of hospitalization was 3-18 days. Five cases of death were noted