Prevalence and risk factors of fetal macrosomia in diabetic women in Tunisian center

The objective of our study was to evaluate the frequency and the risk factors for fatal macrosomia in a population of Tunisian diabetic pregnant women. During five years, 400 pregnant women entered our case-control study, including 200 with diabetes and 200 as a control group. These pregnant women had a single foetus and were at term. The diabetes group was composed of 143 women with gestational diabetes and 57 women with pregravid diabetes. The women with diabetes were significantly older, multiparous and with a more elevated BMI than the women in the control group [p <0.01]. The risk of foetal macrosomia was significantly more associated with a BMI of > 30 [OR = 1.29], a poor diabetic control during pregnancy [OR = 9.41] and previous antecedent foetal macrosomia [OR = 7.93]. However, multivariate analysis after the control for confounding factors [BMI, term, and parity], limited the significantly increased risk for foetal macrosomia to the number of consultations and the insulin doses used in the third trimester of the pregnancy

Local Regional Recurrance of Breast cancer in Tunisian Center

To evaluate locoregional recurrence rate of breast cancer, determine its anatomoclinical characteristics and discuss the available therapeutic alternatives. Patients and methods A retrospective study including 41 patients with LRR following modified radical mastectomy or conservative surgery of invasive breast carcinoma without metastasis, between January 1993 and December 2002. 38 cases of LRR occurred after mastectomy and 3 cases after conservative surgery. LRR rate was 4.84%. mean follow-up 44.7 months. Mean age of patients was 45 years and LRR mean occurrence time-interval 22.4 months. Recurrence was parietal in 25 cases, mammary in 2 cases, and nodal in 14 cases. 18 patients had to be operated on. Conclusion Prognosis of breast cancer depends on distant metastasis. LRR constitutes the second major risk liable to influence the overall prognosis