[Prospective study of the relationship between heart rate fetal anomalies, pH umbilical cord at birth and Apgar]

The search for an acute fetal distress during labor remains one of the objectives of obstetrical surveillance. To find a relationship between different aspects of fetal heart rate [FHR] occurring during labor, Apgar score at first minute and the pH blood at birth. A prospective study which involved 170 single-fetal pregnancies to term. In our population, by comparing the APGAR score in the first minute and umbilical pH, it was found that only 25.7% of newborns with Apgar at 1st minute less than 7 had an umbilical arterial pH <7.15. Thus in our study, the Apgar score did not predict umbilical acidosis and the difference was significant [p = 0.02]. In the same population, by comparing the analysis of FCR and umbilical PH, we found that fetal bradycardia was associated with pH umbilical lowest with an average of 7008 and the difference was significant [p = 0.008]. Other types of ERCF were also significantly associated with neonatal acidosis. Recording fetal heart rate is a limited review to assess the exact condition of the fetus. It has a good negative predictive value but there is little specific consideration. Combination with other techniques to better assess the fetal state

Antepartum detection of macrosomic fetus: the effect of misdiagnosis

To determine the effect of misdiagnosis of macrosomia on maternal and perinatal outcomes. We conducted a retrospective study, between January 2007 and December 2008 of women [n = 464] who delivered singleton neonates with actual birth weight over 4000g and in whom fetal weight was estimated, by both methods :sonographic and clinical, up to 3 days before delivery. Statistical comparisons were made between patients in whom fetal macrosomia was predicted: "prediction " group [n=336]and those in whom it was not " non prediction "group [n=128] for outcome variables. The cesarean delivery was performed in 35.9% in " non predicted " group, and in 35.7% in the " predicted " group. The difference was not statistically significant. Failure to detect macrosomia was associated with higher rates of maternal and fetal complications in the group " non predicted " compared with the group " predicted " :perineal trauma, post partum hemorrhage, 5- minute Apgar scores less than 7, and shoulder dystocia, mostly related to the higher rate of surgical vaginal deliveries. The misdiagnosis of fetal macrosomia substantially did not modify the cesarean section rate but leads to increase the maternal and neonatal complications

[Tubo-ovarian actinomycosis. A report of two cases and literature review]

Actinomycosis is an infection due to an anaerobic Gram-positive bacillus bacteria: Actinomyces. Tubo-ovarian locallisation is rare. It more often appears clinically as a pseudo-tumoral and feverish syndrome, evoking wrongly a malignant tumoral pathology, and often leads to a mutilating surgical treatment. Intra-uterine device appears as the principal favorable factor of this pathology. Basing on two cases reported by the authors, and after literature review, physiopathology, clinical and paraclinical expression, and treatment of this affection are discussed. A set up is made

[Indicators for successful vaginal delivery after cesarean section: a proposal of a predictive score]

The purpose of this study is to determine predictive factors of successful vaginal delivery after cesarean section, and to estimate the risks of this trial of labor [TOL]. A retrospective study about 352 women undergoing a TOL after cesarean section was carried out. Different variables stratified by the termination of the TOL were analysed with statistic tests. TOL success rate was 76.1%. Parity >/= 3, prior vaginal delivery following cesarean section, body mass index < 30, fundal height < 34 cm, and low fetal head level at the beginning of labor increased significantly the probability of success. Uterine rupture rate is 1.1%. Failure of TOL was associated with a higher risk of uterine scar dehiscence and rupture, and higher fetal morbidity. A predictive score of successful vaginal delivery after cesarean section is proposed