[Exploration of infertility: Correlation hysterography hysteroscopy]

In literature, a uterine lesion in found in half of the infertile womenTo compare the results of the hysteroscopy and the hysterosalpingography in the study of the uterine cavity as exploration of feminine infertility. Retrospective study, over a period of four years from 1 January 2005 to 31 December 2008however, on 140 cases of infertile patients explored in the gynecology obstetrics department in Mahmoud El Matri hospital. Compared with hysteroscopy, hysterography had an overall sensitivity of 76.56%, a specificity of 77.63%, a PPV of 74.24%, an NPV of 79.72% and a very strong correlation with coefficient of 0.83. Best correlations between the two examinations were found with polyps, fibroids and synechia. Hysterosalpingography remains the first line examination in the exploration of feminine infertility. However, hysteroscopy must be realized as a second examination in case of lesions found at the hysterography or at once in certain cases

Maternal and fetal outcomes of large fetus delivery: a comparative study

To review the deliveries of macrosomic babies, weighing over than 4000g and their obstetrical and neonatal outcomes. Retrospective study involving a total of 209 deliveries at term of macrosomic babies between Marsh 2006 and February 2007 in the Maternity Hospital of Mahmoud ELMATRI, Tunis. The study concerned risk factors, mode of delivery and the incidence of maternal and perinatal complications.We compared data in the study group to a control group of normal weight infants delivered at the same period. Macrosomia occurred in 9.2% of all deliveries. The main risk factors of macrosomia were maternal age over 30 years [p=0,017], multiparty [p<0.001], diabetes mellitus [p=0.012] and prolonged term of delivery [p=0.02]. These risk factors were statistically significant compared to control group. Caesarian delivery was achieved in 24.4% in macrosomy group and in 13.7% in control group [p=0,003] the major part occurred during labor. Among vaginal deliveries in macrosomia group, shoulder dystocia was noted in 1,9%, fetal respiratory failure and admission in intensive care unit was noted in 4,8% of the cases and hypoglycemia complicated 15,8% of deliveries. Maternal complications were dominated by post partum hemorrhage documented in 1.2% of the cases and perineal tears noted in 8,2% of vaginal deliveries.Vaginal delivery is the most frequent mode of delivery for a fetus weighing in excess of 4 kg and vaginal delivery should be attempted in the absence of contraindications and there is no need for elective systematic caesarian. However, shoulder dystocia remains the main complication of vaginal delivery for macrosomic fetuses and requires experienced obstetricians to manage these deliveriesbetter, other tests are requiring: magnetic resonance imaging and Tc-Squid biosusceptometers

[Prenatal diagnosis and management of fetal megacystis]

Prenatal diagnosis of fetal megacystis particularly in the first trimester requires assessement of pronostic and aetiotogycal criteria. Report anew case we report a case of severe megscystis in female fetus diagnosed at 23 weeks of gestation. There are no other associated ultrasound findings. Fetal karyotyping was normal [46XX]. Termination of pregnancy for medical indications was realised because of progressive enlargement of the fetal bladder. Post-mortem examination showis megacystismicrocolon-in testinal hypoperistalsis syndrome. Fetal megacystis is a severe condition when diagnosed early in pregnancy. Ultrasonography follow-up and fetal karyotyping are important to evaluate prognosis

[Imaging of neuro-behcet]

Behcet's disease is a vasculitis affecting predominantly the venous system. It's characterized by a classical triad of recurrent uveitis, oral and genital ulceration. Behcet's disease is more frequent in Japan. the Middle East and some Mediterranean countries. Its pathogenesis is still uncertain. Neurological manifestations in Behcet's disease are not rare and are associated with poor prognosis. These manifestations can be inaugural in 5% of cases and they are polymorphous. We report 15 new cases of neuro Behcet's disease explored by magnetic resonance imaging [MRI] and magnetic resonance angiography [MRA]