Epidemiolpgie de la macrosomie

The purpose of this work is to study the epidemiological profile of macrosomia in the Moroccan context stressing on the aetiological factors. Material and methods: We studied pregnancy and delivery of 2160 macrosomal cases during a period of four years [1994-1997]. We adopted the correlation coefficient for the statistical study. The macrosomal frequency was 7,5%. Specially in young parturient women aged 20-30 years, multipara, fatty, tall, diabetic, having had previous antecedents of a macrosomian newborn and having a fundal level more than 35 cm. Delivery was normal in 90,7%, assisted by ventouse in 32% and forceps in 3% of cases. The caesarean section was practised in 9,3% of cases. The neonatal morbidity in the for of distress was [6%], paralysis of brachial plexus in [2,1%], fracture of the clavicle or humerus [0,3%] and one case suffered from facial paralysis. Maternal morbidity was mainly dominated by post-partum hemorrhage [1,9%], infections and uterine rupture [0,8%]. The foetal macrosomia raises many problems: the best way to confirm its diagnosis is by using the echography although it has a high error margin. The question here is starting at what weight should the prophylactic caesarean section be done systematically

Monitoring HIV through sentinel surveillance in Morocco

HIV sentinel surveillance was performed in five provinces of Morocco in 1993, expanded to 10 provinces in 1996. The activity was done by unlinked anonymous testing procedures. We analysed the data from 1993 to 1999. The groups studied were sexually transmitted infections, clinic attendees, pregnant women and patients with pulmonary tuberculosis. The results show that overall HIV prevalence rate over the whole period in 10 cities was 0.10% [45/44,233]. Casablanca had a significantly high rate with 0.39% [10/2567]. The patients with pulmonary tuberculosis displayed the highest prevalence with 0.36% [9/2530]. These data confirm the assumption that the HIV epidemic is low in Morocco. However, the increase of HIV prevalence lately calls for reinforcing preventive measures to limit its spread