Apport de l'echographie endovaginale en gynecologie obstetrique

Echography imposes itself as a reliable, harmless and repectitive technique in the exploration of female pelvis. Endovaginal echography is a new technique that should be used complementarily with classical over the pubis echography. Authors insist on the contribution of endovaginal echography: In gynecology in the diagnosis of extra utrine pregnancies. itI completes the echography of over the pubis in the study of uterine and ovarian pathology - In obstetrics in the precocions diagnosis of the pregnancy and the study of low-inserted placentas And in interventional echography in the embryonary reduction and the punction of ovocys in the techniques of procreation that are medically aided

[ menopause [clarification]]

The menopause is a subject of topicality, which has aroused numerous scientific articles, and which has touched about 30% of the feminin population. The augmentation of menopausal wives and the lengthening of the hope of life is a phenomenon which concerns not only industrialized countries but also developed countries. The menopause, a physiologic and natural phenomenon in a woman's life may cause manifested troubles which may handicap the patient's social. During the previou years, considerable progress have been done first in the comprhension of endocrinal phenomenon which occur to the menopause then in the clarification of the mode of cellular action, the ovarian and in the clarification of pharmacology of deputizing. Thus, there is still a considerable gap betwen the scientific progress and the current medical practice. The authors insist under the lights of some data of writing on: - The effects of the substitutive hormonal treatment of the menopause and of its modalities. One benefical effect of this treatment is not discussed and the present tendency is in a well supervised subtitutive hormonal treatment. - The strict rules of selection, prescription and supervising a regular supervision is found in a precocious detection of cancer and also hypertension

[Hypertension pregnancy: doppler study]

Doppler's foetom ternal appears as an indispensable + technique in the modern obstetric in the supervision of the hypertension pregnancy. The authors repot a prospective work on 25 pregnancies with hypertension and insist in the light of literature data on: - The prognostic interest of the evaluation of circulatory resistances by Doppler's exam umbilical, uterine and cerebral arteries[6,28]. - The significant correlation between velocimetric perturbation at the level of these arteries and the hypotrophy's foetal risk and the death of foetus in the uterus, the maternal risk of a sharp vascular accident [retroplacentary hematom, eclampsia]. Also, we have noticed the presence of intrauterine delay in 65% of patients with a pathologic uterine velocity and 80% of these cases where this is associated with an abnormally of the umbilical velocimetry. Among the 10 patients with a uterine notch 3 have been hospitalized for eclampsia [30%]. Finally, the perinatal mortality touched 6 children; 4 of them [80%] were in the groupe where Doppler exam revealed pathologic at the level of uterine sites umbilical [absent diastolic flow] and cerebral

Pregnancy and sickle cell disease

Sickle-cell anemia is a hereditary affection due to the presence of abnormal hemoglobin [S.H.B] in red cells. We have been proposed in an opportunity of a major sickle-cell and pregnancy. Observation to sum up this association and its reciprocal repercussion. The foctomaternal repercussion is important in the homozyot form. On the other hand it is partielly nul in its heterozygote form. Authors insist on the necessity of a rigorrous supervision of pregnancy, labour and dehivance as well as theraputics

Diabete et grossesse A propos d'une serie de 44cas

Our purpose in this study which has been carried out in collaboration with.endocrinologists and which concerned 44 observations of diabetic pregnancy.Reminding on the basis of literary data, the particularities of the association diabete mellitus-pregnancy ans insisting on the items that seem to be of importance for the amelioration of the results. The pregnancy in the diabetic woman is a pregnancy at risk. The risk is maternal and especially foetal mortality perinatal, morbidity, congenital malformation, macrosomia, hypoglycemic.]. We have concluded through our study, the gravity of prognosis in case of a non supervised daibetic pregnancy. in case of an old diabete. The foetal prognosis is developed only by: Supervising the diabetic woman before the pregnancy insisting on the normoglycemic and during the before the pregnancy. The collaboration of a multidusciplinary team gathering the obstetrician. The diabetologist the pediatrician and the patient herself. And in the pregnancy of planification, in fact, the diabetic pregnancies must be expexted if possible early in the diabetic life and their number will be limited

Indications et apport de l'echographie transfontanellaire dans le diagnostic et la surveillance des complications neurologiques des meningites [a propos de 48 cas]

Having been displayed during one year, this prospective work has fixed the aim of tracking down the meningitis complications and to evaluate the contributions and validity of the transfontanellar ultrasound [TFU] in diagnostic and supervising the neurologic complications of this affection. In 1985, Among the 141 children hospitalized in infectious disease departement [P.1.] 48 children less than 2 years old presenting some signs of gravity, have benefited from 91 T.F.U. The echographic exploration is normal in 58% of the cases. The echographic signs during the sharp phase of the disease are transitory. The T.F.U. has visualized 34 complications distributed in 14 hydrocephalus, 12 ventriculitis, 5 abscesses, 3 subdural hematomas and one case of cerebral tuberculosis. Apart from its diagnostical contribution, the T.F.U. also allows the appreciation of the therapeutic efficacy and the consistency of the evolution of different complications. Certain of our patients whom were submitted to computed tomography [C.T.] made it possible for us to make the correlation T.F.U./C.T. this latter being the examination reference. Thus, we have noticed a kind of superiority of the T.F.U. in the supervising and appreciation of the evolutivity in the ventricular dilatations,and the visualization of the ventriculitis either isolated or associated to abscesses. The C.T. on the contrary is more performant than the T.F.U. in the study of the cerebral tuberculosis, the visualization of the transudation witnessing the hydrocephalus evolutivity, the appreciation of the lesion multiplicity, the research of oedema in cerebral abscess, the visualization of subdural collections. These two techniques have the same performance in the study of ventricular dilatation in the appreciation of the site of obstruction, the effect of the mass and the ventricular dilatation in cerebral abscesses. The T.F.U. contributes equally for the choice of the therapeutic and constitute an excellent method for the follow up, we suggest that the T.F.U. is more recommended in presence of serious clinical signs of gravity and during the neo-natal period where it must be systematic in meningitis because of the lack of anatomoclinic parallelism