[Cerebral venous thrombosis during pregnancy: about 7 cases]

cerebral venous thrombophiebitis [CVT] is a rare but serious pathology. The pregnancy and especially the postpartum constitute supporting circumstances occured of the CVT. the aim of our study is to remember the symptomatology of CVT, the importance of the IRM and the angio IRM in the diagnosis of CVT, and its treatment. We present a retrospective study relating to 7 cases of CVT during gravidopuerperality over 7 years [1996 to 2002]. The average age of our patients is .32,1 years. The CVT occured during the first trimester of the pregnancy in one case and in the postpartum in 6 cases. The symptomatology was dominated by cephalgia and the signs of intracranian hypertension. Convulsions occured in 3 cases. The diagnosis of CVT was confirmed by IRM coupled with the Angio-IRM in all cases. The treatment by heparinotherapy was instaured immediately and relayed by the Anti-Vit K as the evolution was favorable in all cases. cerebral venous thrombophebitis [CVT] is a serious pathology [especially in pregnancy and post partum]. The diagnosis is performed by the magnetic resonance imaging [IRM] and the early introduction of the heparinotherapy

[Intra-uterine growth retardation: etiologic factors and management]

The aim of this study is to define the etiologic factors, the diagnostic procedures and obstetrical rules to be observed during a pregnancy in relation with low birth weight. This is a retrospective study of 124 cases, carried out at the military hospital of Tunis, between January 1st 1999 and December 31st 2001. The frequency of intra-uterine growth retardation [IVGR] was 2.1%. 46.8% of the patients were primiparous. The mean age of the patients was 30 years. 25.8% of the patients developed toxemia. The etiology was predominantly renovascular-syndromes, urinary infections, and idiopathic hypotrophy. The positive diagnosis was suggested by the measure of the uterine height in 96% and was confirmed by sonogaphy in all cases. The umbilical Doppler was pathological in 17.76% of the cases. A corticosteroid administration for pulmonary maturation was prescribed in 28% of the cases. Obstetrical common rule was fetal extraction; 42.7% of the patients were delivered by cesarean. There is a real need to insist on the importance of early detection of fetal hypotrophy and of better management of the women at risk

[Endometrectomy. Analytical study of 20 cases]

Endometrial removal represents a therapeutic alternative to hysterectomy. Through a retrospective study of 20 cases of endometrial removal collected over a period of 4 years, the authors try to determine the indications of this therapeutic method, its efficiency, its advantages as well as its contra indications. Average age of the patients was 44 years. Average parity was 4. Functional menstrual disorders were found in 90% of cases. Gynaecological examination revealed a uterus of normal size in 85% of cases, and increased in size in 15% of cases. All the women had a preoperative diagnostic hysteroscopy. A simple endometrectomy was performed in 70% of the cases, an endometrectomy with a polypectomy in 25% of the cases and an endometrectomy with a myomectomy in 5% of the cases. The rate of success was 90%. We had a case of uterine perforation, because of uncontrollable bleeding a hysterectomy had to be carried out in 2 cases. Endometrectomy is an alternative to hysterectomy in cases of menorrhagia due to mild functional disorders resistant to medical treatment

Caracteristiques de la grossesse et de l'accouchement chez la femme cardiaque

The authors present 78 cases of pregnant women suffering from cardiopathy, which cover a period of 4 years. Rhumatismal valvulopathy is the most frequent [90%]. Cardiopathy is correctly followed in 74.5% of cases and the pregnancy in 50% of cases only. Delivery was premature in [15.3%]. The work was short [6h in 75%]. Only one delivery was achieved by cesarian. Hemorragic delivery is observed in [12.4%] and is very frequent. Two maternal deaths were reported [2.58%]. Prematurity [15.38%] and hypotrophy [17.5%] were the essential complication of the newly born

Pregnancy on top of cicatricial uterus about 300 cases

We report 300 cases of delivery in women who had previously uterine section on 6501 cases of delivery during 1984. Vaginal delivery is possible in 50% of cases in women who had only one uterine section. Instrumental delivery is used in about 50% of cases. For women who had more than one uterine section prophylactic cesarian is performed before labor. Maternel prognosis is good uterine rupture is noted in 2.3% of cases repaired without complication; foetal prognosis after 36 weeks of gestation is excellent and the same for vaginal delivrey or cesarian