[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

[Impact of endometric thickness on embryo implantation in vitro fecondation. a study of 414 cases]

Study of endometrial thickness is central to the monitoring of ovulation in in vitro fecondation [IVF]. Actually, failures of in vitro fecundation are mainly due to implantation failure of embryo. To assess whether the endometrial thickness the day of the induction of ovulation influences or not the result of the IVF attempt. To determine the endometrial thickness for which the chances of pregnancy are the highest. To determine if there is any effect of the stimulation protocol or the gonadotrophin on the endometrial thickness. A retrospective study at the Reproductive Medicine-Unit of Farhat Hached teaching hospital, Sousse -Tunisia, concerning all the cases of IVF conducted the year 2008. A total of 414 cycles of IVF were studied. The rate of pregnancies in our series was 23%. There was not statistically significant relation-ship between the women's-age and the endometrial thickness; nor between the rate of the ?stradiol before the IVF trial and the endometrial thickness. The endometrial thickness after ovarian stimulation was significantly linked to the rate of FSH before the IVF attempt [P = 0.01]. The total rate of pregnancies was significantly linked to the endometrial thickness before the ovulation induction [P = 0.02]. The best rate of pregnancy was reached with an endometrial thickness >12 mm [43%] and the chances of success in that case were roughly 3 times higher than if the endometrial thickness was