[Obstetric Vesicovaginal fistulas, about 131 cases]

Vesicovaginal fistulas are the most frequent type of urogenital fistulas. Obstetrical cause remains the dominant etiology. They still represent a public health problem. to study epidemiological aspects of obstetric vesico-vaginal fistulas and their management. a retrospective multicentric study among 19 hospital departments from February 1982 to January 2007. 131 VVF [92% of urogenital fistulas]. The vaginal route for surgical repair was used in 2/3 cases. The mean diameter of the fistula was 11.35mm. In 122 cases [86.5%], the fistula was unique. IVU findings were normal in 83% cases. All patients had normal renal function apart one who had acute renal failure. 177 interventions were performed [1.37 intervention per patient]. Our findings suggest a regression in obstetrical VVF. However many efforts on institutional, socioeconomic and obstetrical levels have to be done in order to eradicate this pathology that is of major handicap for women regarding socioeconomic, functi6nal and psychological effects

[Ovarian pregnancy. about three cases]

Ovarian pregnancy is a rare type of ectopic pregnancy. Its diagnosis and management are often difficult. To highlight specific diagnostic and therapeutic properties of ovarian pregnancy. Retrospective Study over a period of 4 years. We observed the patients presenting ovarian pregnancies. Diagnosis was evocated in time of surgery and confirmed by histological data. We observed three patients presenting ovarian pregnancies. All our patients had an abdominal ache. Diagnosis was made by ultrasound scan examination in one case. One patient had a laparotomy as a matter of urgency; the two others had a laparoscopy. All the patients were managed conservatively. The diagnosis of ovarian pregnancies was evocated in time of surgery and confirmed by the histological data. The ovary is a rare location for extra-uterine pregnancy. This type of ectopic pregnancy has some clinical properties. The diagnosis is intricate and based on per operatory observations. The management is in spite of medicines improvement, based on surgery

[First trimester ultrasound: an early screening tool for fetal structural and chromosomic abnormalities]

Prenatal diagnosis has been greatly expanded in recent years. Many biological and sonographic criteria participated in the development of fetal medicine. Analyze the contribution of first trimester ultrasound in prenatal diagnosis of aneuploidy and early fetal malformations, and its impact on the strategy of prevention of disability. A prospective longitudinal descriptive study including all women who did a first trimester ultrasound during their pregnancy. We evaluated the detection rate of malformations and chromosomal abnormalities of the morphological embryonary study and nuchal translucency. These tests were then confronted with the results of fetal samples and the outcome of pregnancy. 593 ultrasound examinations were performed. The average age of pregnant women was 32.7 years. The mini-morphological ultrasound study revealed 26 abnormalities [3 major lethal malformations, 5 cystic hygroma and 18 increased nuchal translucency]. Chromosomal abnormalities were found in six cases. The first trimester ultrasound has ensured the detection of 2/3 of total aneuploidies of the study. The first trimester ultrasound allows early detection of a large number of aneuploidies and fetal malformations