[Ectopic pregnancy]

Ectopic pregnancy is defined as the implantation of pregnancy outside the uterus. It is considered as a gynaecological emergency which is necessary to think about for women in the age of procreation before abnormal signs of pregnancy due to its mortality. Our study deals with a retrospective series of 79 cases compiled through the OB-GYN emergency service during the period from 2007 to 2009. It represents 3.1% of the activity of the surgical obstetrical and genecological emergency. The average age of patients was 30 years, with a predominance of multiparty and the presence of the risk factors of ectopic pregnancy. Clinic symptomathology was classic, diverse and dominated by amenorrhea, metrorrhagia and pelvic abdominal pain. Para clinic diagnosis is based on the pair plasma Bet-HCG/ pelvic and or transvaginal echography. In this series the treatment has always been surgical by laparotomy with Pfannenstiel incision or median in umbilical laparoscopy, mainly radical sapling ectomy, with an abundance of ampullary locations isthmic and tubal. The post-operative course was uneventful in most cases with a fatality rate of 10%. It is a vital and functional dreadful disease in terms. It is the leading cause of death during the first trimester of pregnancy. Its incidence has tendency to increase due to the upsurge in sexually transmitted infections, medical assistance to procreation, tubal surgery and female smoking. Semiological description in our series is subject to that described in the literature. The progress of transvaginal echography and the determination of beta-HCG have revolutionized the diagnosis and allow for postponement of the diagnostic laparoscopy. The treatment of ectopic pregnancy uses very different treatments. They vary from the less invasive preserving future fertility of women to the more invasive one. In our context, today an early is possible diagnostic and allows an optimal support. Yet, there is much progress to make in terms of the laparoscopic surgery, conservative chirurgical and medical treatment

[Uterine sarcomas, about 13 cases]

The uterine sarcomas are malignant tumors which have two main problems; the first is their unclear epidemiology, the second is the non codified treatment. We related 13 cases of uterine sarcoma, treated at Gynecologic and Obstetric ward Ml, of Maternity Souissi University of Rabat. The uterine sarcomas are uncommon and represent 1% of hole tumor pathology of the uterine corpus. It happens preferentially in menopaused women [62% of cases]. The genital bleeding is the more frequent sign [85% of cases]. Pre-operative diagnosis of sarcoma is made in 46% of cases ; the diagnosis of malinancy is made in 92% of cases. Surgery is the best mean of treatment. The radiotherapy and chemotherapy have a few indications and an unsure efficacy. The prognosis is very bad

Hematocolpos: a diagnostic trap

The heamatocolpos is a retention of menstrual bleeding in the vaginal cavity. The main etiological factor is imperforate hymen. According to the literature data and this observation, this affection is discovered at puberty and could reveal other malformations notably uterine and renal. The diagnosis can be easily confirmed in front of some clinical signs, as amenorrhoea with periodic pelvic pains and the inspection of vulvoperineal area. However normal hymen does not eliminate the diagnosis. The heamato colpos can be top of obstructed hemivagina. The pelvic ultrasonic scan is essential to check up any associated malformation. Delayed diagnosis may give rise to some complications [endometritis, infection] which may interfere with the prognosis of ulterior fertility. The treatment of these malformations is surgical more often through the vaginal approach. The prevention of this affection depends on the early diagnosis of malformation at birth by a careful inspection of vulvoperinial area and its treatment during the prepubertal period