Partial hydatidiform mole in Morocco: an epidemiological and clinical study

This retrospective study reviewed cases of partial hydatidiform mole [PHM] diagnosed at the University Hospital in Casablanca from 2000 to 2010 in order to examine the epidemiological, clinical, therapeutic and progressive pathological factors associated with PHM. All PHM cases confirmed clinically and sonographically at pathological examination were included. We identified 24 cases of PHM among 60 748 births and 1704 abortions, giving a frequency of 0.4 per 1000 pregnancies and 1.4% of abortions. The mean age was 26 years [range: 16-55 years]. The circumstances of discovery and clinical ultrasound varied: 79.2% of patients sought consultation for bleeding; clinical thyrotoxicosis syndrome was found in 1 patient [4.2%]. Physical examination showed increased uterine size in 83.3% of cases associated with a latero-uterine mass in 25%. The diagnosis was supported by an ultrasound examination combined with measurement of plasma beta HCG. Histological confirmation was made in all cases and treatment was endo-uterine aspiration. Neoplastic drift was observed in 1 case [4.2%] which went into remission with chemotherapy

Epidemiolpgie de la macrosomie

The purpose of this work is to study the epidemiological profile of macrosomia in the Moroccan context stressing on the aetiological factors. Material and methods: We studied pregnancy and delivery of 2160 macrosomal cases during a period of four years [1994-1997]. We adopted the correlation coefficient for the statistical study. The macrosomal frequency was 7,5%. Specially in young parturient women aged 20-30 years, multipara, fatty, tall, diabetic, having had previous antecedents of a macrosomian newborn and having a fundal level more than 35 cm. Delivery was normal in 90,7%, assisted by ventouse in 32% and forceps in 3% of cases. The caesarean section was practised in 9,3% of cases. The neonatal morbidity in the for of distress was [6%], paralysis of brachial plexus in [2,1%], fracture of the clavicle or humerus [0,3%] and one case suffered from facial paralysis. Maternal morbidity was mainly dominated by post-partum hemorrhage [1,9%], infections and uterine rupture [0,8%]. The foetal macrosomia raises many problems: the best way to confirm its diagnosis is by using the echography although it has a high error margin. The question here is starting at what weight should the prophylactic caesarean section be done systematically

Pregnancy and delivery among adolescent

The high risk of adolescent pregnancy is due to morphologic, socio-economic and psychologic factors and to the lack of prenatal supervision. In a retrospective study about 508 adolescents, we tried to emphasize the specific aspects of moroccan adolescent women. The unmarried ones represented 15%, mainly very young girls. The incidence of the preclampsia was 6%. The rate of premature delivery was 8%. These complications seen to be due to the lack of prenatal supervision and to the unmarried status of the adolescent. The delivery was most often eutocic. The instrumental extraction was necessary in 20,43% of the cases especially because of bad maternal cooperation at the expulsion. The caesarian section has been practiced in 5.12% of the cases. The average weight of newborns of unmarried women was by 280 grammes lower compared to newborns of married women. The weak neonatal weight [2500 grammes] was noticed in 12% of the cases mainely related to prematurity. The perinatal mortality represented 36.3% births. The pregnancy of adolescents doesn't seem to be subjet to high medical risk, provided that it takes advantage of prenatal follow up and adequate supervision