Place of the sulprostone in therapeutic interruptions of the pregnancy

Therapeutic interruption of the pregnancies of the 2-nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone [Nalador] is a big contribution. The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use. It is about a forward-looking study opened from the 01-07-02 led in the service [A] of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone. The average age was of 27 years with extremes from 18 to 39 years50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2,25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol [cytotec], the Probe extra amniotic dries and the wet Probe. The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90%

Prise en charge en reanimation des pathologies obstetricales graves

We report a retrospective study over a period of 4 years and half and bearing on 59 patients that require an intensive care. The number of childbirth during this period was 22237 with 8.97% of Caesareans. The main obstetrical diseases were: gravidic toxaemia 75.5%, uterine inertia 7%, cardiopathy 5% of the cases. The reasons for the transfer were: eclamptic state in 27% of the cases, hemostasis disorder 22% of the cases, and acute pulmonary oedema 18.6% of the cases. Average duration of hospitalization was 3-18 days. Five cases of death were noted

Place du sulprostone dans la prise en charge des inerties uterines. A propos de 60 cas

The serious haemorrhages of the delivery still one of the'first causes of maternal mortality. We report an analytical study over a period of 18 months and gathering 60 cases of haemorrhage of the delivery by uterine inertia having imposed the recourse to the sulprostone. The average age of the patients was 31 years, the average parity was L9, the rate of childbirth per Caesarean was 65%. The uterine surdistension was fhe principal etiology of the uterine inertia. The average time of administration of the sulprostone was 10 mn. No complication related to the product was noted. The effectiveness of the treatment was observed in 93.3% of the cases, with 4 cases of failure

La seroprevalence de la toxoplasmose et de la rubeole parmi une population de femmes enceintes consulant au C M N R: service A

Toxoplasmosis and rubella are two grave infections in pregnancy. The toxoplasmosis primo-infection rate in pregnancy is 1%. The risk of congenital rubella in child issud from seronegative women is estimated at 0.4/1000 birth. It's a prospective study in 11 month period [Jannuary 81 - June 91 and August 93 - December 93] concerning 1398 pregnant women the prenatal survey is done in the maternity center of la Rabta - Tunis. The aim of this study is to evaluate the seroprevalence of toxoplasmosis and rubella in this population. A statistic analysis based on the X2 test is performed: - 43% of women are not immunisated against toxoplasmosis. - 20% of women are not immunisated against rubella. Therefore, there is an insuffisient rate of vaccination against rubella. Concerning toxoplasmosis, the prenatal survey remain the unique possibility of prevention. We propose a common attitude and management in these two infections

L'hygroma kystique retrocervical: a propos d'un cas

The posterior nuchal cystic hygroma is a rare congenital malformation: 1/700 pregnancies throughout a case of posterior nuchal cystic hygroma ultrasonographically diagnosed in the prenatal follow up; the authors develop the criteria of diagnosis;the etiologic factors; and propose practical management