[Ovarian drilling in treatment of infertility with dystrophic ovaries]

Dystrophic ovaries represent the main cause of female infertility in Tunisia. To assess the contribution of ovarian drilling in the treatment of infertility in patients with ovarian dystrophy. A retrospective study of 23 patients with dystrophic ovaries that have benefited through their subfertility of laparoscopic ovarian drilling, in the gynecology-obstetrics hospital Mahmoud EL Matri, Ariana, Tunisia. Our study spans a period of 3 years from January 2004 to December 2006. Among the 23 patients who underwent drilling for clomiphene citrate resistance, 9 have been pregnant. The average age of patients having had a pregnancy after ovarian drilling was 29.6 years, the average delay was 7.1mois. Regarding prognostic factors, only infertility's duration lower than 3 years was predictive of a good result. Ovarian drilling is an interesting alternative to induction by FSH for patients with dystrophic ovaries

Selective salpingography and tubal catheterization in infertile women

Use of selective salpingography [SS] and fallopian tube catheterization [TC] has revolutionized the diagnosis and treatment of proximal tubal infertility. To evaluate results of women treated for proximal tubal obstruction by selective salpingography and tubal catherization. Selective salpingography was performed in women with proximal bilateral tubal obstructions. Follow-up ranged from 4 to 12 months. Twelve patients had been shown to have bilateral proximal obstruction of the fallopian tube. After SS/TC, patency was achieved in 8 cases. Spontaneous conceptions occurred in 4 women. SS and TC should be used more widely because it is simple and effective in case of proximal tubal blockage

[Premature rupture membrane at term with unfavourable cervix]

Between expectant attitude in hospital and labour induction, management of and premature rupture membrane at term stay controversial. The aim of our study was to evaluate the management rupture of the membranes at term with unfavourable cervix. We conducted a retrospective study. An expectant delay of 24 hours had been followed by induction labour in women with favourable Bishop. Maturation by prostaglandins E2 [PGE2] was performed in case of unfavourable cervix. We administrate one dose each 24 hours [3 doses maxima]. Over, labour induction by ocytocine was started. The prescription of antibioprophylaxis is systematic until delivery. We included 137 patients. 51%of patients had a spontaneous labour during the expectant delay. There was no significant difference in neonatal and maternal morbidity in case of expectant management of premature rupture membrane at term. Based on our findings and a review of the literature, an expectative of 24 hours is interesting in case if unfavourable conditions. Prostaglandin E2 maturations can be performed in unfavourable cervixes