[Ovarian cyst: comparison between sonography, coelioscopy and patholy about 100 cases]

The ovarian cysts are a common pathology in gynecology. The aim of our study is to confront ultrasound and coelioscopic data in final anatomo pathological diagnosis of ovarian cysts and to assess the efficiency and the morbidity of coelioscopic treatment. We report a retrospective study of 100 ovarian cysts collected in CHU of Mongi Slim La Marsa from October 1st, 2003 to November 30th, 2007. The coelioscopic exploration coupled with the extemporany review has a sensitivity of 100%. The benefits of coelioscopy are: less esthetic desagrement, a decrease in morbidity per and post operatory and economic benefit. The risk of ignoring a malignant lesion is not zero with a risk of spread tumor .That's why it must respect strict rules and convert if malignancy is suspected. Coelioscopy has let a reliable diagnosis of malignancy with a low morbidity, it is an efficient and comfortable technic for patients

[Red-cell alloimmunization: epidemiology, prevention and management]

Although very rare, red-cell immunization is a main factor of hemolytic fetal anemia and severe neonatal jaundice. We emphasize on the prevention of immunization in different situations of feto maternal bleeding by early intravenous injection of 200 at 300 IU or more depending on the term of pregnancy, the circumstances and results of the Kleihauer's test. Prophylaxis conrresponds a systematic intramuscular injection of 300 IU immunoglobulin [Natead [R]] at 28 WA, is performed in many countries. This measure implies information and rigor from Perinatal's professional. If this systematic prophylaxis was conducted, it is not necessary to repeat the IAR until the birth. But if the patient has not received the injection of 28 WA, IAR of the 8[th] month must be maintained

[Role of the hysteroscopy and laparoscopy in managementof the female infertility: about 200 cases]

Infertility is a common disease which affects nearly 10% of women at reproductive age. The hysteroscopy and laparoscopy are becoming very important in the management of this pathology. We tried to assess the current results of both hysteroscopy and laparoscopy, to study the prognosis factors as well as operating techniques and to clarify their contribution in comparison with other therapeutic techniques. This is a retrospective study about 200 cases of hysterolaparoscopy performed for female infertility in women admitted at the department of Gynaecology and Obstetrics in Mongi Slim's Hospital La Marsa. The hysteroscopy was abnormal in 75% of cases: the uterine synechias [23%], endometria hypertrophy [19%], endometrial polyps [10%], uterine fibroids [9%], atrophy [7.5%] and malformations [3.5%]. The operating hysteroscopy procedure was performed in 27.3% of cases with a rate of subsequent pregnancy in 34.9%. There is different data between the hysterosalpingography and hysteroscopy in 34.8%. The operating laparoscopy was performed in 70% of cases divided between adhesiolysis [27.2%], tubal surgery [37.8%], electrocoagulation or excision of endometriosis nodule [17.2%] and ovarian drilling for PCOS [17.8%]. The rate of pregnancy is 39.9% after laproscopic surgery [divided between intrauterine pregnancy 37.1% and ectopic pregnancy 2.8%]. The data of the hysterosalpingography and laparoscopy are different in 21.1%. Hysteroscopy and laparoscopy are diagnosing and treating both uterine and tubal infertility as well as some ovarian abnormalitis.They have, thus, the main role in diagnosis and treatment of female infertility.They permit to correct data from the HSG in more than a quarter of cases and to improve the rate of pregnancy in more than one third of cases

[Transvaginal ultrasound of the cervix in the estimation of severity of premature labour]

Premature labour is a frequent situation,it complicates about 6% of births, with increasing perinatal morbidity and mortality.The purpose of this study is to analyse the place of the ultrasound of the cervix in the coverage of a premature labour and the evaluation of the severity of the premature labour being able to have therapeutic implications. It is about a prospective study 56 patients presenting a premature labour between 28 and 34 weeks realized in the service of maternity in Mongi Slim hospital of Marsa for a period of 12 months going from January 2006 till January 2007. In our study 56 patients presented an ultrasonographic cervical length

Hematocolpos with imperforate hemivagina and duplicated uterus: diagnosis and treatment

To document the means of diagnosis and treatment of the exceptional malformation hematocolpos with imperforate hemivagina and duplicated uterus. Cases of four patients treated at La Marsa University Hospital, in the Department of Obstetrics and Gynecology between 2000 and 2004, were reported. Mean age17.2 years [range: 15-22 years]. Three left hematocolpos and a right one are observed. All patients underwent vaginal conservative surgical treatment [excision of vaginal septum] +/- radical treatment: hemi-colpohysterectomy in case of failure of conservative treatment. The clinical presentation was a primary dysmenorrhea associated with a pelvic collection. An ipsilateral renal agenesis is present in all cases. Sonography is essential to assess the diagnosis of renal anomalies. Pelvic MRI is the most important examination. It occurately localises the different collections and identifies their content. Conservative surgical management was effective in three cases out of four

[ role of practitioner in the management of sexual aggression]

Sexual violences constitue a problem of public health whose frequency is alarming in all the contries. Any doctor, what ever his specialization must feel concerned by this medical problem. Thi report helps and guides doctors to find the best manner to expecting and reception of victims. The principal objectives of sexual violence victims managment are: 1].To ensure near the victim and the family a multidisciplinary,psycho-medicosocial managment to accomodate and inform the victim. The multidisciplinary team joins together psychological, doctors, welfare officers and other professionals of health. Organization of reception center specialized open 24 hours a day with structuring of regional network and training of professionals of health in order to ensure a follow-up of the victims and to evaluate the results of this managment. 2].To ensure a medical managment of optimal competence[examination with care] in order to avoid with the victims of sexual abuse the repetation of the genital examinations. Collection on a structured file of all the data elements as well as the medico-legal elements wich can contribute to establish the proof of the aggression[taking away for cytology and molecular biology]. 3].To prevent the infections risks, the pregnancy and psychological risks of after-effects. In conclusion, the managment of the supposed victim must be global, prolonged, and multidisciplinary.It will comprise medical care, a psychological follow-up to organize without imposing it and finally without forgetting medico-legal aspects

Maternal and neonatal metabolic complications in cases of gestational diabetes about 220 cases

We report a retrospective study of 220 cases of gestational diabetes collected during a 5 year period [2001-2006]. Hypoglycemia was the most frequent maternal metabolic complication [11%], whereas ketoacidosis was rare, seen in only two patients [0.8%]. Neonatal metabolic complications were mostly hypoglycemia [19%] and hypocalcaemia [7%]. Pregnancy in diabetic women involves more risks than pregnancy in non-diabetic women. However, these risks are now better controlled

Reflexion sur l'association de la maladie de Recklinghausen et grossesse. A propos de six cas

Recklinghausen's neurofibroimatosis is a phacomatosis with dominant autosomal transmission and variable expression. The authors propose an analysis of six cases of Recklinghausen's disease associated to the pregnancy. From these observations and review of the literature, they release the particularities of this association. The appearance of high blood pressure seems more frequent at the patients affected by Recklinghausen's disease than in the unhurt population. A disease prevention of hypertensive complications by the use of low dose of Aspirine can be proposed in the presence of gravity's criteria

tumeur de Brenner maligne: Particularites et prise en charge

Brenner's tumour of the ovary is rare, mostly benign. It was described for the first time by mac naughton jones in 1898. von numers listed the first malign form in 1945 that represents 2% of tumours. On the basis of a personal report and of 160 cases listed in the literature, we propose to study anatomoclinical and epidemiological elements of this hurt and to study histological particularities and various therapeutic processes. Malignant brenner's tumour arises mostly in peri and postmenopausal period. Clinical signs are not specific. Histological exam puts the problem of the choice of the histological malignant criteria. Metastasis occurs in half of cases. They are mostly loco-regional. The treatment is essentially surgical. The efficiency of an additive treatment seems to be debatable

[Adolescent's pregnancy and foetal maternal prognosis]

The adolescent's pregnancies is not rare. In the clinical view the maternal prognosis is better than the foetal which is reserved. In fact the rate of prematurity, intra-uterine under development, genetous malformation and perinatality death is increased. In the psychosocial view, these pregnancies occurs problems specially the relationship between mother and child and real social break of these adolescents