i(18q) in amniotic and fetal cells with a normal karyotype in direct chorionic villus sampling: cytogenetics and pathology.

A case of false-negative discrepancy between results of chorionic villi (direct preparation) and those of fetal tissue with an isochromosome 18q [i(18q)] in amniotic cells and fetal blood is reported. Fluorescence in situ hybridization (FISH) confirmed this uncommon chromosomal rearrangement. The fetus showed cyclopia and multiple congenital anomalies which have never been reported in cases of i(18q).

[Pelvic arteriovenous fistulas. Apropos of a case report]. / Les fistules artérioveineuses pelviennes. A propos d'une observation.

Gynaecological arteriovenous fistulae are a difficult diagnosis and their aetiology is often difficult to determine. The surgical treatment is not always satisfactory and the prognosis can be transformed by means of embolisation.

[Current aspects of fetomaternal immunizations]. / Aspects actuels des immunisations foetomaternelles.

The authors study all of the possible forms of foeto-maternal immunisation (ABO system, D antigen and other antigens). They present a general review of the course of allo-immunisations since the establishment of prophylaxis against anti-D allo-immunisations and they define the current situation.

[Endometrial hyperplasia]. / Les hyperplasies de l'endomètre.

Atypical and severe hyperplasia of the endometrium is often associated with a carcinoma and, on their own, present a malignant potential which requires a specific treatment, involving an extension of the indications for hysterectomy after the menopause.

[Pregnancy and childbirth in gypsies]. / La grossesse et l'accouchement de la gitane.

The features of the gypsy population, including the conditions of their lifestyle, are very unusual and medical follow-up is very irregular, resulting in obstetric and neonatal pathology. On the basis of a series of 1571 pregnancies, the authors describe the disadvantages of these features which can only be improved by a reciprocal confidence between gypsies and the medical profession.

[Pregnancy and childbirth in the North African woman]. / La grossesse et l'accouchement de la Nord-Africaine.

The obstetric pathology of North African women, which used to be fairly different from that of French women, is now tending to resemble that of the French population, as the customs of the immigrants tend to coincide with those of the local population, especially in the context of information and antenatal care.

[The labor test under epidural analgesia. Apropos of 87 cases]. / Lépreuve du travail sous péridurale. A propos de 87 cas.

Two series of trials of labour are compared: the first series without any particular analgesia and the second under epidural analgesia. The caesarian rate was significantly less in the second series because the trial of labour was able to be pursued for a longer period of time without any danger to the foetus. The authors consider that, provided cases of mechanical dystocia and maternal agitation are eliminated, trial of labour under epidural anaesthesia can result in a real cephalopelvic engagement.

[Sterility in North African immigrant women]. / La stérilité de la femme nord-africaine immigrée.

Sterility in North African immigrants does not differ greatly from the sterility observed in French women. The authors emphasise one particular difference: the frequency of genital tuberculosis present in 1/3 of cases compared with 6 per cent of the general population.

[Value of the radioimmunological assay of HCG and its subunits in the diagnosis and follow-up of gestational trophoblastic disease]. / Intérêt du dosage radio-immunologique d'hCG et sous-unités dans le diagnostic et la surveillance des maladies trophoblastiques gestationnelles.

The value of the assay of the sub-units of human chorionic gonadotrophin in the diagnosis and follow-up of trophoblastic disease is generally recognised. The authors stress that this follow-up allows a maximal preservation of the genital tract of the patients and an evaluation of the real effectiveness of treatment.

[Impact of pregnancy on the bladder and urethra. Prospective study]. / Incidence de la grossesse sur la vessie et l'urètre. Etude prospective.

In connection with a prospective study of 200 expectant mothers, the authors discuss the disorders of the lower urinary tract in the course, and at the end, of pregnancy, which are reversible in the vast majority of cases. They also describe the physiopathological mechanisms of lasting sequelae and the precautions to be taken at the time of childbirth in women identified as high-risk vesico-urethral cases.

[The elderly primipara]. / La primipare âgée.

From the analysis of 190 case histories of elderly primiparas, the following conclusions were drawn concerning their pregnancy and delivery. Frequency = 0.6%. The high frequency of spontaneous abortion (26.8%) and infertility treatment (20.5%) should be stressed. Age-related obstetric pathology in the sample group is dominated by the high frequency of toxaemia (32.4%), premature delivery (14.3%) and uterine fibromata (17.3%). Dystocia is frequent: normal, unassisted vaginal deliveries: 32%; forceps: 33.2%; Caesarean section: 34.2%. Neonatal mortality remains high: 5.2% as does morbidity (Apgar less than 7: 29.6%).