ABSTRACT
PURPOSE: To assess the prevalence, morphology and distribution of retinal hemorrhages in healthy newborns and their relationship to neonatal, maternal and obstetrical factors, and to determine their natural history. PATIENTS AND METHODS: The present study prospectively included 2,031 consecutive healthy newborns. Indirect ophthalmoscopy was performed within 24 hours after birth in all newborns. Infants with retinal hemorrhages were reexamined weekly until the hemorrhage resolved. Annual ophthalmologic follow-up was also scheduled in these children. Neonatal, maternal and obstetric parameters were analyzed in all newborns and compared between newborns with retinal hemorrhages and those without retinal hemorrhages. RESULTS: 31.8 % of newborns exhibited retinal hemorrhages. 72.6 % of hemorrhages were bilateral. They tended to be localized around the optic discs and in the posterior pole, but their distribution was variable. Retinal hemorrhages were of variable shapes. The prevalence of retinal hemorrhages was higher in newborns delivered with vacuum-assisted extraction (38 %, P<0.001), intermediate during normal vaginal delivery (32.6 %, P<0.001) and lower with cesarean section (20.8 %). Comparative analysis between elective cesarean section and emergency cesarean showed a higher incidence of retinal hemorrhages in the emergency cesarean group (P=0.006). On multivariate analysis, vacuum-assisted delivery was the only factor associated with a higher prevalence of retinal hemorrhages in newborns (P=0.045). Two thirds of hemorrhages had disappeared by one week after birth. Retinal hemorrhages had resolved in all newborns within four weeks. CONCLUSION: Birth-related retinal hemorrhages are common (1/3 of our newborns). Vacuum-assisted delivery is the main risk factor in this study. All hemorrhages resolved by one month of age. These findings may help in differential diagnosis with shaken baby syndrome.
Subject(s)
Birth Injuries/complications , Retinal Hemorrhage/epidemiology , Retinal Hemorrhage/etiology , Female , Humans , Incidence , Infant, Newborn , Male , Obstetric Labor Complications , Pregnancy , Pregnancy Complications , Prevalence , Prospective StudiesABSTRACT
UNLABELLED: The intrauterine contraceptive device (IUCD) is frequently used. The use of IUCD can be responsible of serious complications as transuterine migration. In this study, we evaluate the physiopathology, the strategy of diagnosis and treatment of the IUCD translocation. MATERIAL AND METHODS: We conducted a retrospective study of nine cases of IUCD migration having occurred between 2004 and 2009. We discussed the age, the type of IUCD, the risk factors, the mechanisms of migration, the circumstances and methods of diagnosis, the treatment and the evolution of IUCD migration. Mean age of the patients was 35 years. The risk factors were: multiparity, anteversus uterus, scarred uterus, IUCD postpartal insertion, inexperience of the operator. Most patients were asymptomatic. Two patients had urinary symptoms. The diagnosis of an extrauterine device was confirmed by abdominal X-ray and ultrasound results in all patients. The endoscopic treatment was successful in 66% of cases. All patients had an uneventful recovery. Transuterine migration remains one of the least common but most serious complications associated with the use of an IUCD. This complication could be controlled if thorough gynaecological exam was performed, if risk factors were delineated, if the IUCD was technically well inserted and a rigorous surveillance was performed.
Subject(s)
Intrauterine Device Migration , Adult , Diagnostic Imaging , Female , Humans , Retrospective Studies , Risk FactorsABSTRACT
Malignant transformation of mature cystic teratoma of the ovary is a rare complication occurring preferentially during peri- and post-menopausal period. No clinical nor radiological, nor biological signs are specific to malignant transformation. The treatment is surgical and similar to that of epithelial tumors of the ovary. We report an observation of a squamous cell carcinoma developed on a mature cystic teratoma of the ovary, in a patient aged 46 years.
Subject(s)
Ovarian Neoplasms/pathology , Teratoma/pathology , Cell Transformation, Neoplastic , Female , Humans , Middle AgedABSTRACT
OBJECTIVE: Adolescent pregnancy is considered to be a high-risk situation in a large part of the world. The aim of this study is to assess the validity of this notion for Moroccan teenagers. MATERIAL AND METHODS: From January 1999 to December 2000, there were 311 teenagers who gave birth in the "Les orangers" maternity hospital in Rabat, Morocco. We compared these adolescents with 155 women aged more than 18 years who delivered during the same period. RESULTS: We were unable to demonstrate a high risk for complications among our adolescent population. The only statistically significant differences found between the two groups concerned use of contraception (22.4% for teenagers vs. 57.6%), traditional practices (6.1% vs. 1.93%), frequency of episiotomy (90% vs. 67.14%), instrumental extraction (37.32% vs. 27.14%), lower birth weight in teenagers (3074 g vs. 3199 g) and a higher rate of low birth weight in unmarried adolescents in comparison with married ones (23.3% vs. 9.6%). CONCLUSION: Adolescent pregnancy in Morocco remains well accepted, particularly within the context of marriage.
Subject(s)
Delivery, Obstetric/methods , Pregnancy Complications/epidemiology , Pregnancy in Adolescence , Adolescent , Contraception , Delivery, Obstetric/adverse effects , Episiotomy , Female , Humans , Infant, Low Birth Weight , Infant, Newborn , Maternal Age , Morocco , Pregnancy , Pregnancy Outcome , Pregnancy in Adolescence/psychology , Pregnancy in Adolescence/statistics & numerical data , Risk FactorsABSTRACT
INTRODUCTION: Behçet's disease is particularly frequent in the Mediterranean countries and in the Far East. Its predominance in men is the reason why its association with pregnancy has rarely been reported in the literature. OBSERVATIONS: Three pregnancies occurred in two patients with Behçet's disease. In the first case the disease was diagnosed post partum. The second pregnancy in a stabilized patient was complicated by depression and abortion at 16 weeks of amenorrhea. The second patient presented with an articular episode after delivery, requiring an increase in dose of corticosteroids. COMMENTS: The interventions between pregnancy and Behçet's disease are obscure. The progression of the disease varies from one women to another and from one pregnancy to the next in the same woman. The observations reported here add to those describing aggravation of Behçet's disease during or after pregnancy.
Subject(s)
Behcet Syndrome/drug therapy , Glucocorticoids/therapeutic use , Pregnancy Complications/drug therapy , Adult , Female , Humans , PregnancyABSTRACT
The abortion for medical reasons is the only abortion allowed in Morocco and it aims to preserve maternal health or to forewarn the birth of handicaped children. The author has ascribed 22 cases of medical abortion, their indications have maternal origin in 91% cases. In europeans series the indication have 80% of foetal origin. In order to change the profil of our indications, the author insists on the necessity to program the pregnancy in maternal pathology, to eliminate an early, pregnancy before any therapeutical act and to encourage antenatal diagnosis according to legal dispositions.
