[The value of magnesium pyrrolidone carboxylate in true cervix dystocia. A double blind versus placebo study]. / Intérêt du pyrrolidone carboxylate de magnésium dans les dystocies cervicales pures. Etude en double aveugle contre placebo.

The efficacy of spasmolytics in cervix dystocia during labor is very contested. For this reason the authors studied the action of pyrrolidone carboxylate of magnesium for this indication in a double-blind versus placebo study (48 patients divided in two groups). Strict inclusion criteria and homogeneity of the two groups of patients allowed them to find out that the use of this particular magnesium salt reduced significantly the length of labor. Consequently the authors assess that spasmolytics work not only through their placebo effect, which is thought by some authors.

[Prolapse of the umbilical cord. 79 cases]. / Procidence du cordon ombilical. 79 procidences.

The authors are considering the prolapse of the umbilical cord, based on 79 personal observations collected in 15 years and data from the literature. They demonstrate that a simple approach (forcing back the presentation and caesarean section) decreases the perinatal mortality rate. The total rate of fetal deaths is 10 p. cent, the corrected rate of children dead on admission is 1.5 p. cent. 77 p. cent of caesarean sections were performed.

[Epidemiologic study of extra-uterine pregnancy. Apropos of 375 cases]. / Etude épidémiologique de la grossesse extra-utérine. A propos de 375 observations.

From a retrospective study over 11 years of 375 ectopic pregnancies, the authors have analyzed the epidemiological factors that could account for a very sensible and regular increase of the frequency of this gravidic accident. If a past history of tubal infection is usually considered as a major cause, in this series, we must mainly consider the abnormal frequency of the use of a modern contraceptive method at the time of the ectopic pregnancy, found in 32% of the cases. The place and the role of intra-uterine devices are discussed since a coil was associated with an ectopic pregnancy in 22.5% of the patients while the notion of a previous usage does not seem to be a predisposing factor: approximately only 2% of these patients had resorted to it. A hormonal contraception in progress may also lead to a late diagnosis, especially in patients using mini and micro-pills (8% of ectopic pregnancies). Finally, the advantages of conservative tubal surgery contingent on an earlier diagnosis are kept in mind by the authors because of the persistence of a high recurrence rate on the contralateral side, even after salpingectomy.

Plasma renin activity, blood uric acid and plasma volume in pregnancy-induced hypertension.

UNLABELLED: Plasma renin activity (PRA), plasma aldosterone (PA), blood uric acid (BUA), plasma concentrations of catecholamines (Pcat) and plasma volume (PV) were measured simultaneously in 24 patients with pregnancy-induced hypertension. This hypertensive group was divided into labile (LH) and permanent hypertension (PH) groups according to the response of their blood pressure to home bed rest. As compared to normal theoretical values, PV was decreased in both hypertensive groups (LH = -70%; PH = -14%). As compared to a control group of 16 normotensive pregnant women, PRA was higher in LH and lower in PH whereas PA was lower in both hypertensive groups. In both hypertensive groups, BUA was higher than in the control group. No difference in Pcat was found between the three groups. In the PH group negative correlations were found between BUA and PRA, as well as between BUA and PV, but no correlation between PRA and PV nor between Pcat and BUA were found. CONCLUSIONS: LH and PH are two pathophysiologically different entities in pregnancy-induced hypertension. In PH, renin secretion is not appropriate to hypovolemia and therefore not primarily involved in the pathogenesis of hypertension. The role of hypovolemia in the increase of BUA may be discussed.

Plasma renin activity, blood uric acid and plasma volume in pregnancy-induced hypertension.

UNLABELLED: Plasma renin activity (PRA), plasma aldosterone (PA), blood uric acid (BUA), plasma concentrations of catecholamines (Pcat) and plasma volume (PV) were measured simultaneously in 24 patients with pregnancy-induced hypertension (PIH). This hypertensive group was divided into labile (LH) and persistent hypertension (PH) groups according to the response of their blood pressure to home bed rest. Compared to normal theoretical values, PV was decreased in both hypertensive groups (LH = -7%; PH = -14%). Compared to a control group (C) of 16 normotensive pregnant women, PRA was higher in LH and lower in PH whereas PA was lower in both hypertensive groups. BUA was higher than in C in both hypertensive groups. No difference in PCat was found between the three groups. In the PH group negative correlations were found between BUA and PRA, as well as between BUA and PV but no correlation between PRA and PV nor between Pcat and BUA were found. IN CONCLUSION: LH and PH are two pathophysiologically different entities in PIH. In PH renin secretion is not appropriate to hypovolaemia and therefore not primarily involved in the pathogenesis of hypertension. Hypovolaemia may play a role in the increase of BUA in PIH.