ABSTRACT
We report on a case of severe epistaxis in pregnancy with maternal collapse and fetal death. A few similar cases have been published in the literature. These epistaxis happen towards the end of the pregnancy and occur with hyperaemia of the nasal mucosa, which is very probably hormone dependent. Delivery or death of the fetus brings about immediate cessation in the bleeding. The mother's life and that of the fetus can be jeopardised because of the severity of the bleeding or its recurrence, which makes it a very severe condition. When local treatment is useless in such a case two radical treatment have to be considered: the one is surgical, and is ligature of the sphenopalatine artery, and the other is obstetrical, and is termination of the pregnancy (which brings to an end the aetiological factor).
Subject(s)
Epistaxis/complications , Fetal Death , Pregnancy Complications, Cardiovascular/therapy , Adult , Epistaxis/therapy , Female , Humans , Pregnancy , Pregnancy Trimester, ThirdABSTRACT
We have seen 12 cases of pelvic echinococcus in the Gynaecological and Obstetric Department of the Charles Nicolle Hospital in the last 10 years. These case histories have been worked up into a thesis. The frequency of this infection in a country like ours where it is endemic, and the rarity of its localisation in the pelvis among other sites has persuaded us to report the conclusions of this study. It recalls the difficulties of the diagnosis and of the treatment of pelvic hydatid disease.
Subject(s)
Echinococcosis/diagnosis , Genital Diseases, Female/diagnosis , Adolescent , Adult , Echinococcosis/epidemiology , Echinococcosis/therapy , Female , Genital Diseases, Female/epidemiology , Genital Diseases, Female/therapy , Humans , Middle Aged , TunisiaABSTRACT
We present the case of a multiparous woman of 32 years of age who, at term after a more or less normal pregnancy, went into severe shock in labour. The patient in this case was very difficult to diagnose. Her life was only saved after massive blood transfusions and after delivering a fresh stillborn infant. It was not a case of uterine rupture nor of retro-placental haemorrhage. The site of origin of the hypovolaemic shock was intestinal. The patient had an ulcer of the pylorus which was diagnosed after fibroscopy. Some authors state that it appears that the few ulcers that have been diagnosed before pregnancy go into remission during pregnancy. All the same it would appear that sometimes very serious complicated ulcers which have to be treated with great respect do occur, especially in toxaemic patients at the end of pregnancy, and these carry with them a significant mortality both for the mother and the fetus. Although medical treatment (resuscitation) is essential, surgery should be resorted to if necessary because it may save the mother and sometimes the infant and so improve the prognosis of complicated ulcers occurring in pregnancy.
Subject(s)
Obstetric Labor Complications/etiology , Peptic Ulcer Hemorrhage/complications , Peptic Ulcer Perforation/complications , Stomach Ulcer/complications , Adult , Blood Transfusion , Female , Fetal Death , Humans , Infant, Newborn , Male , Parity , Peptic Ulcer Hemorrhage/etiology , Pregnancy , Shock, Hemorrhagic/etiology , Shock, Hemorrhagic/therapyABSTRACT
The change in maternal mortality during the time of pregnancy, labour and the puerperium is similar in our department to that reported in many countries. The overall figure for maternal mortality between 1972 and 1975 is 0.54 per 1000 (54 per 100,000 deliveries. This is a halving of numbers as compared with our previous statistics. This improvement can be ascribed to several factors, which are increased in number and quality of medical and para-medical personnel, and the better environmental factors of the inhabitants of the region. On the other hand if mortality is looked at in relationship to aetiology, there has been no change in the order of the causes, which are principally haemorrhage and eclampsia. The former is avoidable in most cases by better prevention and blood replacement, which has to be fought for. The second, in spite of the drop of 50%, remains very worrying. Improvement in the prognosis for the mother depends on measures that are taken such as better equipment of maternity departments and informing and educating pregnant women.
Subject(s)
Maternal Mortality , Eclampsia/mortality , Female , Health Education , Humans , Obstetrics and Gynecology Department, Hospital , Pregnancy , Pregnancy Complications, Cardiovascular/mortality , Puerperal Disorders/mortality , Tunisia , Uterine Hemorrhage/mortality , Uterine Hemorrhage/prevention & controlSubject(s)
Hospital Departments , Maternal Mortality , Obstetrics and Gynecology Department, Hospital , Female , Humans , Pregnancy , TunisiaABSTRACT
A vesico-uterine fistula has been seen after a caesarean section. Unusually, the discharge ran from the bladder to the uterus. The problems of the aetiology, the diagnosis and the treatment are discussed.
