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1.
J Gynecol Obstet Biol Reprod (Paris) ; 43(5): 401-6, 2014 May.
Article in French | MEDLINE | ID: mdl-23706157

ABSTRACT

We describe a case of uterine necrosis, following Gelitaspon(®) embolization for postpartum hemorrhage resulting from vaginal laceration. Previous cases published help to improve the safety of this effective method by showing the risk factors, as particles sizes, ultraselective embolization, prevention of infection. Controlling bleeding by surgery is the priority when hemorragy is due to laceration without uterin atony. In case of failure, embolization is an option which should be proposed without delay. Uterine necrosis should be suspected in case of postembolization septic syndrome.


Subject(s)
Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/therapy , Uterine Artery Embolization/adverse effects , Uterus/pathology , Vagina/injuries , Adult , Female , Humans , Necrosis/diagnosis , Necrosis/etiology , Pregnancy
3.
Ultrasound Obstet Gynecol ; 33(6): 716-9, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19479679

ABSTRACT

We describe the findings on computed tomography (CT) in a prenatally diagnosed case of bladder exstrophy, and compare them with the findings on two- and three-dimensional sonography. The CT data of the affected fetus were compared with the CT findings of 14 fetuses with normal bony pelvises. The CT images showed differences in the structure of the bony pelvis in the case of bladder exstrophy, with a wide gap between the iliopubic and ischiopubic rami and a widening of the iliac bones. CT scanning was useful in confirming the sonographic diagnosis of bladder exstrophy, and it may also be helpful for planning early surgery following delivery.


Subject(s)
Bladder Exstrophy/diagnostic imaging , Pelvic Bones/diagnostic imaging , Adult , Bladder Exstrophy/surgery , Female , Humans , Infant, Newborn , Pregnancy , Tomography, Spiral Computed/methods , Treatment Outcome , Ultrasonography, Prenatal/methods
4.
Fetal Diagn Ther ; 24(4): 444-7, 2008.
Article in English | MEDLINE | ID: mdl-19023211

ABSTRACT

Patent urachus cyst is a rare umbilical anomaly, which is poorly detected prenatally and frequently confounded with pseudo bladder exstrophy or omphalocele. A 27-year-old woman was referred to our prenatal diagnosis centre at 18 weeks of gestation after diagnosis of a megabladder and 2 umbilical cord cysts. Subsequent 2D, 3D and 4D ultrasound examinations and fetal magnetic resonance imaging (MRI) revealed a typical umbilical cyst and an extra-abdominal cyst, communicating with the vertex of the fetal bladder through a small channel that increased in size when the fetus voided urine. Termination of pregnancy occured at 31 weeks because of associated cerebral septal agenesis, and autopsy confirmed the prenatal diagnosis of urachus cyst. Few cases of urachus cyst diagnosed prenatally are reported in literature, but none were associated with other extra-abdominal disorders and none used 3D, 4D and fetal MRI. Our case illustrated the efficiency in prenatal diagnosis of 3D and 4D ultrasound examinations. This could help pediatrician surgeons to explain to a couple about neonatal surgical repair and plastic reconstruction in the prenatal period.


Subject(s)
Magnetic Resonance Imaging , Ultrasonography, Prenatal/methods , Urachal Cyst/diagnostic imaging , Urachus/abnormalities , Urachus/diagnostic imaging , Abnormalities, Multiple , Adult , Fatal Outcome , Female , Humans , Infant, Newborn , Male , Pregnancy
5.
Rev Mal Respir ; 25(7): 853-6, 2008 Sep.
Article in French | MEDLINE | ID: mdl-18946411

ABSTRACT

INTRODUCTION: Tuberculosis is the most common infectious complication in HIV infected patients. The incidence of tuberculosis and the proportion of disseminated disease increase with more severe immuno-suppression. Septic shock and multiple organ failure are uncommon but are of markedly bad prognostic significance. CASE REPORT: A forty-four year old HIV seropositive man was admitted to the intensive care unit (ICU) with acute respiratory distress. The patient had been febrile for the previous two weeks. His thoracic radiograph showed a discrete interstitial infiltrate and at bronchoscopy small whitish granulations were observed in the main bronchi. All bacteriological investigations remained negative at the time of ICU admission. The patient died sixteen hours later due to multiple organ failure. Mycobacteria were identified after patient's death on the smear from BAL, from blood cultures, and in a postmortem liver biopsy. CONCLUSIONS: Septic shock is an infrequent complication of disseminated tuberculosis. Mortality is very high. Treatment should be started early in cases with a high diagnostic suspicion.


Subject(s)
AIDS-Related Opportunistic Infections , Multiple Organ Failure/etiology , Shock, Septic/etiology , Tuberculosis/complications , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-HIV Agents/therapeutic use , Bronchoscopy , Humans , Immunosuppression Therapy , Intensive Care Units , Male , Multiple Organ Failure/mortality , Radiography, Thoracic , Respiratory Insufficiency/etiology , Tuberculosis/diagnostic imaging
7.
Gynecol Obstet Fertil ; 35(9): 861-6, 2007 Sep.
Article in French | MEDLINE | ID: mdl-17765593

ABSTRACT

This article explains why we have had to come to a central role for innate immunity rather than the threat of maternal rejection of the foetal allograft. We encompass briefly the role of inflammation in implantation, not only for invasion adhesion, but also to prepare future "tolerance". In this context, we envisage the role of TWEAK and complement.


Subject(s)
Embryo Implantation/physiology , Embryo Implantation/immunology , Female , Humans , Immune Tolerance , Immunity, Innate , Inflammation/physiopathology , Pregnancy , T-Lymphocytes/immunology , Uterus/immunology
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