[Uterine ruptures. 32 cases]. / Les ruptures utérines. A propos de trente-deux cas.

On the basis of qqq 32 cases of rupture of the uterus observed over a 5-year period at the Monastir University hospital (Tunisia), the authors recall the high incidence of this obstetrical emergency: 1 incident per 548 deliveries. The usual aetiological factors were present: multiparity, caesarean scar, mechanical dystocia, oxytocic dystocia and obstetric manoeuvres. The foeto-maternal prognosis is poor with a maternal mortality rate of 3.13% and a perinatal mortality rate of 46.9%. Treatment should be conservative whenever possible. The authors attempt to define a prophylactic approach on the basis of the aetiological context.

[HELLP syndrome. Epidemiological, nosological and prognostic aspects]. / HELLP syndrome. Apports épidémiologique, nosologique et pronostique.

The authors report a prospective and controlled study of hellp syndrome in two groups of patients: normal and preeclamptic. Hellp syndrome was seen only in the pre-eclamptic group (19.3 per cent). Maternal prognosis was poor when Hellp syndrome was confirmed. Several maternal complications were seen: severe hypertension, subarachnoid hemorrhage, coagulation disorders and renal failure. Maternal mortality was high (16.7 per cent). Hellp syndrome does not worsen fetal prognosis, which is already compromised by pre-eclampsia.

Furcation anatomy of the first mandibular molar in dogs.

Tooth surface and interradicular area (furcation) measurements were taken of 20 first mandibular molar teeth obtained randomly from canine cadavers. The lingual furcation entrance had a mean width of 1.2 +/- 0.3 mm. The buccal furcation entrance had a mean width of 1.3 +/- 0.4 mm. There was no significant difference between mean furcation entrance measurements. The horizontal attachment area between the cementoenamel junction and the coronal roof of the lingual furcation was 1.1 +/- 0.4 mm. The horizontal attachment area between the cementoenamel junction and the coronal roof of the buccal furcation (0.5 +/- 0.3 mm) was significantly different from the lingual horizontal attachment area. Distal root length and mesial root length were 16.0 +/- 1.5 mm and 16.1 +/- 1.6 mm, respectively. The mean coefficient of variation for variables measured was 14.0%. Tooth size did not have a significant effect on furcation entrance measurement. All teeth had a concavity coronal to the furcation area, which extended apically for a mean distance of 65.6% of the distal root length and 83.8% of the mesial root length. Furcation anatomy of the first mandibular molar is complex and may be a contributing factor in periodontal disease involving the interradicular area.

Potential attachment area of the first mandibular molar in dogs.

Tooth root and root trunk surface area measurements were taken from 20 first mandibular molar (M1) teeth obtained randomly from canine cadaver specimens. The mean root surface area for all teeth was 497.1 +/- 116.2 mm2. The cumulative surface areas of the mesial (MR) and distal (DR) roots were 251.4 +/- 70.2 mm2 and 211.7 +/- 51.9 mm2, respectively. The root trunk surface area was 34.0 +/- 21.4 mm2. Surface area measurements for individual roots and the root trunk were significantly different. Cumulative individual root surface area (MR + DR) was 93.2% of total root surface area. The MR surface area contributed most to total root surface area (50.6%) and cumulative individual root surface area (54.3%). The mean distance from the beginning of the root trunk to the furcation was 2.1 mm. On the basis of the linear variation of the percentage of root surface area of the M1, 44.6% of the total root surface area was 3 to 7 mm apical to the most coronal aspect of the cementoenamel junction. The MR was heart-shaped, compared with the more cylindrical shape of the DR.

Potential attachment area of the fourth maxillary premolar in dogs.

Tooth root and root trunk surface area measurements were made on 20 permanent fourth maxillary premolar (P4) teeth randomly harvested from canine cadaver specimens. Mean root surface area for all 20 teeth was 562.8 +/- 124.9 mm2. Cumulative surface areas of the mesiopalatal, mesiobuccal, and distal roots were 113.8 +/- 29.0 mm2, 138.5 +/- 34.6 mm2, and 180.8 +/- 39.9 mm2, respectively. The mesial root trunk and distal root trunk surface areas were 60.0 +/- 17.5 mm2 and 72.1 +/- 33.2 mm2, respectively. There was not a significant difference between the root surface area of the mesial root trunk and distal root trunk; however, all other root surface area measurements were significantly different (P less than 0.01). Cumulative individual root surface area (distal root + mesiobuccal root + mesiopalatal root) was 76% of total root surface area. The distal root surface area contributed most to total root surface area (32.1%) and cumulative individual root surface area (41.7%). Observation of the linear variation of percentage of root surface area revealed 40.8% of the total root surface area to be in the portion located between 5 and 9 mm apical to the most coronal aspect of the cementoenamel junction. The mesiobuccal root and distal root were cylindrical compared with the flattened, concave shape of the mesiopalatal root.