[Intravaginal misoprostol before induced abortion in nulliparous women]. / Le misoprostol par voie vaginale avant interruption volontaire de grossesse chez la nullipare.

One hundred and twenty nine nulliparous requesting first trimester induced abortion between 7 and 12 weeks of amenorrhea (SA) were included in the study to evaluate the effectiveness and the side effects of misoprostol in the cervical ripening before aspiration. Three randomized groups of 43 patients received misoprostol 12 hours before induced abortion: group A received 200 mug inserted vaginally; group B received 400 mu g inserted vaginally and group C received 400 mu g orally. Cervical dilatation after treatment and maximal dilatation realized with Hegar dilatator were significantly higher in group B. The rate of partial abortion is significantly higher in group B. Tolerance is good in the three groups. No significant difference between the three groups related digestive disorders, pelvic pain and hyperthermia were noted. On the other hand the rate of metrorrhagia and hemorrhages more important than menstruation is higher in group B. Misoprostol 400 mu g inserted vaginally 12 hours before induced abortion in nulliparous women seem to be an effective, safe, practical and cheap method for cervical ripening before aspiration.

[Randomized study of sulprostone versus misoprostol in the cervical preparation before elective abortion in nulliparous women]. / Etude randomisée sulprostone versus misoprostol dans la préparation cervicale avant IVG chez la nullipare.

OBJECTIVE: To assess the effectiveness and side effects of misoprostol versus suprostone in cervix preparation before aspiration abortion in the nullipara. METHODS: Ninety nulliparous women requesting medical abortion with gestations varying from 7 to 12 weeks were included in a prospective randomized study after informed consent. Women with contraindications for prostaglandins and those consulting before 7 weeks gestation were excluded from the study. The women were assigned to 30 groups randomly: women in group A were given 500 micrograms sulprostone in 250 saline solution infused at a rate of 100 micrograms/h 12 hours before the abortion; women in groupe B were given 400 micrograms misoprostol per os 3 hours before abortion; and women in groupe C were given 400 micrograms misoprostol per os 12 hours before abortion. RESULTS: The three groups were not different for age, parity or gestation, gestational age at abortion or type of anaesthesia. Dilatation of the cervix after treatment was identical in groups A and C (8.60 +/- 1.3 vs 8.20 +/- 1.3; NS) but was greater in group A than in group B (8.60 +/- 1.3 vs 7.23 +/- 2.2; p = 0.02). Maximal dilatation was the same in the three groups (9.50 +/- 0.8, 9.10 +/- 1.3, 9.17 +/- 0.8 respectively). Rate of partial expulsion was higher in groups A and C (23 and 6%) compared with group B (0%). Tolerance was much better with misprosol than with sulprostone: 43% digestive disorders in group A versus 15% in groupe B and C (p = 0.003); 80% pelvic pain with sulprostone versus 53% with misoprostol (p = 0.01); 70% metrorrhagie with sulprostone versus 38% with misoprostol (p = 0.04) and 36% with more bleeding than cycles in the sulprostone subjects versus 12% in the misoprostol subjects (p = 0.005). CONCLUSION: Misoprostol at a dose of 400 micrograms per os 12 hours before abortion in the nullipara is an interesting alternative to sulprostone. It is equally effective for cervix dilatation, tolerance is much better and cost is lower.

[Ultrasonographic fetal growth curves in the West Indies. Apropos of 2930 measures of 889 fetuses]. / Courbes échographiques de croissance foetale aux Antilles. A propos de 2,930 mesures portant sur 889 foetus.

OBJECTIVE: To establish the echographic foetal growth curves between 20 and 40 weeks amenorrhoea in the specific population of the West Indies. SITE. Gynecology-Obstetrics Unit, Redoute Hospital, Fort-de-France. POPULATION: All echographies performed between the 20th and 40th week of amenorrhoea in single foetus pregnancies in women of local origin who had undergone an echography before 15 weeks of amenorrhoea were included. Major malformations and chromosomic abnormalities were excluded. METHODS: A total of 2,930 measurements of the biparietal, transverse abdominal diameters and length of femur were recorded in 889 foetuses. The curves for the 10th, 50th and 90th percentiles were constructed by smoothing with a second end linear curve for each of the echographic parameters. For each parameter, the growth curves were compared with the curves established by Leroy and Bessis for the French population. The difference in the growth curves between the two populations were correlated to gestational age in order to establish whether there is a difference between the West Indies population and the metropolitan French population. RESULTS: Comparison with the Leroy and Bessis curves revealed that the rate of growth in the transverse abdominal diameter and the length of femur was significantly different between the West Indies population and the French population (p < 0.01). Inversely, the rate of growth of the biparietal diameter was comparable for the two populations. CONCLUSION: These growth curves provide echographists and obstetricians who examine patients of West Indies origin to adapt their obstetrical management. An ethnic factor cannot be excluded in explaining the difference between the two populations. This study confirms the requirement to establish foetal growth curves of each separate region.

[Dacryocystocele. Prenatal ultrasonic diagnosis]. / Dacryocystocèle. Diagnostic anténatal échographique.

The authors report a case of bilateral dacryrocystocele (lacrimal duct obstruction) in a fetus of 32 weeks amenorrhoea, diagnosed by ultrasound. This pathology has been rarely described in a fetus although it is relatively frequent in the new born. This case has made it possible for the authors to define the ultrasound appearances and the prognosis.

[Antenatal diagnosis of atrioventricular block. A case report]. / Diagnostic anténatal d'un bloc auriculo-ventriculaire. A propos d'un cas.

The authors report the case of a congenital atrio-ventricular block (AVB) diagnosed after 32 weeks of amenorrhea in a woman, suffering from AVB, fitted with a pacemaker and who had already given birth to two children suffering from congenital AVB. The authors recall the physiopathology and antenatal diagnostic criteria of AVB and how it should be managed.

[Heart surgery with extracorporeal circulation during pregnancy. Review of the literature with a case history]. / Chirurgie cardiaque sous circulation extra-corporelle durant la grossesse. Revue de la littérature à propos d'un cas.

The authors report a case of replacement of a mitral valve and of tricuspid annuloplasty using extracorporeal circulation in a pregnancy of 23 weeks amenorrhoea with a satisfactory result for the mother and the birth of a healthy baby after 35 weeks of amenorrhoea. A review of the literature made it possible to analyse the problems occurring in pregnancies in woman who have been fitted with a cardiac valve prosthesis and who have to have cardiac surgery in pregnancy.