[Induction of labor in fetal death in utero using a Foley catheter and extra-amniotic perfusion of physiologic serum]. / Déclenchement du travail dans les morts foetales in utero par sonde de Foley et perfusion extra-amniotique de sérum physiologique.

Nineteen cases of induction of labour by Foley catheter and extra-amniotic perfusion of normal saline for fetal death in utero occurring more than 24 weeks after the LMP were collected in the La Rabta Maternity and Neonatology Centre, Tunis, during the final 6 months of 1987. The mean age of the women was 27.8 and their mean parity 2.9. Two patients had uterine scars. The mean duration of the pregnancy was 33.3 weeks and initial Bishop score was 4 or less. When the catheter fell out, after 26.4 hours on average, the Bishop score had improved by 4.5 points. Labour occurred spontaneously in 5 cases and required oxytocin stimulation in 5 cases. The interval between induction and fetal expulsion was 44.4 hours. Delivery was followed by routine manual evacuation of the uterus. Two complications were seen: one case of accidental rupture of the membranes and one of rupture of the uterus affecting a scarred uterus. The authors point out certain risk factors concerning rupture of the uterus which should be considered to be contraindications to the method. With the exception of these situations, this method of induction is recommended because of its advantages of efficacy, safety and low cost, in particular in developing countries.

[Robert's uterus with menstrual retention in the blind cavity]. / Utérus de Robert avec rétention menstruelle dans la cavité borgne.

Robert's uterus or asymmetric septate uterus is a rare malformation. It presents with two cavities, one of which is blind. The authors report an original case: the blind cavity, on the right side of the septum, contained retained secretions. The embryologic and physiopathologic mechanism of this anomaly still are to be discussed.

[Association of Takayasu arteritis, Crohn disease and pregnancy]. / A propose de l'association artérite de Takayasu, maladie de Crohn et grossesse.

The authors report a case of a pregnant woman with Takayasu's arteritis and Crohn's disease. The course of pregnancy was uneventful. It is suggested that these two inflammatory diseases may be immunologically related. A brief review of the literature confirm that fetal and maternal prognosis are generally excellent.

[Intramural pregnancy: a case report]. / Grossesse intramurale: un cas.

Implantation into the muscle wall is one of the rarer forms of ectopic pregnancy. We report an uncomplicated case which was discovered during therapeutic termination of pregnancy at 10 weeks. We point out how valuable the use of ultrasound during the operation is for making the diagnosis when suction does not provide adequate quantities of products.

[The role of culdocentesis in the diagnosis of ectopic pregnancy. Prospective study of 478 cases]. / Place de la culdocentèse dans le diagnostic de la grossesse extra-utérine. Etude prospective à propos de 478 cas.

Four hundred and seventy height Culdocenteses were carried out in cases of possible ectopic pregnancy between the 20th September 1986 and 31st December 1987. Culdocentesis was considered to be positive if 2 cm3 or more of dark non-coagulated blood was removed, and negative if only a yellow liquid or blood stained serum was removed. It was not conclusive if nothing could be aspirated or if the blood was coagulated. Of the 94 cases where culdocentesis was positive, 74 were found to have an ectopic pregnancy. There were 20 false positive cases (due to 5 haemorrhagic ruptures of follicles, 3 refluxes of menstrual blood, 2 with other aetiology, and 10 without known cause). There were 21 cases of ectopic pregnancy in the 293 cases where culdocentesis was non-conclusive. Of the 91 cases where culdocentesis was negative, a second culdocentesis showed an ectopic pregnancy. It was positive 11 days after the first. In our series this diagnostic test was reliable in 77.1% of cases. Laparotomy was carried out in 22.3% of cases and only 18.6% had to have laparoscopy thanks to the use of culdocentesis.