[Prenatal diagnosis of a placenta praevia percreta with color Doppler. A case report. Review of the literature]. / Diagnostic anténatal d'un placenta praevia percreta grâce au Doppler couleur. A propos d'un cas. Revue de la littérature.

Placenta praevia percreta, with bladder invasion, was diagnosed at 29 weeks of amenorrhoea with colour Doppler which visualized vascular bundles leaving the placenta and reaching the lower part of the bladder. These bundles were identified as including arterial elements with pulsed Doppler. The criteria for the diagnosis of placenta accreta with ultrasonography and colour Doppler have been presented in the literature. This prenatal diagnosis allowed adapted preoperative management and intensive care, however air embolism could not be avoided and the patient died at the end of the operation.

[Subclinical breast lesions manifested by microcalcifications. Historadiologic correlations. Apropos of a retrospective series of 127 cases]. / Lésions mammaires infracliniques révélées par des microcalcifications. Corrélations historadiologiques. A propos d'une série rétrospective de 127 cas.

OBJECTIVE: To ascertain the correlations between the histology and radiology of microcalcifications revealing subclinical carcinoma. TYPE OF STUDY: A retrospective series of 127 exereses of microcalcifications of the breast identified on preoperative radiographs. RESULTS: Histology revealed 43 (33.9%) carcinomas including 72% in situ cancers and 17 borderline lesions (13.3%) for a total of 47.2% cancerous or high risk lesions. 56% of the malignant lesions were diagnosed by mammography during screening. In most cases, conservative treatment was carried out. Axillary node invasion was not found in any of the cases of in situ carcinoma. 16% of the invasive carcinomas were pN+. Re-examination of the radiographs revealed that there was a correlation between the histology and the radiographic findings. 68% (n = 59) of the localizations with less than 30 microcalcifications were benign and 73% (n = 30) were malignant. The triangular appearance of the microcalcification localizations rwas in favour of a carcinoma in 88% (n = 22) cases. The polymorphism microcalcifications within a given localization was suggestive of malignancy in 69% (n = 25%). On the basis of data in the literature, different criteria can be used to provide precise information preoperatively.

[Essential thrombocythemia and pregnancy. A review of the literature]. / Thrombocytémie essentielle et grossesse. Etude de la littérature.

Essential thrombocythemia is a myeloproliferative syndrome confined to platelet production. Once the character of a megakaryocyte abnormality has been confirmed, the prognosis is good depending on thrombotic and haemorrhagic complications. The authors report the outcome of a pregnancy in a patient who had essential thrombocythemia treated by anti-aggregating drugs from the 10th week of amenorrhoea. In the previous history there were two obstetrical complications of the illness (one spontaneous abortion and one intrauterine fetal death). A caesarean section carried out after 32 weeks of amenorrhoea led to the birth of a baby weighing 1890 gm. Only a few cases have been reported in the literature. There is always a drop in the number of platelets in pregnancy. After delivery the number of platelets becomes pathological within a few weeks. The prognosis for the fetus is linked to the risk of placental thrombosis, not to the numbers of platelets. The problem lies in the choice of indications for the use of acetylsalicylic acid in low dosage, particularly since cases of pregnancy taken to term without any specific type of treatment have been reported.

[The presence of an ovarian granulocytic sarcoma concurrent with a type M2 acute myeloblastic leukemia: a case]. / Localisation ovarienne d'un sarcome granulocytaire contemporain d'une leucémie aiguë myéloblastique type M2: un cas.

The authors report a case of granulosa cell tumor principally located in the ovary associated with M2 type acute myeloblastic leukemia (AML) in a trisomy 22 patients. Surgery and chemotherapy were combined with a bone marrow allograft. Frequency of granulosa cell tumor is 8 percent or less of AML cases. Diagnosis is particularly difficult when haematologic expression occurs late in the disease course. An immunohistochemical work-up is required in these cases. Aetiopathogenesis is discussed. Treatment relies essentially on chemotherapy. The prognostic is variable according to different case reports in the literature.

[Urinary tract infection in gynecology-obstetrics: resistance to beta-lactam antibiotics and previous antibiotic therapy]. / Infection urinaire en gynécologie-obstétrique: résistance aux bêtalactamines et antibiothérapie préalable.

From June 1988 to October 1989, 190 women from the department of Obstetrics-Gynecology with bacteriuria due to Gram-negative rods were studied. One hundred and three were investigated as ambulatory patients. Fifty three had received treatment with a bêta-lactam antibiotic during the past three months and 11 between three and six-months before sampling. The organisms causing bacteriuria were 163 E. coli, 12 P. mirabilis and 15 were due to other species. Thirty three E. coli and the 15 other species were resistant to amoxicillin and/or to cefalotin. When comparing previous treatment and resistance to amino-penicillins it appears that: of the women who had received a beta-lactam antibiotic within the three months before testing, 57% of the strains recovered were found resistant for amino-penicillins; of the women without treatment during the past six months, 89% of the strains recovered were sensitive and six per cent of E. coli plus five per cent of another Gram negative rod were resistant to amino-penicillins.

[Fetal risk in viral hepatitis. Reflections and management of a case of death in utero in a patient with viral hepatitis A]. / Le risque foetal au cours des hépatites virales. Réflexions et conduite à tenir à propos d'un cas de mort in utero chez une patiente atteinte d'une hépatite virale A.

Fetal death in-utero during viral hepatitis is not the infection itself. It seems that the alteration of the liver functions is the determinant, as it is exactly the case during cholestasis in pregnant women. On the occasion of a death in utero during a viral hepatitis A, the authors review the literature.