RESUMO
BACKGROUND: The breech delivery is considered dangerous because of the higher rates of perinatal mortality and morbidity which become attached to it, consequences of obstetric traumas bound to the obstetric operations. What way of delivery is it necessary to privilege? What are the arguments which we have to support our choice? AIM: To assess the maternal and fetal outcome according to the way of delivery. METHODS: In this retrospective study, 194 women with a singleton pregnancy in a breech presentation delivered at term in our maternity unit in Ariana's Hospital from January 2007 to December 2009. RESULTS: Breech presentation was noticed in 2, 59%. The main factors favoring this presentation are: the primipara, the uterine deformations, the pathological ponds, the abnormalities of the amniotic liquid, the fetal weight and the fetal deformations. Vaginal delivery was accepted in 57,7% of women and 75% from them delivered in natural way. The rate of caesarians was 56,7 %. Among these patients, 74, 5 % were indications in a cold caesarian (scar womb, pathological pond, RPM > 12 hours, estimated (esteemed) fetal weight > 3800g). The Apgar's score was superior to seven in 97.6% of cases. There was no significant difference in fetal morbidity, Apgar's score or in the need of transfer in intensive care unit. CONCLUSION: When the acceptance conditions of the vaginal delivery are combined and when the surveillance of the labour is rigorous, it seems that there is no excess of neonatal risk by the natural ways.
Assuntos
Apresentação Pélvica/terapia , Parto Obstétrico/métodos , Adulto , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
BACKGROUND: Dystrophic ovaries represent the main cause of female infertility in Tunisia. AIM: To assess the contribution of ovarian drilling in the treatment of infertility in patients with ovarian dystrophy. METHODS: A retrospective study of 23 patients with dystrophic ovaries that have benefited through their subfertility of laparoscopic ovarian drilling, in the gynecology-obstetrics hospital Mahmoud EL Matri, Ariana, Tunisia. Our study spans a period of 3 years from January 2004 to December 2006. RESULTS: Among the 23 patients who underwent drilling for clomiphene citrate resistance, 9 have been pregnant. The average age of patients having had a pregnancy after ovarian drilling was 29.6 years, the average delay was 7.1mois. Regarding prognostic factors, only infertility's duration lower than 3 years was predictive of a good result. CONCLUSION: Ovarian drilling is an interesting alternative to induction by FSH for patients with dystrophic ovaries.
