[Laparoscopic surgery of an intraperitoneal intrauterine device]. / Traitement coelio-chirurgical du stérilet intrapéritonéal.

This study involved 13 cases of patients fitted with intra-uterine contraceptive devices which migrated in the abdominal cavity. Laparoscopy enabled localization of the IUCD and full lesion assessment. It was removed by celio-surgery in all 13 cases. Difficulties encountered were due to parietoepiploic adhesions and IUCD impacted in the wall of the rectum.

[Maffucci syndrome and ovarian tumor]. / Syndrome de Maffucci et tumeur ovarienne.

Maffucci's syndrome was first described in 1881 and results of a mesodermic dysembryoplasia, congenital but not hereditary. Pathogenic hypothesis are multiple. This syndrome is characterized by the occurrence of multiple haemangiomas in the soft tissue, and multiple enchondromas of the bones. The association of ovary tumor is however exceptional. Four cases are reported in the literature; we report the fifth case.

[Hysteroscopy and hysterosalpingography. Which examination to chose?]. / Hystéroscopie et hystérosalpingographie. Quel examen choisir?

The authors report 58 patients undergoing hysterosalpingography (HSG) then hysteroscopy (HC) for investigation of the uterine cavity. Comparison of HSG and HC findings revealed the following: In 26.9 per cent of cases HC disproved or rectified the result of HSG. Results of the two investigations were in agreement in 74.1 per cent of cases. In the light of our results, and after a review of the literature, HSG is indicated as the first line investigation for exploration of the uterine cavity and/or the tuboperitoneal level. HC alone is sufficient for exploration of the cervical canal and of the uterine cavity.

[Uterine fixation to the promontory and the Orr-Loygue operation in associated genital and rectal prolapse]. / La promonto-fixation utérine et l'intervention d'Orr-Loygue dans l'association prolapsus génital et prolapsus rectal.

The association of genital prolapse and rectal prolapse is rare. The authors report six cases of simultaneous mixed prolapse treated surgically via an abdominal approach. The latter technique enables the treatment of genital prolapse by uterine fixation to the promontory and rectal prolapse by rectopexy using the Orr-Loygue technique. Chronic constipation and obstetric trauma are constantly found among etiological factors. Four of our patients had urinary stress incontinence. There were no preoperative complications. One patient reported worsening of her constipation. Mean follow-up is only 20 months (2 months to 3 years), but no recurrences have occurred. Review of the literature and of series with more than fifteen years follow-up shows that the Orr-Loygue operation is reliable with a low complication rate and only rare recurrences.

[Evaluation of neonatal prognosis using Doppler velocimeter in cases of a high risk fetus]. / Evaluation du pronostic néonatal par la vélocimétrie Doppler des foetus à haut risque.

The authors describe the main characteristics of the Doppler method in the early diagnosis of chronic fetal distress, and report their personal results in the study of 51 high risk pregnancies. In their study the fetal doppler ultrasound findings were correlated with birth weight related to gestational age, and neonatal morbidity. The parameters established from the doppler ultrasound assessment were the placenta resistance (calculated from the formula of Pourcelot: R = S-D/S applied to the umbilical artery) and the cerebro-placental index, Rp/Rc, Rc being the index of cerebral arterial resistance. The diagnosis performance of the method appeared very good: the Rp index was found to be highly specific for hypotrophy (85,7%) and for neonatal morbidity (90%), the RCP index adding its own good sensitivity (85% for hypotrophy and 83,3% for neonatal morbidity). The authors conclude upon the interest to study simultaneously the fetal umbilical and cerebral arterial circulations. The pathological significance of the two indexes appears different so that they are to be complementary in the evaluation of fetal distress.

[Swallowing of an amniotic string by a fetus at term]. / Déglutition d'une bride amniotique par un foetus à terme.

Amniotic band syndrome is a rare pathology which involves a group of fetal malformations due to the formation of bands between the fetus and the extraembryonic derivatives. These fetal malformations are extremely variable and their type depends upon the period of gestation during which the bands develop. In rare cases, these bands could strangulate the umbilical cord vessel and lead to fetal death. The authors report an exceptional case fo swallowing of the amniotic band by a fetus at term and fetal death due to strangulation of the umbilical cord vessels by amniotic band.