[The 7th pregnancy was in the tube!!]. / La 7e était dans la trompe!!

The authors report a case of ovarian hyperstimulation leading to 6 endo-uterine pregnancies and one extra-uterine pregnancy. After embryonic reduction, and salpingectomy, a twin pregnancy was carried through, in a bifid uterus. Review of the literature enables to emphasize the difficulties in diagnosing heterotopic pregnancies, and to discuss the indications and techniques of selective embryonic reduction, along with the ethical and legal problems it raises.

[Twin pregnancy after iatrogenic menopause]. / Grossesse gémellaire après ménopause iatrogène.

The authors present the case of a young woman who had Hodgkin's disease when she was 29 years of age. This was treated with 5 courses of M.O.P.P. (Mustard (nitrogen mustard), Oncovin, Procarbazine, Prednisone). These courses were followed by radiotherapy and the patient was given the combined oestrogen-progesterone pill while under treatment. After 20 months following treatment the patient was clinically and biologically menopausal. She was treated with hormone replacement therapy on alternate months. 10 months later, she started a twin pregnancy (there was no family history of twins) and after 37 weeks of amenorrhoea she delivered twins weighing 2,180 g and 2,300 g. The review of the literature shows that the ovaries are affected by this type of treatment, which causes ovarian fibrosis and failure of maturation, with disappearance of follicles. The effects of such treatment are variable and may leave the patients with normal ovarian function, or with a menopause from the outset. The essential prognostic feature is the age of the patient at the time of treatment. The dose of the antimitotic drugs used does not seem to have a great effect on ovarian function. The role of giving oestrogens and progestogens is disputed. The fact that twins occurred in this case could be explained by the fact that twin pregnancies do occur more often in the pre-menopause because the higher levels of gonadotrophins ripen several follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

[Injury of the umbilical cord during late amniocentesis]. / La blessure du cordon au cours de l'amniocentèse tardive.

Damage to the umbilical cord is a rare complication of late amniocentesis. It is so serious for the fetus that it should be recognized immediately and the baby should be delivered as quickly as possible. We report a new case here and analyse the principal features to be found in the literature.

[Cervical pregnancy. A rare entity that should not be missed]. / La grossesse cervicale. Une entité rare à ne pas méconnaître.

The authors report a new case of cervical pregnancy in a primigravid woman of 31 years of age who had had 15 weeks of amenorrhoea. They review the clinical and anatomo-pathological criteria necessary to make the diagnosis. The diagnosis which had become suspected because of ultrasound was confirmed by examination under a general anaesthetic before interrupting pregnancy. Conservative treatment was made possible because there was no very heavy bleeding after the curettage to evacuate the products.