[Age, gynecologic status and urinary stress incontinence]. / Age, status gynécologique et incontinence urinaire d'effort.

Based on a series of 1,000 female patients examined in office practice, the authors of this study seek to define the incidence of USI according to the patient's age gynecological status. Concerning age, this factor only has a clear effect in patients over 35 years of age. No significant difference in the incidence of USI was observed between sexually active women over 35, women approaching the menopause or post menopausal women; for this reason, the authors believe that in these cases, USI is related more to concomitant factors than to trophic lesions which however certainly are also present. During pregnancy, USI frequently occurs during the 2nd and 3rd trimesters; in contrast, in the first trimester of pregnancy, frequently there is increased intraabdominal pressure thus explaining why the incidence of USI is less than in sexually active women.

[What lesions of the myometrium are responsible for hemorrhage?]. / Quelles sont les lésions du myomètre responsables d'hémorragies?

Based on a personal series of 54 cases of endo-uterine haemorrhage with normal endometrium, the authors show that lesions of the myometrium which may result in haemorrhages, consist mainly of interstitial or submucous myomas and adenomyosis, i.e. lesions on which medical treatments are ineffective. Ultrasonography, but mainly clinical data and hysterography very often demonstrate the lesions and are sufficient to indicate a hysterectomy or a myomectomy. The problem is more difficult when the clinical, ultrasonographic and hysterographic work-up is negative or barely evocative. In these cases, after ruling out certain functional haemorrhages or a haemorrhagic disease, it is useful to take an histological sample of the endometrium either by curettage or biopsy, on an ambulatory basis (using Inocurette for instance). If this examination is normal, hysterectomy is indicated, because, in their experience, there are such lesions of the myometrium, that recurrence of the haemorrhages is inevitable.

[Indications and contraindications of peridural anesthesia in obstetrics. Review of the literature]. / Indications et contre-indications de l'anesthésie péridurale en obstétrique. Revue de la littérature.

With the help of an extensive review of the french and foreign literature, and personal statistics concerning 500 peridural anesthesias (PDA), the authors analyze the indications and contraindications of this type of anesthesia, in 1987. It is possible to differentiate well accepted indications: caesarean section, inducement, labor test, dynamic dystocia, delivery of fragile fetus, desire of the patient; definite contraindications: patient's refusal, coagulation disorders, emergency situations, some cardiopathies; debatable indications: breech delivery, scarred uterus, twin delivery, maternal medical problem, where each particular case must be evaluated. In his study, the authors demonstrate that indications tend to become broader and contraindications to become more infrequent. They stress a necessary co-operation between obstetrician and anesthetist to make this decision.