[Prevention of prematurity in the French community at the approach of the year 2000]. / La prévention de la prématurité en Communauté française à l'approche de l'an 2000.

The actual results confirm the dominating influence of psychosocial factors on prematurity and low birth weight. The study performed in Liège indicates that these factors must be taken into account for better care of the future mother. The systematic use of a prenatal questionnaire on psychosocial factors draws attention towards the personal situation of the future mother. Detection of some organic or psychosocial risk factors must prompt prophylactic measures even in the absence of any sign of pathologies. Prevention of prematurity has, over the last 30 years, been the primary objective of prenatal follow-up. Its importance must be further emphasized.

[Psychosocial environment and premature birth]. / Environnement psychosocial et naissance prématurée.

For about twenty years, prematurity has been the subject of many preventive actions. In spite of the elaboration of different screening programmes, preterm deliveries rate doesn't decrease. Some somatic risk factors are now known and are the subject of an unconditional screening in prenatal consultation. However we consider that the etiology of many preterm deliveries remain unknown and 55% of preterm cases could be idiopathic without any explanation of pathological order. The clinical observation suggests the existence of a link between preterm delivery and the psychosocial environment of the pregnant woman. According to that suggestion, they are now making a study in the university obstetrical service of the CHR Citadelle (Liège). The first part of the research has enabled to identify different risk factors such as: illegitimate pregnancy, future mother living alone, unemployed husband, no wage, stress, earlier miscarriage, social isolation, less than 2 years between 2 babies, bad satisfying pregnancy on a psychological and/or physical point of view. According to the study and literature results, a psychosocial risk screening overview has been elaborated. It would permit to identify the cases leading surely to a preterm delivery. That study is financed by a convention between the "Ministère de la Culture et des Affaires sociales de la Communauté française".

[Precancerous states of the endometrium: hormonal aspects]. / Les états précancéreux de l'endomètre: aspects hormonaux.

The two types of endometrial carcinomas are preceded by precancerous lesions. Type I endometrial carcinomas are most commonly encountered in perimenopausal women with the classical risk factors associated with estrogen exposure: obesity, multiparity, diabetes, estrogen treatment, ... Hyperplasia (simple, followed by complex forms without cellular atypias and subsequently by complex hyperplasias with cellular transformation) precede such cancers. Estrogens exert a promoting effect on these lesions but do not initiate them. Progesterone and progestins exert a preventive and protective effect. However, the progressive loss of steroidal receptors is correlated to the progression of tissular anomalies and to the onset of cytogenetic anomalies and to mutations of p53 anti-oncogene. The preventive role of progestin is well established, but their curative beneficial effect on atypical precursors forms of endometrial cancers and on endometrial carcinomas remains controversial. The second type of endometrial cancer appears during the postmenopause and is characterized by an increased invasiveness and a poor prognosis, devoid of identifiable risks factors, these aggressive cancers are not preceded by hormone-sensitive precancerous lesions, but by an intra-epithelial endometrial carcinoma. This lesion appears most often in an atrophic endometrium. Finally, the two types of precancerous states are characterized by distinct gene anomalies suggesting two different pathogenic mechanisms of cancerisation.