[Malign Brenner's tumor particularities and coverage]. / La tumeur de Brenner maligne: particularites et prise en charge.

Brenner's tumour of the ovary is rare, mostly benign. It was described for the first time by Mac-Naughton-Jones in 1898. Von Numers listed the first malign form in 1945 that represents 2 % of tumours. On the basis of a personal report and of 160 cases listed in the literature, we propose to study anatomoclinical and epidemiological elements of this hurt and to study histological particularities and various therapeutic processes. Malignant Brenner's tumour arises mostly in peri and postmenopausal period. Clinical signs are not specific. Histological exam puts the problem of the choice of the histological malignant criteria. Metastasis occurs in half of cases. They are mostly loco-regional. The treatment is essentially surgical. The efficiency of an additive treatment seems to be debatable.

[The obstetrical advantages of epidural analgesia in a trial of labor]. / Les avantages obstetricaux de l'analgesie peridurale au cours de l'épreuve de travail.

Two series of labour trial were compared in a forward-looking study. The first series of 24 parturient women (series I) to whom the labour trial took place under peridural analgesy. The second series of 80 parturient women (series II) to whom the labour trial took place without peridural analgesy. The rate of caesarean section is significantly less important in the series I (33.3% versus 58%) P = 0.37. The average duration of the labour trial is significantly prolonged under peridural analgesy but without bared effects for the newborn children. The authors consider that the peridural analgesy is the method that brings ideal conditions for a real test allowing to eliminate dynamic dystocia and maternal restlessness in order to have an accurate cephalo-pelvic confrontation.

[The association of Recklinghausen's disease and pregnancy. Report of 6 cases]. / Reflexion sur l'association de la maladie de Recklinghausen et grossesse. A propos de six cas.

Recklinghausen's neurofibromatosis is a phacomatosis with dominant autosomal transmission and variable expression. The authors propose an analysis of six cases of Recklinghausen's disease associated to the pregnancy. From these observations and review of the literature, they release the particularities of this association. The appearance of high blood pressure seems more frequent at the patients affected by Recklinghausen's disease than in the unhurt population. A disease prevention of hypertensive complications by the use of low dose of Aspirin can be proposed in the presence of gravitiy's criteria.

[Advantages and risk of a trial of vaginal delivery in the scarred uterus]. / Avantages et risques de la tentative de la voie basse sur utérus cicatriciel.

We present a retrospective study of 1235 deliveries in scarred uterus. The aim of this study is to analyse the materno-fetal mortality and morbidity after caesarean section and a trial vaginal delivery. Uterine challenge has been tried is 578 cases with success in 12.14%. The global rate of real uterine rupture is 1.3% and of scare opening is 3.16%. The trial vaginal birth was complicated by uterine rupture in 5.9% versus 2.89% in planned caesarean section. (P = 0.00967). The length of hospitalization, the number of blood transfusion and the rate of puerperal infections are lower in the vaginal delivery trial group. The rate of new-born with Apgar < 7 in the 5th minute is in a significative way, lower in the iterative caesarean section group. (2.58% versus 4.67%), (P = 0.048). In the other hand, uterine rupture rate as well as fetal distress rate are higher in case of failure of the vaginal delivery. Maternal and fetal complications are rare and seem to be more frequent in case of failure of the uterine challenge. Accurate analysis of different obstetrical situations is necessary in order to predict the success or the failure of the vaginal delivery trial. It may lessen the maternal and fetal morbidity.

[Delivery by forceps: indications and materno-fetal morbidity]. / L'accouchement par forceps: indications et morbidité materno-foetale.

A retrospective study concerning patients having had a delivery by means pair of forceps over a period going from 1st Jun 1999 to 31st December 2000. The frequency of the use of forceps for delivery is 4.95%. The defect of eviction was an indication of the pair of forceps. Fetal suffering was the main indication. Maternal morbidity was represented essentially by a more or less injury of the genital tract with a rate of 11.1%. The rate of neonatal mortality is 1.28%. The maternal improvement of the maternal and fetal prognosis depends on an accurate indication of the use of forceps. In certain circumstances, mainly in fetal suffering, it is often difficult to choose between the high way and the low way.

[Cervical maturation in post-term pregnancy: prostaglandin E2 versus Foley probe]. / La maturation cervicale dans le dépassement de terme: prostaglandine E2 versus sonde de Foley.

To compare two methods of cervical maturation in frame of labor induction the case of overtaking of term. Study review compare two groups, first group is to form of 51 patients having had one cervical maturation by gel of predipil, second in compound of 63 patients having benefited of one maturation cervical by one probe of Foley. The entrance spontaneous in labor later administration cervical of gel of prostaglandin is of 45% against 8% only in-group of patients having had one maturation by probe of foley. Duration of labor is more short in first group. Probe Foley countered so effective that gel of prostaglandin it appears as one method of cervical maturation of choice in our environment.

[Acute gravidic steatosis: review and management]. / La steatose aigue gravidique: revue et mise au point.

The acute gravidic steatosis is a specific hepatopaty of pregnancy that has a low frequency witch often very serious. On the light of a gravidic steatosis case histological proved progenitors analyse the clinical criteria of positive diagnosis. The coexistence of an hepatic anomaly that is of an hyperuricemia with a normotensive woman is too suggestive of the diagnosis. The maternal mortality exceeded 92% before 1970, now it has reached 10%. his amelioration is mainly due the obstetric attitude of evacuation and the progress of reanimation.

[The association between Takayasu's arteritis and pregnancy]. / A propos de l'association arterite de TAKAYASU et grossesse.

We present about three observations of patients suffering from TAKAYASU's arteritis two of home have necessitated one carotidien's angioplasties. From these three cases and from a review of literature, we analyse the different materno-foetal risks of the association TAKAYASU'S arteritis and pregnancy. The high arterial pressure and the pre-eclampsia constitute the aim maternal complication. The vascular accident and the cardiac decompensation can be seen in five percent (5%) of cases. The back wordiness of the intrauterine growth the major foetal complication. Eventually, we suggest the behaviour to hold in order to improve the materno-foetal prognostic.