[Obstetric management after ectopic pregnancy in the caesarean section scar: a case report and review of literature]. / Prise en charge obstétricale après grossesse ectopique intracicatricielle: à propos d'un cas et revue de la littérature.

We report the case of a patient who came out pregnancy twelve months after medical and surgical treatment of an ectopic pregnancy in a previous caesarean section scar. The preconceptional management consisted in a saline infusion sonohysterography and a pelvic magnetic resonance imaging. Judging the risks of abnormal placental insertion to be higher in this case compared to a simple caesarean section, a careful ultrasonography with color doppler imaging was carried out. The myometrium fragility caused by the ectopic pregnancy in the caesarean section brought us to recommend a prophylactic caesarean section around 37. The high risks of hemorrhage required a medical center with embolization possibilities. A review of literature in order to define the medical care adapted in this case was come out.

[Obstructive Sleep Apnea Syndrom during pregnancy: prevalence of main symptoms and relationship with Pregnancy Induced-Hypertension and Intra-Uterine Growth Retardation]. / Le syndrome d'apnées du sommeil pendant la grossesse: prévalence des symptômes cliniques et corrélation avec la pathologie vasculaire gravidique.

OBJECTIVE: To investigate the frequency of main symptoms of Obstructive Sleep Apnea Syndrom (OSAS) and their relationship with Pregnancy Induced-Hypertension (PIH) as well as Intrauterine Growth Retardation (IGR) as suggested by recent studies. METHODOLOGY: Four hundred (and) thirty-eight enquiry forms completed during post-partum period were analysed, after exclusion of multiple pregnancies. Collected data were demographic characteristics, obstetrical events, sleep disorders during last trimester, screening of snoring and vigilance troubles with an Epworth score. RESULTS: Forty-five percentages of the patients reported to have habitual snoring during pregnancy. Among these, 85% were non-snorers before pregnancy. Daytime somnolence concerned 84,5% of the population with an Epworth score significatively increased (P<0,0001). The prevalence of PIH was found to be 4,5%, with two apparently independent risk factors: the body mass index (OR=1,1) and an association between snoring and increased vigilance trouble (OR=2,6). No statistical difference was found concerning IGR. CONCLUSIONS: SAS symptoms are frequent during pregnancy and snoring appears to be linked with PIH. However, polysomnographic data are not yet sufficient to explain pathophysiological mechanisms and find relevant diagnostic markers during pregnancy.