[Definition of pregnancy losses: Standardization of terminology from the French National College of Obstetricians and Gynecologists (CNGOF)]. / Standardisation de la terminologie des pertes de grossesse : consensus d'experts du Collège national des gynécologues et obstétriciens français (CNGOF).

OBJECTIVE: While a number of glossaries have been produced by various authorities in different countries, at present there is no internationally accepted common set of definitions for many terms used to describe pregnancy losses. The objective of the current study was to provide a standardized French/English terminology/glossary relating to pregnancy losses. METHODS: Literature review, construction of a glossary and rating of proposals using a formal consensus method. The glossary was subject of a critical comprehensive review by a meeting of professionals (multidisciplinary panel). RESULTS: A miscarriage is a spontaneous evacuation of an intra-uterine pregnancy<22WG. A missed early miscarriage is when ultrasound (<14WG) shows no growth of intra-uterine sac/embryo and/or loss of fetal heart activity. An early miscarriage is when spontaneous evacuation of intra-uterine pregnancy occurs <14WG. A complete early miscarriage is when there is no retained products of conception (empty uterus on ultrasound) and no bleeding nor pain. Incomplete early miscarriage is when ultrasonography shows retained products of conception in the uterine cavity (including cervical canal). Repeat miscarriage or recurrent pregnancy loss is when the woman experiences 3 or more consecutive miscarriages <14WG. A late miscarriage is when there is spontaneous evacuation of pregnancy ≥14WG and <22WG. A threatened late miscarriage is when shortening/opening of the cervix±uterine contraction occur ≥14WG and <22WG. An intra-uterine fetal demise is when there is a spontaneous loss of fetal heart activity ≥14 WG. CONCLUSION: The final current terminology should be used by all healthcare professionals.

[Sickle cell anemia and pregnancy: review of 68 cases in Guadeloupe]. / Drépanocytose et grossesse: revue de 68 observations en Guadeloupe.

Pregnancy in women with major sickle cell syndromes is a high risk maternofetal situation. This descriptive study presents the features and the clinical course of 68 pregnancies in sickle cell women who were delivered in Guadeloupe from January 1(st) 1993 to December 31(st) 1997. Specific complications were observed in all hemoglobin types, but with a severer course in SS women. Painful vaso-occlusive crises were the main causes of hospitalisation (88% of SS pregnancies and 27% of SC pregnancies) associated most often with worsening anemia and / or infection. Acute chest syndrome was observed in all genotypes at any time throughout pregnancy and during the post partum period. One death occurred (a 16 years old SBeta(+)thal woman). Fetal mortality and morbidity were also high, intrauterine growth retardation and fetal death being the most frequent fetal complications. The rates of prematurity (21%) and caesarean section (48%) were higher than in the whole population. Three (3) neonatal deaths occurred. A multidisciplinary and specific approach, vigilance of health care providers and patient compliance are required to manage efficiently pregnancy, delivery and post partum in sickle cell women.

Urethral cytology and diagnosis of the pregnancy term. About some observations on the use of this method in an hospital setting.

A retrospective study of routine urethrocytograms performed over a 10-year period in 3,478 pregnant women for the diagnosis of pregnancy term was carried out to determine the reliability of urethral cytology when two, three, or four successive urethral smears were performed at 2- or 3-day intervals, and to investigate the correlations between the cytological results and the neurological ages of newborns. Microscopical examination of the 3,478 routine smears demonstrated the existence of a before-term aspect, a near-term aspect, or an at-term aspect in 7.4%, 66.7%, and 22.1% of cases, respectively. The diagnosis of post-term was noted only in 1 smear. Repeated urethrocytograms (1, 2, or 3 smears after the firstone) in women with a previously diagnosed before-term aspect or a near-term aspect revealed the occurence of the at-term aspect over time. Concordant correlations between cytological results and the neurological ages of the newborns were noted in 98.1% of cases. Three developmental stages (beginning, middle, end) of the near-term aspect and three stages of the at-term aspect were described. Due to its interest, the urethral-smear method should be worth generalizing as the other laboratory examinations that are routinely used to determine the term of pregnancy.

[Double cystic duct. Apropos of a case]. / Le canal cystique double. A propos d'un cas.

In relation to a case of duplicated cystic duct encountered in surgical practice and based on a review of the literature, the authors stress the rarity of this condition. After reviewing the classification of the accessory hepatic ducts, they emphasise the surgical consequences of failure to recognise this type of anomaly during cholecystectomy.