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Figurelli J.,Service de gynecologie et dobstetrique | Bresson L.,Center Oscar Lambret | De Gasquet B.,Institute Of Gasquet | Bigot J.,Service de radiologie | And 3 more authors.
Journal of Obstetrics and Gynaecology Canada | Year: 2014

Background: An incarcerated uterus refers to the retroversion of a pregnant uterus within the pelvis due to the absence of a forward tilt at the end of the first trimester. An incarcerated uterus that is overlooked or only discovered perpartum can cause severe obstetrical complications. Several authors have shared their experience with uterine incarceration management at 12, 14, and 16 weeks of amenorrhea. Case: Our report concerns a case of uterine incarceration management at 21 weeks of amenorrhea, achieved by way of a specific anesthesia protocol and the positioning of the patient, which allowed the disimpaction of the uterus with the help of external maneuvers. No recurrence was observed. Conclusion: Uterine incarceration management is possible beyond 16 weeks of amenorrhea. © 2014 Society of Obstetricians and Gynaecologists of Canada.


Thirty patients presenting a pudendal neuralgia received a series of three transgluteal nerve blocks at 6-8 weeks interval with lidocaine and 80. mg of methylprednisolone acetate. Motor distal latency of the affected pudendal nerve improved in 94.7% of the three-block-series. However, only 73% of the patients had pain relief and no predictive factor of efficacy could be identified. © 2014 Elsevier Masson SAS.


Kebaili S.,Service de Gynecologie et dObstetrique | Charfi S.,Laboratoire Danatomie Et Of Cytologie Pathologiques | Abid M.,Service de Gynecologie et dObstetrique | Louati D.,Service de Gynecologie et dObstetrique | And 3 more authors.
Imagerie de la Femme | Year: 2013

Myoid hamartoma of the breast is a rare variant of mammary hamartoma. It is composed of mammary glandular, fibrous and fatty tissues and areas of smooth muscle. We report the case of 45-year-old-woman with mammary hamartoma. We describe imaging appearance and pathological features of this rare entity. Etiopathogenesis of smooth muscle tumors are discussed. © 2013 Elsevier Masson SAS. Tous droits réservés.


Bardou M.,French Institute of Health and Medical Research | Hadi T.,French Institute of Health and Medical Research | Mace G.,Service de Gynecologie et dObstetrique | Pesant M.,University of Milan | And 8 more authors.
American Journal of Obstetrics and Gynecology | Year: 2014

Objectives To study the influence of pregnancy and labor on the proportion and level of activation of monocyte subpopulations in human pregnancy. Study Design Peripheral blood samples were obtained from healthy nonpregnant women (n = 6); women in the third-trimester of healthy pregnancies (n = 18) and women with preterm premature rupture of membranes (n = 46), just before delivery for the last 2 groups. Monocyte subpopulations were characterized by flow cytometry using CD14, CD16, and activation level using macrophage chemoattractant protein-1 (MCP-1) and CCR2 antibodies. Results The relative proportion of each monocyte subset in nonpregnant women was similar to that in women with healthy or complicated pregnancies. However, pregnancy was associated with a significant decrease in MCP-1 expressing monocytes (79.5% ± 19.8% vs 9.3% ± 6.8% and 11.9% ± 8.3% for nonpregnant, healthy pregnancy, and preterm premature rupture of membranes (respectively, P <.05). Spontaneous labor was associated with a return to nonpregnant values for the proportion of MCP-1 expressing monocytes in both normal (74.4% ± 16.9) and preterm premature rupture of membranes pregnancy (68.4% ± 35.6), irrespective of the mode of delivery (vaginal or cesarean section). This was not observed in women who delivered without spontaneous labor onset. CCR-2 (MCP-1 receptor) expression was not modified in monocytes at the time of labor, but was significantly increased in granulocytes (3646 ± 1080 vs 7338 ± 2718 for nonlaboring and laboring preterm premature rupture of membranes, respectively, P <.05) Conclusion In light of previous reports of a role for MCP-1 in labor, our results suggest the downregulation of activation levels of monocytes, via MCP-1 expression might be involved in maternofetal immune tolerance. Monocyte reactivation might be associated with labor. © 2014 Mosby, Inc. All rights reserved.


Peigne M.,Service de Gynecologie Endocrinienne et Medecine de la Reproduction | Andrieux J.,Laboratoire Of Genetique Medicale | Deruelle P.,Service de Gynecologie et dObstetrique | Vuillaume I.,Laboratoire Of Biochimie Et Biologie Moleculaire | Leroy M.,Service de Gynecologie Endocrinienne et Medecine de la Reproduction
Fertility and Sterility | Year: 2011

Objective: To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction. Design: Case report. Setting: Academic reproductive medicine center. Patient(s): A 31-year-old woman, gravida 0, who underwent her second IVF cycle after three IUIs. Intervention(s): After 5 years of primary infertility, three IUIs, and one IVF, the patient underwent her second IVF cycle with transfer of two fresh embryos on day 2. Main Outcome Measure(s): Development of five separate embryonic sacs. Fetal reduction to twins at 12 weeks of gestation. Successful pregnancy and delivery. Deoxyribonucleic acid analysis of the three reduced embryos, the live-born twins, and their parents. Result(s): Analysis of the seven DNA samples, because all were different, confirmed the superfecundation and disproved the zygote's division after transfer. Fetal growth restriction motivated preterm delivery by cesarean section. Both twins were in good health. Conclusion(s): Superfecundation can explain high-order multiple pregnancy and can be proved by DNA analysis. Couples must be informed because of the implications of fetal reduction for ethical issues, risks of pregnancy loss, fetal growth restriction, preterm delivery, and its consequences. © 2011 by American Society for Reproductive Medicine.


Amadou A.,Service de radiologie | Sonhaye L.,Service de radiologie | Douaguibe B.,Service de gynecologie et dobstetrique | Tchaou M.,Service de radiologie | And 3 more authors.
Medecine et Sante Tropicales | Year: 2013

Objective. To report a series of cases of anencephaly in twin pregnancies and assess the prognosis of the normal twin. Patients and methods. Retrospective study covering 4 years, at the CHU Campus in Lomé, assessing the sonographic aspects and management of cases of anencephaly in twin pregnancies. Results. Anencephaly was found in 6 twin pregnancies. The mothers' mean age was 31 years and all had a very low socioeconomic status. All had drunk a plant infusion of an unknown chemical composition in early pregnancy. Mean gestational age at diagnosis was 25 weeks. Ultrasound performed in all cases showed that 5 cases involved monochorionic diamniotic placentas, and 1 case a dichorionic placenta. Both fetuses were alive at diagnosis in all cases: one had anencephaly and the other twin was normal. The average estimated weight of the anencephalic twin at diagnosis was 659 grams, and of the normal twin, 749 grams; growth was thus discordant. Hydramnios was noted in all cases. Expectant monitoring was instituted; both twins died before 30 weeks in 4 cases. Conclusion. Anencephaly in twin pregnancy is a rare occurrence. Ultrasound can be involved in the diagnosis and management.


Masmoudi J.,Service de Psychiatrie A | Trabelsi S.,Service de Psychiatrie A | Charfeddine F.,Service de Psychiatrie A | Ben Ayed B.,Service de Gynecologie et dObstetrique | And 4 more authors.
Encephale | Year: 2010

Introduction: Postpartum depression (PPD) is a frequent psychiatric condition, but little is known about its potential bipolar nature and the implication of affective temperaments. The goal of this study is to estimate the prevalence of PPD and assess the affective temperamental profile of those affected. Method: The study was conducted in the department of gynecology and obstetrics of the CHU of Sfax, Tunisia. The selected population included all 213 consecutive admissions (mean age = 29 years). Postpartum depressive symptomatology (SPPD) was assessed during the first week after delivery by using the Postnatal Edinburgh Scale Depression (EPDS) in its Arab version. The Arabic version of the Temperaments Auto-questionnaire of Memphis, Pisa, Paris, and San Diego (TEMPS-A) was simultaneously filled out by subjects. The subjects were divided into two subgroups, depressed (D+) versus not depressed (D-), for comparative analyses. For affective temperaments, dimensional (mean scores) and categorical (quartiles) approaches were used. Results: Forty-one women (19,2%) had a score higher than 9 on the EPDS (group D+). Lower educational level, lower social and family support, dysfunctional marital relationship, problems with accepting the pregnancy and prior psychiatric disorders were significantly more present in the D+ group. The majority of the affective temperaments, excepting hyperthymic, were correlated between them. The EPDS scores were correlated with all temperamental scores, except for hyperthymic. Higher scores on the depressive, irritable, anxious and cyclothymic temperaments were observed in the group D+. Women belonging to the 3rd and 4th quartiles of the depressive, cyclothymic and irritable temperaments and those belonging to the 4th quartile of the anxious temperament were significantly more depressed. Cyclothymic and depressive temperaments seemed to influence the pregnancy acceptance. Other interactions were observed between SPPD, temperamental profiles and quality of marital relation, and family support. The opposite seems true for the hyperthymic temperament, which could be protective against SPPD through better psychosocial conditions. Multivariate regression analysis showed that cyclothymic and anxious temperaments are significant risk factors independently from psychosocial factors, such as problems with accepting the pregnancy, which seemed to be the most important risk factor. Conclusion: PPD represents a frequent disorder, which needs to be correctly screened and recognized especially with its temperamental attributes, a mixture of anxious, irritable, depressive and cyclothymic traits. This complex unstable temperament should be considered as a predisposing factor, which interacts also with other common risk factors. © 2009 L'Encéphale, Paris.


Errarhay S.,b 10 | Bouchikhi C.,Service de Gynecologie et dObstetrique | Chraybi M.,Service de Gynecologie et dObstetrique | Chaara H.,Service de Gynecologie et dObstetrique | And 4 more authors.
Oncologie | Year: 2010

Malignant ovarian germ cell tumours (MOGCTs) are rare but curable at all stages of the disease. We report the case of a 25-year-old patient who consulted for pelvic pain in her 4th day of post-partum. The gynaecological examination revealed a firm mass independent of the uterus. A pelvic ultrasound and abdomino-pelvic tomography revealed a heterogeneous mass probably linked to the ovary, with ascetic fluid. A laparotomy was indicated. It showed an ovarian tumour localized in the left ovary with ascetic fluid. The patient underwent a left salpingo-oophorectomy with biopsies of the right ovary, peritoneum and the omentum. The histological study showed a dysgerminoma and yolk sac tumor. The level of human chorionic gonadotropin and fetoprotein was normal. Sixmonthly abdomino-pelvic tomography and marker measurements revealed no abnormalities. The patient did not experience any recurrence. MOGCTs are rare neoplasms that affect girls and young women and have good prognosis at all stages of disease with optimal therapy and the majority of MOGCT patients retain their reproductive function. © Springer-Verlag 2010.


Aissi G.,Service de Gynecologie et dObstetrique | Sananes N.,Service de Gynecologie et dObstetrique | Veujoz M.,Service de Gynecologie et dObstetrique | Felder A.,Service de Gynecologie et dObstetrique | And 4 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2013

Vasa previa is a rare complication of pregnancy (1/2000 to 1/6000) with a high fetal mortality rate (75 to 100%). We will discuss two case reports of vasa previa: the first was diagnosed before labor, while the second was during delivery. In the first case, the diagnosis of vasa previa was confirmed by a transvaginal ultrasound and color doppler, while the second case involved late diagnosis during delivery and after gross examination of the placenta. Risk factors for vasa previa are: low-lying placenta, bilobed or succenturiate lobed placenta, velamentous and in vitro fertilization (IVF). Antenatal diagnosis of vasa previa is crucial because it allows for prophylactic caesarean section and prevents severe Benckiser's hemorrhage responsible for a very high neonatal mortality. © 2012 Elsevier Masson SAS. Tous droits réservés.


Chbani L.,Service dAnatomie et de Cytologie Pathologique | Znati K.,Service dAnatomie et de Cytologie Pathologique | El Fatemi H.,Service dAnatomie et de Cytologie Pathologique | Harmmouch T.,Service dAnatomie et de Cytologie Pathologique | And 4 more authors.
Oncologie | Year: 2010

Non-Hodgkin primary ovarian lymphoma is an extremely rare tumour of which the histogenesis remains debated. Some authors consider it the manifestation of a generalized lymphoma disease. The prognosis is evaluated on the basis of the clinical stage, the histological type and the phenotype.Wepresent the case of a 13-year-old girl who presented with pelvic pain. Pelvic ultrasonography and tomography confirmed the ovarian origin. The diagnosis of B diffuse large cell lymphoma was established from the anatomic specimen after exploratory laparotomy and pathologic examination. Problems related to this rare entity are discussed in terms of diagnosis and therapy. © Springer -Verlag 2010.

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