Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 6 Articles
Cervical pregnancy is defined as the implantation of the egg below of the internal\ncervical orifice, and remains a rare clinical entity which affects on average\n1 out of 20,000 pregnancies worldwide. Its hemorrhagic complications\nare life-threatening in case of late diagnosis. It occurs mainly on a history of\ncurettage or caesarian which are the most recognized risk factors. The objective\npursued here is to discuss the possibility of the occurrence of this rare\nclinical entity in a primigravida without risk factors and the different therapeutic\npossibilities according to the technical platforms. Authors report a case\nof cervical pregnancy at 6 weeksâ?? gestation occurring in a primigravida without\nrisk factors who consulted at University clinics of Kinshasa (UCK) for a\ngenital hemorrhage chart. The diagnosis was made using ultrasound and\ntreatment provided by curettage followed by the placement of an intra-\ncervical foley tube for hemostatic purposes. Given its high mortality, the\ndiagnosis must be early even in pregnant women without obvious risk factors.\nThe diversity of therapeutic means gives practitioners a choice depending on\nthe technical platform....
Introduction: The clandestine abortions remain a major health problem in\ndeveloping countries including the Central African Republic. At the main\nmaternity hospital of Bangui in the Central African Republic, a study conducted\nin 2000 indicates that clandestine abortions (CAs) accounted for\n43.4% of all abortions recorded in the service. The purpose of our study was\nto evaluate the evolution of CAs about the health care management efforts\nmade over the last 4 years. Patients and Methods: We conducted a prospective\ndescriptive and analytical study over a period of 4 years (from January\n2016 to December 2019). This study focused on the complications of clandestine\nabortions that occurred during the course of our study at the HCB reference\nmaternity hospital. Results: We identified 267 clandestine abortions for\n783 spontaneous abortions. The frequency of CAs was 34.1%. The highest\nnumber of CAs was observed in patients aged between 20 and 24 years with\nan average age of 23.7 years. The average parity was 2.6. It appeared in our\nstudy that students were the most represented (40.8%). Rescuers were the\nmost incriminated (29.2%) in clandestine abortion (CA). Infectious complications\npredominated in (79.1%) of cases. Antibiotic therapy was almost\nsystematic (96.6%). Laparotomy was performed in (38.9%) cases. The proportion\nof deceased women who had a pregnancy of more than 12 weeks was\nhigher with a statistically significant difference .......................
The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9\ntimes more common in black women. Weâ??ll talk about giant fibroids (GFs)\nwhen uterine height reaches or exceeds the navel. We have initiated this study\nin order to report the epidemioclinical and therapeutic aspects of giant fibroids\nat the Hôpital du Mali. A descriptive retro-prospective study, conducted\nin the service of gynecology of the Hôpital du Mali from November 2017 to\nDecember 2018 were included in this study, any patients, regardless of their\nage, having developed a fibroid, the uterine height of the patient reaching or\nexceeding the umbilicus on physical examination and who were on surgical\ntreatment. We had collected 30 cases of GFs out of the 92 patients who had\nundergone myomectomies, with a frequency of 32.60%. The age group 25 - 29\nyears accounted for 46.6% with an average age of 35 years. Housewives\nrepresented 50% and nulligravida made up 33% of our patients. Desire to become\npregnant was the main reason for consultation in 34.4% of cases. The\nuterine height was between 25 and 29 cm on physical examination in 46.66%\nof cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3%\nof cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our\npatients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy.\nThe treatment is either hysterectomy or myomectomy and depends\non the indications....
There are still some controversies regarding the risks and benefits of fetal reduction from twins to\nsingletons. We aimed to evaluate if fetal reduction from twins to singleton improves pregnancy outcome.\nMethods: Retrospective analysis of all dichorionic-diamniotic twin pregnancies, who underwent fetal reduction.\nPregnancy outcome was compared to ongoing, non-reduced, dichorionic-diamniotic gestations. Primary outcome\nwas preterm birth prior to 37 gestational weeks. Secondary outcomes included: preterm birth prior to 34\ngestational weeks, gestational age at delivery, birthweight, small for gestational age, hypertensive disorders,\ngestational diabetes and stillbirth.......................
Pregnancy-induced Cushingâ??s syndrome (CS) with an adrenocortical adenoma overexpressing\nluteinizing hormone (LH)/human choriogonadotropin (hCG) receptors (LHCGR) has been rarely reported in the\nliteratures. This peculiar condition challenges the canonical diagnosis and management of CS.\nCase presentation: A 27-year-old woman (G2P0A1) presented at 20 weeks gestational age (GA) with overt\nCushingoid clinical features. Adrenocorticotropic hormone (ACTH)-independent CS was diagnosed based on\nundetectable ACTH and unsuppressed cortisol levels by dexamethasone. Magnetic resonance imaging (MRI)\nscanning without contrast revealed a left adrenal nodule while pituitary MRI scanning was normal. A conservative\ntreatment strategy of controlling Cushingoid comorbidities was conducted. At 36 weeks GA, a caesarean operation\nwas performed and a live female infant was delivered. At 8 weeks after parturition, our patient achieved\nnormalization of blood pressure, blood glucose, serum potassium, and urinary cortisol level spontaneously. During\nnon-pregnancy period, stimulation testing with exogenous hCG significantly evoked a cortisol increase. The woman\nunderwent resection of the adrenal tumor at 6 months after parturition. Immunohistochemistry (IHC) showed the\ntumor tissue that stained positive for luteinizing hormone (LH)/human choriogonadotropin (hCG) receptor (LHCGR),\nwhereas negative for both melanocortin 2 receptor (MC2R) and G protein-coupled receptor-1 (GPER-1).\nConclusions: Stimulation test with exogenous hCG after parturition is necessary for the diagnosis of pregnancyinduced\nCS. LHCGR plays an essential role in the pathogenesis of this rare condition....
Obesity in pregnant women increases the incidence of pregnancy-induced\ncomorbidities and the rate of operative deliveries. Purpose of the Study: As bariatric surgery is\nthe reference method of treatment of obesity, we wanted to evaluate its influence on the course of\npregnancy and perinatal outcomes. Material and Methods: Data was collected from 627 female\npatients after bariatric surgery, of whom 107 had a history of pregnancy after the surgery, and 345\nnon-bariatric patients who had a delivery at a tertiary perinatal center. Sixty-one cases were matched\n(1:1) with controls for age, pre-pregnancy BMI and presence of pre-pregnancy comorbidities. The\nmain endpoints were gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH),\nsmall (SGA) and large for gestational age infants (LGA) and cesarean sections (CS). Results: Patients\nafter bariatric procedures were significantly less likely to have GDM.........................
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