Ectopic Cornual Pregnancy: Case Report

This article showcases a clinical case of ectopic pregnancy lodged in the cornual. A pregnancy implanted in this location is a rarity, making it difficult to diagnose. By describing this case and screening of the literature, we explain the various diagnostic and therapeutic methods, both medical and surgical. Highlighting the importance of conservative treatment flush with the uterine horn, and conclude with some practical recommendations.

Rectal Endometriosis Revealed by a Colonic Tumor Obstruction: A Case Report

Endometriosis is defined as the presence of endometrial tissue that is located outside the uterine cavity, associated with fibrosis and inflammatory reaction. The most common atypical locations are the gastrointestinal tract, urinary tract, lung, as well as abdominal surgical scars. Its diagnosis is still very difficult, especially when it manifests itself as an acute large bowel obstruction. We report the rare case of a 41-year-old patient diagnosed with acute colonic obstruction following a rectal tumor. She had undergone colonostomy even though colonoscopy biopsies were nonspecific, and a computed tomography (CT) scan was requested. It showed an adnexal heterogenous mass, therefore the patient had a laparotomy and a subtotal hysterectomy with bilateral salpingo-oophorectomy and a biopsy of the recto-colonic hinge. Histologic examination revealed a diagnosis of rectal endometriosis. The purpose of this work is to report a rare case of colonic endometriosis responsible for an acute large bowel obstruction.

Is There a Relationship between COVID-19 Infection and the Occurrence of Anencephaly? Observation of the Maternity of Mohammed the VI University Hospital of Marrakech

Introduction: Morocco has experienced, like the whole world, the COVID-19 pandemic. Until the writing of this article, a subjective observation of the increase in the number of anencephaly has been observed in our facility. And since the teratogenic potential of the SARS Cov 2 virus is not sufficiently documented, we wondered if there would be a relationship between the relatively high number of anencephalic fetuses and COVID-19 infection. Aim: the objective of the study is to look for a possible correlation between the period of conception of these anencephalies and the pandemic. Material and methods: This is a retrospective study (from June 1, 2020 to May 31, 2022 in the Obstetrics Gynecology department, Faculty of Medicine and Pharmacy, CADI AYYAD UNIVERSITY Marrakech Morocco) consisting of the analysis of the number of patients in the target embryonic period (namely the closure of the neural tube: D18 to D30 of embryonic life) compared to the reference curves of the evolution of the SARS Cov2 pandemic. Results: The analysis of the number of patients at the target embryonic phase shows that many of our anencephalons (63%) were conceived during periods of high diffusion of the SARS Cov 2 virus in Morocco. Conclusion: Our study suggests a relationship between the COVID-19 pandemic and the occurrence of anencephaly, we cannot, however, highlight the type of direct or indirect relationship that binds them. Therefore, further studies should be considered to better investigate this relationship.

COVID-19 and Pregnancy—Series of Cases and Review of Literature

Objectives: To bring out the clinical, biological, and therapeutic aspects of pregnant women and women in the post-partum infected by the SARS COVID-19 in the University hospital of Marrakesh. To study the vertical transmission of the virus if it exists, and the impact on the newborn. Methods: It is a prospective observational study on women infected by COVID-19 virus admitted in the gynecology obstetrics department of the University hospital of Marrakesh during the period between March 1st and July 15th. Data collection was insured thanks to a customized form containing the medical history, clinical criteria, biological and, radiological findings as well as the treatment and maternal and neo-natal outcomes. Results: The clinical, biological and radiological presentation of COVID-19 infection in pregnant and post-partum women doesn’t seem to be different from general population. Pregnant and post-partum women don’t seem to be more at risk to develop severe features of the disease. Vertical transmission via placenta is possible. COVID-19 infection may cause premature labor, premature rupture of membranes, preeclampsia or fetal distress.

A Case of Complete Neu-Laxova Syndrome: Report and Literature Review

Neu-Laxova syndrome (NLS) is a rare autosomal recessive and early fatal disease. It is a complex entity that includes intrauterine growth retardation, abnormal facial structure, limb and skeletal abnormalities, and ichthyosis and severe malformations of the central nervous system. We report a rare case of recurrence of Neu-Laxova syndrome in a 32-year-old pauciparous woman, which occurred after a first cousin’s consanguineous marriage. Typical ultrasound findings included hydramnios, severe intrauterine growth restriction, craniofacial and central nervous system abnormalities such as ventriculomegaly. The newborn shows a terrible face with a usual craniofacial aspect, eyeball proptosis, puffy hands and feet, large bilateral cleft lip/palate, severe hall body ichthyosis. The overcome was fatal, the death occurred in less than one hour after birth. Consanguinity remains the most implicated cause which is high in developing countries. Prenatal serial ultrasound examinations with genetic counselling should be performed on high-risk pregnant women to terminate affected pregnancies.

Passive Smoking and Other Principal Risk Factors Associated with Low Birth Weight

Background: Neonatal morbidity and mortality is one of the most public health problems in the world. A lot of neonatal deaths occur in foetus with low birth weight (LBW). Several risk factors of LBW have been described in the literature such as maternal age, chronic and gestational hypertension infection and anémia. Smoking is one of the most important preventable risk factor of LBW in developed and developing countries. Aims: In this study, we evaluated the incidence and the impact of passive smoking and some other principle risk factors of LBW. Material & Methods: This case control study was conducted in the department of obstetrics and gynecology of Marrakesh university hospital in Morocco. During a period of 3 years, all LBW babies were included in the study. Data analysis was performed by SPSS software. The association between LBW and each variable was studied by the chi square test comparing cases and controls groups. Logistic regression analysis was performed after including all variables found to have significant differences on univariate analysis. Results: 288 cases of LBW have been identified representing 2.19% of all births. The study of the categories showed that 84.3% of babies were moderate LBW (1500 - 2500 g), including 49 babies from twin pregnancies. 15.7% were very LBW (<1500 g). Several risk factors have been identified in LBW. Passive smoking was significantly associated with LBW [(OR 1.77;CI: 1.22 - 2.25)]. Conclusion: A number of risk factors are related to low birth weight, which is one of the main predictors of infant mortality. This study shows that passive smoking is one of those risk factors and it is a preventable one.

Conservative Management of Placenta Accreta of Seven Cases

Introduction: Placenta accreta is a potentially life threatening obstetrical condition. The incidence has increased. Diagnosis before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Prenatal ultrasonography is used to support the diagnosis and guide clinical management leading probably to favorable outcomes. Actually a conservative option which includes leaving all or part of the placenta in situ when fertility preservation is desired is recommended. Methods: We retrospectively reviewed the medical records of all patients diagnosed with placenta accreta in gynecology-obstetrics department of the university hospital Mohammed the VI of Marrakesh;Morocco;from January the first 2014 to January the second 2016. Results: We found seven cases. We described: The epidemiological characteristics, risk factors, management of placenta accreta, outcomes and prognosis. The incidence of placenta accreta was 1/3847 deliveries. The mean term of delivery was 35 weeks. We have adopted a successful conservative treatment in six cases (71.4%). The radical treatment was adopted in one patient initially admitted for severe post-partum hemorrhage;the prognosis was good in 85.7% cases. Conclusion: Conservative management of placenta accreta is a safe and efficient and is an interesting alternative for hysterectomy.

Dual Trigger in <i>in Vitro</i>Fertilization: A Case-Control Study

Objective: To evaluate the benefit of dual trigger (hCG + GnRH agonist) in patients underwent controlled ovarian stimulation for IVF in an antagonist protocol. Methods: A retrospective case control study was performed (January 2017 to March 2019) in a single IVF center. The dual trigger group (n = 17), ovulation trigger was achieved with both hCG and GnRH agonist while in the single trigger group (n = 34), it was achieved by hCG alone. The first endpoint was the number of mature oocytes retrieved;the secondary endpoints were total number of oocytes retrieved, the number of cleaved embryos obtained (day 3) and blastocysts (day 5/day 6), the number of embryos transferred, the ongoing-pregnancy/miscarriage rate. Results: The dual vs. the single group showed the followings. The number of retrieved oocytes of 7.1 vs. 6.4 (p = 0.68);mature oocytes of 4.6 vs. 4.1 (p = 0.62), day-3-embryos of 2.9 vs. 2.0 (p = 0.2), day-5/6-embryos of 0.3 vs. 0.03 (p = 0.13), transferred embryos of 2.1 vs. 1.8 (p = 0.48);ongoing pregnancy of 1 vs. 9 (p = 0.14);miscarriage of 0 vs. 2 (p = 1). Conclusion: A dual trigger showed no additional clinical benefits. Future large studies are needed to demonstrate a real clinical advantage.