Background: The discovery of a lethal or disabling malformation requires a thoughtful decision in the event of a termination of pregnancy on medical grounds. The termination of pregnancy can be selective in the case o...Background: The discovery of a lethal or disabling malformation requires a thoughtful decision in the event of a termination of pregnancy on medical grounds. The termination of pregnancy can be selective in the case of multiple pregnancies if a twin is suffering from a serious condition. Objective: To report a case of anencephaly on a twin pregnancy and conduct a review of literature. Case: This is a 30-year-old woman carrying a pregnancy obtained after the third attempt at in vitro fertilization (IVF) with transfer of two embryos. No risk factor was found on this pregnancy except for the twinning. The diagnosis was made at 14 weeks +1 day during first term ultrasound, which discovered an on-going bi-chorial bi-amniotic twin pregnancy, with twin B (TB) carrying a defect on his head. A selective interruption was performed on TB at 16 weeks by cordonal injection with potassium chloride. The pregnancy went on without incident and with spontaneous vaginal delivery of the second twin at 39 weeks of pregnancy. Despite the selective termination, the pregnancy went on without any complication. Conclusion: Anencephaly on twin pregnancy is a rare occurrence. In a bichorial pregnancy, a selective feticide can improve the gestational age at birth.展开更多
Objective: To assess the efficiency and tolerance of misoprostol versus oxytocin in Active Management of the Third Period of Childbirth. Framework and Method of Study: The study was carried out at the Porto-Novo unive...Objective: To assess the efficiency and tolerance of misoprostol versus oxytocin in Active Management of the Third Period of Childbirth. Framework and Method of Study: The study was carried out at the Porto-Novo university maternity in Benin. The hospital is level 3. He acted in a randomized clinical trial with a descriptive and comparative aim referred from 1st January 2017 to 31st December 2017. We included all eligible women in labor in the delivery room during the study period and at that gestational age was greater than or equal to 37 weeks of amenorrhea, delivery was done through vaginal birth and delivered with a live birth and agreed to participate in the study. The cases eligible by order of admission were grouped in blocks of two, “Misoprostol” and “Oxytocin” corresponding to the Active Management of the Third Period of delivery. The data collected were captured and analyzed using the SPSS version 20 software. For the comparison of the results, we used the chi-square statistical test and the difference was assumed to be statistically significant for a p ≤ 0.05. The confidentiality of parturient was respected. Results: we recorded 1234 of which were delivered via vaginal birth. The Active Management of the Third Period of Delivery was carried out in 1202 parturients. According to our inclusion criteria, 892 parturients were retained for the study, of which 446 for each group. The average age of parturients was 26.94 ± 5.65 years. Almost pregnancies were mono-fetal (95.7% vs. 93.5%). The average time to expel the placenta after utero-tonic administration was 4.05 ± 0.27 min in the “Misoprostol” group versus 3.82 ± 0.52 min in the “Oxytocin” group (p > 0.05). We had only 9 cases of placental retention in the group “Misoprostol” versus 5 cases in the “Oxytocin” group. Most of the parturients had blood loss less than 500 ml (96.2% vs. 96.6%). The frequency of delivery hemorrhage was 3.8% in the “Misoprostol” group versus 3.4% in the “Oxytocin” group. The mean blood volume lost was 284.33l ± 13.31 ml in the “Misoprostol” group versus 225.94 ± 21.52 ml in the “oxytocin” group. Maternal prognosis was generally good in both groups. Conclusion: Misoprostol may be an alternative in Active Management of the Third Period of Delivery especially in developing countries where the cold chain is often lacking.展开更多
文摘Background: The discovery of a lethal or disabling malformation requires a thoughtful decision in the event of a termination of pregnancy on medical grounds. The termination of pregnancy can be selective in the case of multiple pregnancies if a twin is suffering from a serious condition. Objective: To report a case of anencephaly on a twin pregnancy and conduct a review of literature. Case: This is a 30-year-old woman carrying a pregnancy obtained after the third attempt at in vitro fertilization (IVF) with transfer of two embryos. No risk factor was found on this pregnancy except for the twinning. The diagnosis was made at 14 weeks +1 day during first term ultrasound, which discovered an on-going bi-chorial bi-amniotic twin pregnancy, with twin B (TB) carrying a defect on his head. A selective interruption was performed on TB at 16 weeks by cordonal injection with potassium chloride. The pregnancy went on without incident and with spontaneous vaginal delivery of the second twin at 39 weeks of pregnancy. Despite the selective termination, the pregnancy went on without any complication. Conclusion: Anencephaly on twin pregnancy is a rare occurrence. In a bichorial pregnancy, a selective feticide can improve the gestational age at birth.
文摘Objective: To assess the efficiency and tolerance of misoprostol versus oxytocin in Active Management of the Third Period of Childbirth. Framework and Method of Study: The study was carried out at the Porto-Novo university maternity in Benin. The hospital is level 3. He acted in a randomized clinical trial with a descriptive and comparative aim referred from 1st January 2017 to 31st December 2017. We included all eligible women in labor in the delivery room during the study period and at that gestational age was greater than or equal to 37 weeks of amenorrhea, delivery was done through vaginal birth and delivered with a live birth and agreed to participate in the study. The cases eligible by order of admission were grouped in blocks of two, “Misoprostol” and “Oxytocin” corresponding to the Active Management of the Third Period of delivery. The data collected were captured and analyzed using the SPSS version 20 software. For the comparison of the results, we used the chi-square statistical test and the difference was assumed to be statistically significant for a p ≤ 0.05. The confidentiality of parturient was respected. Results: we recorded 1234 of which were delivered via vaginal birth. The Active Management of the Third Period of Delivery was carried out in 1202 parturients. According to our inclusion criteria, 892 parturients were retained for the study, of which 446 for each group. The average age of parturients was 26.94 ± 5.65 years. Almost pregnancies were mono-fetal (95.7% vs. 93.5%). The average time to expel the placenta after utero-tonic administration was 4.05 ± 0.27 min in the “Misoprostol” group versus 3.82 ± 0.52 min in the “Oxytocin” group (p > 0.05). We had only 9 cases of placental retention in the group “Misoprostol” versus 5 cases in the “Oxytocin” group. Most of the parturients had blood loss less than 500 ml (96.2% vs. 96.6%). The frequency of delivery hemorrhage was 3.8% in the “Misoprostol” group versus 3.4% in the “Oxytocin” group. The mean blood volume lost was 284.33l ± 13.31 ml in the “Misoprostol” group versus 225.94 ± 21.52 ml in the “oxytocin” group. Maternal prognosis was generally good in both groups. Conclusion: Misoprostol may be an alternative in Active Management of the Third Period of Delivery especially in developing countries where the cold chain is often lacking.
