Objectives.- The GRECO study has collected data on pregnancies, regardless of their outcome, that occurred in women taking an oral contraceptive. Patients and methods.-The analysis concerned 551 women prospectively re...Objectives.- The GRECO study has collected data on pregnancies, regardless of their outcome, that occurred in women taking an oral contraceptive. Patients and methods.-The analysis concerned 551 women prospectively recruited in services of gynaecology or obstetrics, termination of pregnancy centres, family planning centres or consultations of gynaecology in France throughout 2002 and who were 12 weeks pregnant or less. Results.-Contraception used during the cycle of conception was an estroprogestative combination in 88% of cases, a microprogestative in 8.7% , a macroprogestative in 0.9% or another type of pill in 2.4% . Progestatives were levonorgestrel 59.0% , gestoden 17.2% , desogestrel 4.7% , norethisterone acetate 2.9% , norgestimate 1.8% , cyproterone acetate 2.0% , norgestrel 1.6% . When asked about the potential cause of the oral contraceptive failure, 76.9% of women reported events such as missed pills which were the most frequent cause of failure (60.8% of failures and 80.1% of events, 2.7 ± 2.7 missed pills), followed by vomiting and diarrhoea. 81.5% of women chose to terminate their pregnancy. Discussion and conclusion.-The GRECO study, despite its limitations (retrospective collection of missed pills data, declaratory data)-showed that missed pills, even once, were the most common reason for oral contraceptive failure. The most frequent decision was the termination of pregnancy.展开更多
The genital self- mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency...The genital self- mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.展开更多
Acute fatty liver of pregnancy is a rare clinical syndrome of pregnancy that occurs during the third trimester. Clinicians must have a high index of suspicion for this condition when a woman has nausea or vomiting dur...Acute fatty liver of pregnancy is a rare clinical syndrome of pregnancy that occurs during the third trimester. Clinicians must have a high index of suspicion for this condition when a woman has nausea or vomiting during the last trimester. Early diagnosis and prompt delivery improve foetal and maternal prognosis. We report a case of a previously healthy 23- year-old woman who presented an acute fatty liver of pregnancy with intrauterine fetal death. Based on this experience as well as on medical literature, characteristics of this uncommon pathology are discussed.展开更多
BACKGROUND: We describe a case of cesarean delivery by posterior hysterotomy in a woman with uterine torsion secondary to a blocked retroverted uterus. CASE: At 28 weeks of gestation this patient’s fetus was found to...BACKGROUND: We describe a case of cesarean delivery by posterior hysterotomy in a woman with uterine torsion secondary to a blocked retroverted uterus. CASE: At 28 weeks of gestation this patient’s fetus was found to have club feet, initially suspected to be secondary to sacculation of the posterior uterine segment. At cesarean delivery, intraoperative inspection revealed the uterus to be twisted 180° without evidence of posterior sacculation. The uterine incision was performed on the posterior aspect of the lower uterine segment. CONCLUSION: Fixed uterine retroversion with torsion is associated with fetal abnormalities and may require a posterior uterine incision.展开更多
We report two cases of maternal diaphragmatic hernia during pregnancy. Diaphragmatic hernia is an unusual and severe disease. Maternal and fetal prognosis are threatened. Diagnosis is uncertain when confronted to resp...We report two cases of maternal diaphragmatic hernia during pregnancy. Diaphragmatic hernia is an unusual and severe disease. Maternal and fetal prognosis are threatened. Diagnosis is uncertain when confronted to respiratory and digestive symptoms without any specificity. The chest X ray is the first exam to perform. The objective of this work is to discuss the management of such a pathology in terms of ways of delivery and surgical cure of hernia.展开更多
文摘Objectives.- The GRECO study has collected data on pregnancies, regardless of their outcome, that occurred in women taking an oral contraceptive. Patients and methods.-The analysis concerned 551 women prospectively recruited in services of gynaecology or obstetrics, termination of pregnancy centres, family planning centres or consultations of gynaecology in France throughout 2002 and who were 12 weeks pregnant or less. Results.-Contraception used during the cycle of conception was an estroprogestative combination in 88% of cases, a microprogestative in 8.7% , a macroprogestative in 0.9% or another type of pill in 2.4% . Progestatives were levonorgestrel 59.0% , gestoden 17.2% , desogestrel 4.7% , norethisterone acetate 2.9% , norgestimate 1.8% , cyproterone acetate 2.0% , norgestrel 1.6% . When asked about the potential cause of the oral contraceptive failure, 76.9% of women reported events such as missed pills which were the most frequent cause of failure (60.8% of failures and 80.1% of events, 2.7 ± 2.7 missed pills), followed by vomiting and diarrhoea. 81.5% of women chose to terminate their pregnancy. Discussion and conclusion.-The GRECO study, despite its limitations (retrospective collection of missed pills data, declaratory data)-showed that missed pills, even once, were the most common reason for oral contraceptive failure. The most frequent decision was the termination of pregnancy.
文摘The genital self- mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.
文摘Acute fatty liver of pregnancy is a rare clinical syndrome of pregnancy that occurs during the third trimester. Clinicians must have a high index of suspicion for this condition when a woman has nausea or vomiting during the last trimester. Early diagnosis and prompt delivery improve foetal and maternal prognosis. We report a case of a previously healthy 23- year-old woman who presented an acute fatty liver of pregnancy with intrauterine fetal death. Based on this experience as well as on medical literature, characteristics of this uncommon pathology are discussed.
文摘BACKGROUND: We describe a case of cesarean delivery by posterior hysterotomy in a woman with uterine torsion secondary to a blocked retroverted uterus. CASE: At 28 weeks of gestation this patient’s fetus was found to have club feet, initially suspected to be secondary to sacculation of the posterior uterine segment. At cesarean delivery, intraoperative inspection revealed the uterus to be twisted 180° without evidence of posterior sacculation. The uterine incision was performed on the posterior aspect of the lower uterine segment. CONCLUSION: Fixed uterine retroversion with torsion is associated with fetal abnormalities and may require a posterior uterine incision.
文摘We report two cases of maternal diaphragmatic hernia during pregnancy. Diaphragmatic hernia is an unusual and severe disease. Maternal and fetal prognosis are threatened. Diagnosis is uncertain when confronted to respiratory and digestive symptoms without any specificity. The chest X ray is the first exam to perform. The objective of this work is to discuss the management of such a pathology in terms of ways of delivery and surgical cure of hernia.
