Research
Syndrome De Moschowitz Et Grossesse A Propos Daun Cas Avec Revue De La Litterature
Thrombotic thrombocytopenic purpura (TTP) is a form of thrombotic microangiopathy (TMA) particularly serious because it can be accompanied by a multi-organ failure. Postmortem studies in these patients revealed the presence of thrombi in the microcirculation of most organs, suggesting that the TTP is a multi-systemic disease.We distinguish sporadic PTT, which permanently cures the PTT recurrent, on the contrary characterized by regular and frequent relapses and intermittent PTT, where relapses occur with irregular frequency.Different types of MAT may encounter during pregnancy and postpartum, as PTT, HUS and HELLP syndrome.The latter is a more specific form of MAT of pregnancy and postpartum, it is sometimes difficult to distinguish TTP and HUS.. This distinction can be based on hepatic dysfunction and disseminated intravascular coagulation, present in the HELLP syndrome and absent in TTP and HUS. Some HUS occurring during postpartum may be related to a heterozygous mutation in the Factor H gene (E. Rondeau, personal communication).Treatment of TTP in pregnancy is also based on the achievement of plasma exchange. Pregnancy does not affect the response to treatment of TTP. However, the effects of plasma exchange on the fetus have not been evaluated. Moreover, in these patients there is a risk of relapse of TTP without any pregnancy. HELLP syndrome is important to distinguish because most often requires a fetal extraction. The specificity of the care of these patients and the risk of recurrence in subsequent pregnancies should motivate monitoring of these patients by centers with experience in this kind of pathology. The treatment of this microangiopathy is called it to resuscitation and plasma exchange. We report a case of a case of thrombocytopenic purpurathrombocytopenic misdiagnosed at first, occurring in a parturient with 36SA given birth vaginally a healthy baby, the evolution was favorable to the patient due to start after plasma exchange non-response to cortic
Grossesse Sur Uterus Bicorne Menee A Terme Apropos Daun Cas Avec Revue De La Litterature
Frequency of uterine malformations have an impact on reproduction is difficult to assess. Their detection requires a specific review (hysterosa-lpingogram, hysteroscopy, laparoscopy). Spontaneous fertility can be altered depending on the type of uterine anomaly. All these anomalies can affect the evolution of the design type of false early and late layers of ectopic pregnancy of preterm labor, premature delivery of vascular pathologies of pregnancy and growth retardation intrauterine. Ovarian function is not changed. The uterus bicornis is best known defects and represents about half of the anomalies of the uterus. Surgery, including endoscopic allows precise diagnosis, assessment of prognosis and treatment improves the chances of conception and evolution of pregnancies. The occurrence of such a pregnancy is a dangerous situation that can lead to maternal death, but early diagnosis and proper monitoring can carry pregnancies to term of malformed uterus. Ultrasound screening should enable the systematic identification of such cases to take preventive measures are needed. We report a case of a uterus bicornisunicervical carried a pregnancy to 38SA diagnosed during ultrasound first trimester of pregnancy.
Intoxication with Magnesium Sulfate in the Treatment of Eclampsia A Propos of Three Cases and Review of the Literature
Hypertensive diseases of pregnancy are among the first causes of severe maternal morbidity and mortality especially in developing countries. In developed countries, eclampsia is a rare event, but remains responsible for a significant maternal mortality. For over a century, magnesium sulfate is widely used in the United States in many obstetric indications including the treatment of eclampsia crises. There appears to be no consensus to treat or prevent seizures by magnesium sulfate. However, a large, multicentre, randomised trial compared the efficacy of magnesium sulfate with diazepam or phenytoin in eclamptic women. In this trial, magnesium sulfate was associated with a significantly lower rate of recurrent seizures and lower rate of maternal death than that observed with other anticonvulsants. The main objective of magnesium sulfate prophylaxis in women with preeclampsia is to prevent or reduce the rate of eclampsia and complications associated with eclampsia.However, several arguments balance a wide use of magnesium sulfate: the prevalence of eclampsia in the Western world is very low, the use of magnesium sulfate does not affect the neonatal morbidity and mortality, and it is associated with a high rate of side effects, sometimes severe, such as respiratory depression. Prescription the magnesium sulfate must depend the benefit / risk is directly correlated to theprevalence of eclampsia in the risk group considered report. Despiteseveral meta-analyzes and randomized studies methodologically unassailable with proven benefits in the treatment and prevention of eclampsia, despite the Guidelines for Clinical Practice of several learnedsocieties have formalized its Terms of Use, the use of this molecule remains controversial. Many obstetricians consider that the risks of this treatment outweigh the benefits. This raises questions on the role of this treatment in preventing the occurrence of eclampsia. We report three cases of poisoning by magnesium sulfate in the trea
Flow Nipples and Breast Cancer: Value of Senological Assessment About 40 Cases and Review of the Literature
Nipple discharge is defined as the outcome of a liquid by a variable aspect pore galactophoric outside of lactation and postpartum, c 'is a frequent reason for consultation en senology(3rd complaint breastafter mastodyniaand themasses),The pathologic nipple discharge is defined as a spontaneous flow, unilateral, usually unipore and not milky;although benign etiology in most cases, it may also be a telltale sign of breast cancer. Our retrospective study, involving 40 cases of pyramidectomy performed in 40 patients hospitalized and treated in the service of gynecology and obstetrics at the University Hospital HMIMV RABAT, over a period of 11 years from January 2000 to October 2012, aimed to compare radioclinical data and cytologic to histologic findings and the literature data.In this study it was noted the following characteristics: age, history, clinical, mammography ultrasonography, cytology, galactography, the surgical procedure, the final histology. Nipple discharge was more likely to be related to breast cancer, as in our study, there was a telltale sign of cancer in 4 cases, it is necessary to achieve a balance of complementary imaging to identify and locate the lesion at the origin of the flow.Imperfect sensitivity and specificity of these tests and the technical constraints of galactography have recently led to the search for new exploration flow nipple namely methods: galactoscopy; breast MRI.
