[Carcinoma of the cervix stages Ib, II, III. Results of treatment and prognostic factors. Retrospective analysis of 396 cases].

Between 1976 and 1986 we have treated 396 patients with carcinoma of the uterine cervix, stages Ib, II and III. The mean age was 54.2 years.

[Risks of medical complications inherent in technics of assisted procreation (excluding legal incidences)].

Although in France the law is still relatively poor in matters concerning complaints against medical people for accidents and incidents in connection with assisted reproduction, it appeared to the authors that it would be interesting to examine the subjects. There is some French and Anglo-saxon literature about the matter so that the circumstances that can be dangerous for the patients as well as well as for the doctors carrying out the processes can be listed in connection with the medico-legal field. When the legal cases in connection with the manipulation of gametes and of embryos have been excluded, there only remain the risks linked to the complications of the various techniques of assisted reproduction.

[Carcinoma of the cervical stump. Retrospective analysis of 43 cases].

Seven to eight percent of cervix carcinomas are carcinomas of the cervical stump. The prognosis for these tumors has sometimes been considered more unfavourable than that for carcinomas on intact uterus. From 1976 to 1986 we treated 43 patients with carcinoma of the cervical stump.

[Sarcoma of the endometrium. Epidemiology and prognostic factors. Apropos of a study of 22 cases].

Endometrial sarcomas (sarcomas of the endometrial stroma and mixed mullerian tumors) are rare tumors with a bad prognosis. Because of our experience in treating these tumors we have been able to make an analysis of epidemiology and the prognostic factors. We have treated 22 patients.

Fetal cerebral circulation assessment by Doppler ultrasound in normal and pathological pregnancies.

During normal pregnancies (n = 40) the cerebral index (Rc = S - D/S) (with S = systolic and D-telediastolic amplitudes) is always higher than the placental index (Rp), and the cerebro/placental ratio (Rc/Rp) greater than 1. Of 29 pregnant women with hypertension (including two twins), 17 delivered normally (Rc, Rp and CPR normal), 14 delivered an hypotrophic fetus, in 12 out of these 14 pregnancies one of the two indices (Rc or Rp) was abnormal and the cerebro/placental ratio, CPR, was always less or equal to 1. CPR sensitivity was 86% the specificity 100%.

Levels and plasma distribution of free and C4b-BP-bound protein S in human fetuses and full-term newborns.

Levels and plasma distribution of protein S were measured on umbilical cord plasmas from 25 normal full-term newborns and 25 normal fetuses which were between 20 and 31 weeks of gestation. Fetal blood samples were obtained by direct puncture of the umbilical vein under high resolution real-time ultrasound. Total and Free protein S levels were found to be lower in all fetuses and newborns as compared to normal adults.

[Cutaneous angiosarcoma of the breast following surgery and irradiation of breast adenocarcinoma].

We are reporting a localised skin angiosarcoma of the breast. As far as we can tell this is only the fourth time this condition has been published. The tumour appeared 6 years after a conservative lumpectomy with removal of lymphatics and follow-up radiotherapy had been carried out for an adenocarcinoma of the breast.

[Primary pulmonary sarcoma with spindle-shaped cells. Apropos of a case].

Primary pulmonary sarcoma is a very rare malignant tumour. The authors report a case of a fusiform cell sarcoma simulating a pulmonary metastasis in a woman who previously had a mammary carcinoma. Lymph node invasion is rare.

[Doppler examination of the umbilical and cerebral arterial circulation of the fetus].

Umbilical circulation can be explored by Doppler ultrasound methods very easily. The umbilical arteries spectrum provides information on the placental circulation. The diastolic flow is directly related to the vascular resistances of the placenta (Rp).

[Doppler examination of the umbilical arteries. Its role in the surveillance of pregnancy].

Pregnancies with a high risk of fetal growth retardation are at present watched by using clinical observations and biological parameters including ultrasound and estimation of the fetal heart rate. The Doppler waveform in the umbilical arteries provides information about circulatory resistance in the placenta. An index of resistance "R" is evaluated on the Doppler trace.

[Effect of the etiology of sterility on the results of tubal microsurgery].

The authors have carried out a prospective study from the 1 January 1977 to the 31 December 1981 on 168 women, 89.3% of whom (150/168) had pure distal tubal microsurgery and 10.7% (18/168) had mixed surgery.

[Postoperative vaginal pseudosarcoma. Apropos of a case].

We report a case of a pseudosarcoma in the scar of an anterior repair operation. The possibility that the lesion could be sarcomatous was raised by the histologists and by the appearance on the hysterogram of a filling defect in the fundus of the uterus which resembled a sarcomatous lesion. The patient was treated by external irradiation and total hysterectomy and colpectomy.

[Acute fatty liver of pregnancy].

The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy.

[Complications and results of Wertheim's operation performed for the treatment of uterine cancer].

Enlarged colpohysterectomy with lymphadenectomy was performed in 199 patients for cancer of cervix (132 cases), of endometrium (67 cases), of vagina (2 cases) or of tubes (1 case) during combined radiosurgical therapy of these tumors. There was no mortality, the incidence of thrombo-embolic accidents was 3% and urinary fistula was not seen. A lumphocele developed in 7.

[Spontaneous rupture of the liver in pregnancy. Case study and review of the literature].

The authors report a case of "spontaneous" rupture of the liver in a woman of 35 years of age. This occurred immediately after post-partum eclampsia. It was not possible to obtain complete haemostasis using absorbable haemostatic compresses along the convexity of the liver.

[Iatrogenic pneumothorax after puncture of the breast].

The authors describe a very rare aetiology of iatrogenic pneumothorax occurring during breast puncture for cytology. They review the principal origins of iatrogenic pneumothorax and describe the composition of the chest wall beneath the breast.

[Bladder exstrophy and pregnancy. Apropos of 2 cases].

The authors report two cases of pregnant women suffering from exstrophy of the bladder. One of the patients had been operated on in childhood for reconstruction of the bladder, and the other had undergone Coffey's operation, so that both were able to lead practically normal lives in adulthood. Three children were born by prophylactic cesarean.

[Tubal choriocarcinoma: a case].

The authors report a case history of a tubal choriocarcinoma occurring in a woman of 38 years of age. This was 6 years after her second and last pregnancy and was diagnosed before operation. A summary of the complementary examinations is presented: An ultrasound showing a non-specific mass whose value therefore was somewhat limited; A hysterosalpingogram which showed an irregular tubal image suggestive of a cancer of the tube; Pelvic arteriography that made the signs of choriocarcinoma fairly clear.

[Acute gonococcal salpingitis].

The authors describe their experience in handling cases of acute salpingitis in a retrospective study that lasted six years. The protocol of investigation in particular consisted in routine laparoscopy and a complete bacteriological investigation. 266 patients had laparoscopy on suspicion of salpingitis and the diagnosis was confirmed in 199 cases (64.

[Exstrophy of the bladder and pregnancy].

Two patients with bladder extrophy who had been operated on during infancy (the one by reconstruction of the bladder and the other by Coffey's operation) had delivered by Caesarean section, in the one patient of one child and in the other of two normal children. They formed the basis of this study. Vesical extrophy or ectopia vesicae is a rare malformation (in 1/40 000 to 1/50 000 births).