[Placenta percreta management in a patient with a severe congenital hypofibrinogenemia].

The obstetrical follow-up of patients with a severe hypofibrinogenemia requires a multidisciplinary collaboration because of potential maternal-fetal complications (recurrent miscarriages, intrauterine fetal demise, post-partum hemorrhage, thrombosis). We report the obstetrical management of a multiparous patient with a severe congenital hypofibrinogenemia associated with a platelet disorder (abnormal phospholipid externalization). A therapeutic strategy based on a biweekly administration of fibrinogen concentrates associated with enoxaparin and aspirin allowed the maintenance of pregnancy.

[Caesarean risk factors during labor for a class III obese nulliparous].

Objectives: Obesity is a well-known caesarean and obstetrical risk factor. However, the number of obese nulliparous women is increasing worldwide, creating an urgent need for research into the impact of obesity on the mode of delivery. Our objective was to identify caesarean risk factors in obese nulliparous women with a BMI (body mass index) greater than 40kg/m.

[Maternal morbidity and mortality associated with conservative management for placenta morbidly adherent (accreta) diagnosed during pregnancy. Report of 15 cases].

Background: High risk of morbidly adherent placenta increased during past years. Their management is controversial. Cesarean hysterectomy, considered the gold standard treatment by American Society, is associated with high risk of maternal morbimortality.

[Cervical cerclage].

Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination.

[Secondary postpartum hemorrhage].

Objectives: To define secondary postpartum hemorrhage (HSPP), to discuss its main etiologies and suggest a proposal for its management.

Materials And Methods: Bibliographic research by crossing keywords: secondary postpartum hemorrhage, delayed postpartum hemorrhage, postpartum bleeding, placental remnant, placental and hysteroscopy.

Results: The HSPP (0.

Benefits of cord blood collection in the prevention of post-partum hemorrhage: a cohort study.

Objective: The aim of this study was to assess the benefit of umbilical cord drainage through cord blood collection (CBC) for the prevention of post-partum hemorrhage (PPH).

Methods: This is a retrospective cohort study based on data collected prospectively including all vaginal delivery of singletons pregnancies after 37 weeks of gestation between July 2011 and May 2013 at the Strasbourg Teaching Hospital. We performed a univariate comparison of PPH risk factors with χ(2) tests and then we built multivariate logistic regressions to predict PPH, severe PPH (>1000 cc), retained placenta over 30 min and manual removal of the placenta.

Extensive pulmonary embolism after severe postpartum haemorrhage: management with an inferior vena cava filter.

We report the case of a 36-year-old woman with an inferior vena cava thrombosis and extensive pulmonary embolism six days after a severe postpartum haemorrhage. She had undergone caesarean section with bleeding managed by massive transfusion, hysterectomy, and two attempts at uterine artery embolization. Systemic thrombolysis and catheter-directed thrombolysis in intensive care were abandoned due to recent and incomplete uterine artery embolization.

Placental abruption: risk factors, management and maternal-fetal prognosis. Cohort study over 10 years.

Objective: To describe maternal and fetal risk factors, diagnosis, management and prognosis of placental abruption (PA).

Study Design: A retrospective cohort study between January 2003 and December 2012 within the three maternity units of a French university hospital. We included 55,926 deliveries after 24 weeks' gestation including 247 cases of PA (0.

Efficacy and safety of labour induction in patients with a single previous caesarean section: a proposal for a clinical protocol.

Purpose: To evaluate the efficacy and safety of induction in women with a single prior Caesarean section.

Methods: This was a cohort study in which we included all singleton pregnancies in patients with a single prior Caesarean who delivered between 2007 and 2012. Methods of induction were ocytocic infusion plus amniotomy (if Bishop score ≥6) or insertion of a Foley catheter (Bishop <6).

Prediction of spontaneous preterm delivery in singleton pregnancies: where are we and where are we going? A review of literature.

Prematurity is the chief cause of neonatal morbidity and mortality. The objective of this study is to review the different methods for predicting preterm delivery in asymptomatic pregnant women and in situations of threatened preterm delivery. A search of the PubMed/Medline database was carried out for the years 1980-2012.

[Abruptio placentae. Diagnosis, management and maternal-fetal prognosis: a retrospective study of 100 cases].

Objectives: To update knowledge on placental abruption because there are few recent series published although the perinatal care has progressed.

Patients And Methods: A retrospective observational study has been conducted on 100 consecutive cases of abruptio placentae, occurring from January 2008 to June 2011, in the two maternity units of the University Hospital of Strasbourg (France).

Results: One hundred and five births among which five twin pregnancies were included.

Prediction of spontaneous preterm delivery in the first trimester of pregnancy.

Objective: To develop a model for predicting premature delivery before 37 weeks' gestation based on maternal factors, obstetric history and biomarkers in the first trimester of pregnancy.

Study Design: Cohort study based on data collected prospectively between 1 January 2000 and 30 November 2011. Multivariate logistic regression was used to construct a model of the risk of premature delivery.

Amniotic fluid embolism: 10-year retrospective study in a level III maternity hospital.

Objective: To provide updated data on amniotic fluid embolism (AFE) based on our population over a 10 year period, and to propose steps for improving current practice.

Study Design: Retrospective study carried out in the Department of Gynaecology and Obstetrics at the Strasbourg University Teaching Hospital between 1 January 2000 and 31 December 2010. Dossiers of patients with AFE were identified using medical information system programme (MISP) coding and cross-checked with the pathology reports (hysterectomy, post-mortem examination).

[Obstetrical management in the event of persistent or worsening postpartum hemorrhage despite initial measures].

Sulprostone infusion must be started without further delay if the first treatment (oxytocin, manual removal of the placenta, uterine revision, vaginal and cervical examinations) has been unsuccessful in the first 30 minutes after delivery. In France, the use of this treatment has been officially authorized in this indication (marketing approval, AMM). Intramuscular and intramyometrial injections being contraindicated, sulprostone is administered through continuous intravenous infusion.

Breech presentation after 34 weeks-a meta-analysis of corrected perinatal mortality/morbidity according to the method of delivery.

We conducted a meta-analysis of the mortality and morbidity of the breech presentation according to the method of delivery. Using the term 'breech', we used the Medline data base to search the English and French-language literature from 1978 to July 1995. Twenty-two studies (7239 deliveries) were found and analysed.

[Tubal sterilization].

A recent French law, passed on July 4th, 2001, authorizes a person of age to voluntarily undergo a sterilisation on her request. The practitioner has the legal obligation to inform the person of the consequences and the possible complications of the operation. Recent technical progress as well as its assessment on a large epidemiological scale has modified the given data.

[Massive feto-maternal transfusion. Report of 3 cases with review of the literature].

Massive feto maternal hemorrhage is rare. Early diagnosis is important because massive feto-maternal hemorrhage has a poor prognosis. The clinical manifestations of transplacental hemorrhage are related not only to the size of the hemorrhage but also to the time at which the hemorrhage occurs.

Etiology and prevention of pulmonary complications following beta-mimetic mediated tocolysis.

Objectives: This study documents biological (haematocrit variations) and therapeutic parameters (salbutamol doses, volumes perfused) in two groups tocolysed with salbutamol, one with and the other without APO in order to define the risk factors linked to APO and to establish a standard protocol of management.

Study Design: This retrospective study includes data from 68 intravenous salbutamol tocolysis with four resulting APOs, carried out between January 1st, 1993 and December 31st, 1995.

Results: There was an excessive level of salbutamol administered over 48 h in the complicated APO-group (122.

Antenatal diagnosis of brain damage in the survivor after the second trimester death of a monochorionic monoamniotic co-twin: case report and literature review.

At 28 weeks of amenorrhea, 1 fetus of a monoamniotic twin pregnancy died. Ultrasound and Doppler investigations of the surviving twin were normal. Three weeks later, endovaginal ultrasound and magnetic resonance imaging revealed massive bilateral cerebral ischemic necrosis in the surviving twin.

Cervico-vaginal fetal fibronectin: predictive value during false labor.

Objective: The purpose was to determine to what extent fetal fibronectin was a discriminative test of preterm delivery in patients hospitalized for uterine contractions without modification of the cervix.

Study Design: The prospective double-blind study included patients hospitalized between 24 and 34 week for false labor. Cervicovaginal swabs were obtained and assayed for the presence of fetal fibronectin by means of a monoclonal antibody assay.