[Adenoid cystic carcinoma of the breast].

One the basis of personal observation and a review of recent literature (which is somewhat sparse), the authors describe the characteristics of adenoid cystic carcinoma of the breast which is a very unusual tumor. They stress the diagnostic difficulties which frequently make it necessary to use histochemical or immuno-histochemical diagnostic techniques which have been widely developed.

[Is peritoneal endometriosis painful?].

Using a study of 306 coelioscopies as a basis, the authors try to define the relationship existing between the observation of lesions of peritoneal endometriosis and the symptom of pain. Certain observations raise the doubt of there being a cause/effect relationship (i.e.

[Age, gynecologic status and urinary stress incontinence].

Based on a series of 1,000 female patients examined in office practice, the authors of this study seek to define the incidence of USI according to the patient's age gynecological status. Concerning age, this factor only has a clear effect in patients over 35 years of age. No significant difference in the incidence of USI was observed between sexually active women over 35, women approaching the menopause or post menopausal women; for this reason, the authors believe that in these cases, USI is related more to concomitant factors than to trophic lesions which however certainly are also present.

[What lesions of the myometrium are responsible for hemorrhage?].

Based on a personal series of 54 cases of endo-uterine haemorrhage with normal endometrium, the authors show that lesions of the myometrium which may result in haemorrhages, consist mainly of interstitial or submucous myomas and adenomyosis, i.e. lesions on which medical treatments are ineffective.

[Indications and contraindications of peridural anesthesia in obstetrics. Review of the literature].

With the help of an extensive review of the french and foreign literature, and personal statistics concerning 500 peridural anesthesias (PDA), the authors analyze the indications and contraindications of this type of anesthesia, in 1987. It is possible to differentiate well accepted indications: caesarean section, inducement, labor test, dynamic dystocia, delivery of fragile fetus, desire of the patient; definite contraindications: patient's refusal, coagulation disorders, emergency situations, some cardiopathies; debatable indications: breech delivery, scarred uterus, twin delivery, maternal medical problem, where each particular case must be evaluated. In his study, the authors demonstrate that indications tend to become broader and contraindications to become more infrequent.

[Menorrhagia, metrorrhagia and the endometrium. Apropos of 300 cases].

The authors report on the different aspects they have observed when they studied 300 case histories of patients who had a histological examination of the endometrium for menorrhagia or metrorrhagia. In 9.9% of the cases the endometrium was normal.

[Contribution of celioscopy to the diagnosis and treatment of female sterility].

After having specified the current place of celioscopy in the study of female sterility, the authors try to specify, with the use of a short personal series of 64 cases and a large review of the literature, the diagnostic and therapeutic advantage of celioscopy. It is a particularly performing examination for the etiological diagnosis of tubal and peritoneal sterilities, contradicting sometimes the data provided by hysterography. In their experience, it enables to offer a suitable therapeutic strategy in 81% of the cases, whether it is abstention, medical treatment, immediate surgical treatment (per celioscopy, laser or laparotomy) or secondary surgical treatment.

[An ultrasonic trap: pseudocystic degeneration of uterine myomas].

The authors present a rare case of pseudocystic degeneration of fibroids for which they had used an ultrasound scan before the operation. They point out that the ultrasound pictures they found were very similar indeed to those shown by patients with multiloculated ovarian cysts. They emphasize that ultrasound does have its limits in the diagnosis of pelvic tumours.

[Etiology of perimenopausal organic hemorrhages of uterine origin].

The authors study the etiologies of organic uterine bleeding during the menopause in 66 of their own cases. Benign lesions of the endometrium and of the myometrium are, of course, the most common, but the possibility of pregnancy and particularly that of malignant lesions must not be forgotten. The authors emphasize the importance of obtaining endometrial samplings, in particular using the Inocurette, and of the importance of making a histological diagnosis.

[A case of a well-tolerated spontaneous post partum uterine inversion].

The authors report the unusual case of spontaneous inversion of the uterus that occurred three days after a normal delivery. Clinically this was very well tolerated. There did not seem to be a constriction ring which normally occurs in there cases.

[Prognosis for delivery in women with previous cesarean section. Apropos of 209 cases].

The authors have attempted to show the following with the help of 209 cases of delivery in women who had previously had Caesarean sections: Vaginal delivery is possible in approximately one out of every two cases, providing certain precautions have been taken and these are: Maternal morbidity rises to about 12% when a woman is delivered after a previous Caesarean section, whether the delivery is vaginal or, a repeat Caesarean. Furthermore, morbidity rises greatly after a failure of a trial of labour for which the indications should be very carefully considered. The outlook for the fetus is better after a vaginal delivery.

[Supraventricular tachycardia in utero. Apropos of a personal case, review of the literature].

After describing a case of early hydrops fetalis in a fetus demonstrating supraventricular tachycardia (TSVF) the authors review the literature: First they note the increase in the number of cases of TSVF published in the last few years, thanks to better means of monitoring pregnancies and to the place taken by TSVF among the different other troubles of fetal heart rhythm than can occur. The second section enumerates and analyses the pathological associations and the complications that have been observed in cases of TSVF that have been indexed. All have a poor prognosis: as far as those cases where there are faults in the rhythm which are associated with or alternate with TSVF, congestive heart failure occurs in 50% of cases, and organic heart pathological conditions in 20% of cases.

[Prevention of rupture of the uterus before or during birth in women with previous caesarian sections: report on 14 cases (author's transl)].

Based on 14 cases observed during 230 deliveries of women with previous caesarian sections, the authors attempt in define those factors that may weaken hysterotomy scars and provoke uterine rupture. Factors at risk are defined, and can be assessed from the medical history (parity, number of previous caesarians, period since last section, postoperative fever, placenta praevia as the indication for a caesarian, curettage after the operation), and the clinical findings during the present pregnancy (height of the uterus, placenta praevia). Hysterography is an excellent means of evaluating the state of cicatrisation, but this investigational method is rarely available.

[A consideration of "avoidable deaths". A study on early neonatal mortality in Ille-et-Vilaine from 1972 to 1977 (author's transl)].

The authors have made a study of 514 case notes of early neonatal deaths that occurred in Ille-et-Viliane from the 1st January 1972 to the 1st January 1977 among a total of 61,400 deliveries. They had 3 objects in mind: 1. To know what mechanisms had produced these deaths.