[Acardiac fetus].

Acardiac fetus is a rare lethal fetopathy usually encountered in monozygous pregnancies. Ultrasound prenatal diagnosis has enabled an increasing number of observations and raised the need for an adequate therapeutic approach since the spontaneous prognosis for the healthy twin is unfavorable in half of the cases. An acardiac fetus was identified at 12 weeks gestation in a 36-year-old woman.

[Study and significance of ferritin levels in 104 women using intrauterine devices].

Objective: To study the ferritin level in women using an intrauterine device.

Methods: 104 women were enrolled before and during use of the intrauterine device. The subjects were divided into four groups according to whether or not they had used oral contraception previously.

[The intrauterine device: are there still contraindications? A study on 300 Gyne-T 380 users (1987-1992)].

Uterine malformations, history of infection and nulliparity are the classical contraindications to insertion of an IUD, while uterine scars and malpositions constitute relative contraindications. In a context of a marked reduction in the number of IUD users, the author reviews this method based on his personal experience of 300 cases. The indications for this type of contraception can be safely extended, as it constitutes a valuable alternative to other methods.

[Hematoma of the rectus abdominis muscle. Incident or accident of laparoscopy: A case report].

Laparoscopy can lead to complications in the abdominal wall, usually benign in outcome, including damage to an umbilical or epigastric vessel. A few simple rules can be drawn up to avoid (but not always) this type of accident. The treatment of this complication and the prognosis is discussed.

[Uterine rupture due to placenta accreta at 22 weeks' pregnancy. Apropos of a case].

Although early rupture of the uterus is rare, that does not mean that it should not be considered. The case reported here was of a patient in her third pregnancy who suddenly presented with internal haemorrhage requiring immediate laparotomy at the 22nd week of pregnancy. When a broad rupture at the fundus was discovered total hysterectomy had to be carried out.

[Maternal mortality in 1983. A propos of our experiences at Saint-Antoine].

The maternal mortality rate is approximately 3 per 10,000 in France. This figure is not insignificant and merits further consideration. Mortality has decreased at intervals over the course of history, depending upon certain factors such as maternal age, ethnic origin, the country in which the delivery takes place, economic conditions, the delivery setting, etc.

[The epidemiological study of endometrial adenocarcinoma. From 74 cases seen at the Saint-Antoine Maternity Hospital].

The epidemiologic study of 74 invasive endometrial adenocarcinomas seen over five years confirms the following well-known risk factors: early menarche, disorders of menstruation, hypofertility, and late menopause. Obesity, a positive family history and the presence of another cancer are common findings. Hormone dependent endometrial cancer provides a valuable opportunity for studying hormone and cell receptor concentrations.

[Myomectomy in nonpregnant women. Indications. Technics. Apropos of 70 cases at the Saint-Antoine's Maternity Hospital].

Seventy cases of myomectomy performed over 5 years (1977 to 1982) in the department of Gynecology & Obstetrics of the St Antoine Hospital in Paris are analyzed. During the same period, 465 patients underwent hysterectomy for leiomyoma. A brief review shows that myomectomy is not the best surgical treatment of uterine leiomyoma because of its complications.

[Borderline ovarian tumors: an epidemiologic, diagnostic, prognostic and therapeutic study. Apropos of 20 cases reported at the Saint-Antoine Maternity Hospital].

Twenty cases of borderline ovarian tumors were seen in the Department of Gynecology and Obstetrics at the St. Antoine Hospital over 5 years. The epidemiological study of these 20 tumors, relative to 47 invasive ovarian carcinomas seen over the same period, shows that hypofertility is more prevalent and that patients are younger.

[Comparative study of 15 borderline tumors and 31 cancers of the ovaries. Epidemiologic, diagnostic and therapeutic aspects].

46 epithelial tumours of the ovary were seen over a period of 5 years. These tumours could be subdivided into 15 borderline tumours and 31 invasive cancers. An epidemiological study did not make it possible to find special factors in relationship to these two types.

[External pelvic endometriosis: diagnostic study. Our experience in the maternity department of Saint-Antoine Hospital. A propos of 130 cases].

The circumstances leading to the diagnosis of pelvic endometriosis (adenomyosis excluded) were studied in 130 patients. From the epidemiological data yielded by these cases, the profile of women susceptible to this disease is delineated. Hysterosalpingography is the key to the diagnosis of endometriosis in most instances; however, coelioscopy and/or laparotomy are required to establish the diagnosis, as well as for staging the disease which is important for the choice of therapy.

[Acute upper genital tract infections. II. A. bacteriological study and the therapeutic consequences].

The authors have studied a prospective series of 62 cases of acute upper genital tract infections of different severities. Aerobic and anaerobic bacteriological examination were carried out from different sites: urine, blood, vagina, endocervix, intra-uterine devices and the pouch of Douglas. It is absolutely necessary to follow a strict technique according to the clinical examination in order to interpret the results according to a methodological plan.

[Severe acute genital infections (Based on 100 cases). A clinical study and the contribution of laparoscopy (author's transl)].

A continuous prospective series of 100 cases of severe acute genital infections which were collected over a period of 16 months at the Gynaecological and Obstetrical Clinic of the Saint Antoine Hospital has been studies using the same protocol. Analysing the history given by these patients before the onset of the illness shows how young they were and how frequently they were nulliparous, as well as the role of intra-uterine contraceptive devices. The correlation between the clinical features and those found on laparoscopy which was carried out almost routinely shows the great advantages of this examination.

[Neuropathology and pregnancy. 189 consecutive cases (1971--1976) (author's transl)].

The authors report 189 case histories of pregnant women who had a neurological disorder, which either existed before the pregnancy or were discovered during the pregnancy. The most frequent aetiological conditions were, epilepsy, psychoses, vascular accidents, tumours and disseminated sclerosis. Pregnancy and neuropathology are an association for which the prognosis as a whole is good and linked to the time in the pregnancy when the neurological condition, whether it is stable or not, is discovered.

[Pneumoperitoneum of genital origin. Apropos of a case at the beginning of pregnancy].

The authors studied the literature for similar findings in order to try to classify the different types of pneumoperitoneum when they had a case of pneumoperitoneum of genital origin. They then went on to study the mechanism by which these rare cases of genital pneumoperitoneum occurred: the insufflation or aspiration of air through the tubes, tubal antiperistalsis and uterine or vaginal perforations. From the clinical angle it is essential to eliminate pneumoperitoneum secondary to perforation of a hollow organ, and then to look for signs of peritonitis which only occur in genital pneumoperitoneum due to uterine perforation.