FIGO opinion paper: Drivers and solutions to the cesarean delivery epidemic with emphasis on the increasing rates in Africa and Southeastern Europe.

Cesarean delivery rates are rapidly increasing in Southeastern Europe (to more than 60%), North Africa (with a rate as high as 72% in Egypt), and in urban areas in Southern Africa (a rate of over 50% in Lagos, Nigeria). Data on the background to these increases are scarce, but likely to include poor birthing facilities in general hospitals, convenience for the doctor, private medicine, fear of litigation, socioeconomic status, shortage of midwives and nurses, and disappearance of vaginal instrumental deliveries. Options to reverse cesarean delivery trends are discussed.

Abdominal wall endometriosis: A challenging iatrogenic disease.

Introduction And Importance: Abdominal wall endometriosis is a rare clinical condition associated with abdominal pain and psychologic disorders. It's pathophysiology remains unclear. Clinical history and imaging findings are necessary for the diagnosis.

Cecal volvulus: A rare post-partum complication.

Introduction And Importance: Cecal volvulus is a rare clinical condition. It is characterized by axial twist of caecum, terminal ileum and the ascendant right colon around their mesenteric pedicles. The main pathophysiologic mechanism is cecal hyper mobility associated to precipitating factor such as colonic tumor, abdominal mass or pregnancy.

Oncoplastic breast surgery to treat recurrent granulomatous abscess: A new approach.

Introduction And Importance: Granulomatous mastitis is a rare chronic and benign inflammatory breast disease with challenging diagnosis and management. No commonly recognized recommendations are established. Despite of medical and surgical approaches, relapse rate remains high.

Pelvic actinomycosis: A confusing diagnosis.

Introduction And Importance: Actinomycosis is a rare chronic and suppurative infection caused by anerobic Gram Positive bacteria: actinomyces. Pelvic location is extremely rare, usually associated with history of IUD contraception and doesn't have specific signs. Pelvic actinomycosis diagnosis may be confused with pelvic gynecologic malignancies or abscess.

Lotus petal flap for unusual indication: A recto-vaginal fistula with perineal defect after vaginal delivery.

Introduction And Importance: Three to five percent of vaginal deliveries are complicated by third or fourth degree perineal laceration. Misdiagnosed perineal injuries may be associated with a poor sexual and psychological prognosis. Management of old perineal tears and laceration is challenging with a high failure rate.

Spontaneous acute intussusception in a pregnant woman.

Acute intussusception in adults is rare and particularly so in pregnant women. Its incidence ranges from 0.067% to 0.

Lymphangioma of the ovary: etiology and management.

Lymphangioma of the ovary is an extremely rare lesion. It was first described in 1908 [1] and there is only 19 cases reports in a 50-year literature survey [2]. Lymphangiomas are benign congenital malformations of lymphatic system.

[How to predict spontaneous resolution of early pregnancies?].

Background: Assessment of early pregnancy is indicated in women with suspected abnormalities. It is based on biochemical assessment and on trans vaginal sonography .

Aim: To identify clinical, biological and ultrasonographic parameters that are predictive of spontaneous pregnancy resolution.

Prediction of ectopic pregnancy in early pregnancy of unknown location.

Background: Women having pregnancies of unknown location (PUL) can be defined as those having positive pregnancy test when no pregnancy is visualized on transvaginal ultrasound (TVS).

Aim: To identify diagnostic parameters which are predictive of ectopic pregnancies in women with early pregnancies of unknown location.

Methods: We undertook a prospective observational study of pregnant women with suspected early pregnancy complications.

[Prospective study of the contribution of hydrosonography in the exploration of the uterine cavity].

Background: Recent developments in ultrasound have led to a new exploration technique: hydrosonography.

Aim: To evaluate diagnostic performance of hysterosonography in the assessment of the uterine cavity, by comparing it with standard transvaginal ultrasound and particularly with diagnostic hysteroscopy.

Methods: This is a prospective study over a period of nine months from 1st January to 30 September 2009.

[Safety of Magnesium sulfate in severe preeclampsia].

Background: Several observational studies and randomized trials have described the use of various regimens of magnesium sulfate to prevent or reduce the rate of seizures and complications in women with severe preeclampsia.

Aim: To assess the validity of a service protocol in the management of severe pre-eclampsia all specifying the benefits, complications and side effects of magnesium sulfate .

Methods: We have performed a retrospective descriptive study over two years (2009-2010) concerning 150 patients affected with severe preeclampsia in the department "B" of gynecology and obstetrics of the "Rabta" at the Centre of Maternity and Neonatology of Tunis (third level maternity).

Primary leiomyosarcoma of broad ligament.

Background: Primary broad ligament leiomyosarcoma (LMS) is an extremely rare tumor with few well-documented cases. We are aware of 15 previously reported observations.

Aim: Report of a new case.

Primary leiomyosarcoma of the vagina. Case report and literature review.

Background: The vast majority of primary vaginal cancers are squamous cell carcinoma. The leiomyosarcoma of the vagina is extremely rare neoplasm. It comprising 2% to 3% of vaginal malignancies.