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.

[Anti-D prophylaxis in fetal-maternal erythrocyte incompatibility in Tunisia].

Generalization of postnatal prophylaxis using anti-D immunoglobulins decreased the incidence of erythrocyte fetal-maternal incompatibility (EFMI) in the Rhesus system. Few recent studies have investigated the situation of anti-D prophylaxis in Tunisia and its effects on maternal and neonatal health. The aim of this study was therefore to analyze the situation of anti-D prophylaxis in Tunisia to detect defects and propose solutions.

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.

[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.

[Towards a simplification of caesarean section technique: non-closure of peritoneum?].

Objectives: To assess the postoperative morbidity of a technique for caesarean section without closing the visceral and parietal peritoneum.

Patients And Methods: We conducted a prospective cohort study randomized 252 patients over a period of four months (from March 1 to June 30, 2009). We studied the early postoperative morbidity.

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.

[Vein of Galen aneurysmal malformation: a neonatal case with unusual evolution].

We report on a neonatal patient case with a cerebral vascular dilation consistent with a vein of Galen malformation diagnosed on an antenatal doppler ultrasound examination. Antenatal diagnosis was confirmed by fetal MRI scan. After delivery, cerebral MRI scan found the same dilatation and showed no cerebral parenchymal damage.

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.

[Endometriosis with urinary manifestation. A case report].

Endometriosis is an ectopic implantation of endometrial tissue. Authors report a case of a 33 year-old infertile women who presented a deep pelvic endometriosis infiltrating the right ureter with left ovarian endometrioma suspected by the ultrasonography and confirmed with MRI. The patient was treated with Gn-RH analogues with relief of symptoms and normalisation of the upper urinary tract.

[Latex allergy in a hospital environment: results of a study in Sousse (Tunisia)].

Immediate allergy to natural latex has been on the icrease for the last decade in exposed persons and particularly the health personnel. Its prevalence is variable from one study to another. To evaluate the prevalence of later allergy in our nursing staff, we carried out an inguiry in two hospitals in Sousse.