Postoperative Analgesia in Breast Cancer Surgery: Efficiency and Safety of Ultrasound Guided Erector Spinae Plane Block, a randomized controlled double blinded trial.

Introduction: Breast cancer surgeries are the mainstay and usually the first step of treatment.

Aim: To assess the efficiency and safety of ultrasound guided Erector Spinae Plane Block (ESPB) for the management of postoperative pain in patients undergoing elective breast cancer surgery.

Methods: Between December 2018 and June 2019, a prospective, controlled, randomized, double-blinded study was conducted at the maternity and neonatology center of Tunis.

Prognostic value of highly-sensitive troponin in preeclampsia.

Introduction: Pre-eclampsia is a pregnancy complication leading to significant morbidity and mortality. High-sensitivity troponin (hs-cTnI ) is one of the most sensitive cardiac biomarkers, but its variation in preeclampsia remains poorly studied.

Aim: To assess the prognostic value of hyper-sensitive troponin in preeclampsia.

Spontaneous subserosal venous rupture overlying a uterine leiomyoma in a young woman.

Uterine leiomyomas are very common tumors found in women. Rupture of veins on the surface of uterine leiomyoma is an unusual source of hemoperitoneum. It is an extremely uncommon gynaecological cause of hemoperitoneum.

Pelvic Packing for Intractable Obstetric Hemorrhage After Emergency Peripartum Hysterectomy: A Review.

Importance: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Even after emergency peripartum hysterectomy (EPH), bleeding may occur in the setting of acquired coagulopathy. This type of bleeding resistant to clipping, ligating, or suturing could be successfully controlled with a pelvic packing.

Are the Wells Score and the Revised Geneva Score valuable for the diagnosis of pulmonary embolism in pregnancy?

Objectives: To evaluate and to compare the predictive accuracy of the Wells score and the revised Geneva scores for the diagnosis of pulmonary embolism in the pregnant and postpartum population.

Study Design: All pregnant or post-partum patients with a suspected PE and for whom a diagnostic imaging testing was performed (VQ scintigraphy or computed tomography pulmonary angiography) over a 3-year period were included in the study. The Wells and Revised Geneva Scores were calculated on the same cohort of patients and dichotomized into low and intermediate/high probability groups.

[Which surgical strategy to adopt for the management of postpartum haemorrhage and how to improve the effects of hypogastric arteries ligation?].

The objective were to identify the success factors of bilateral hypogastric arteries ligation and to assess its role in surgical treatment of postpartum hemorrhages. We conducted a retrospective study of all the cases of postpartum hemorrhage requiring surgical treatment between January 2008 and December 2011. The study included 88 patients (0,47% of all births).

[Early postpartum discharge: outcomes and risk factors of readmission].

The objective of this study is to evaluate the practice of early postpartum discharge by analyzing maternal readmission rates and identifying readmission risk factors. This is a prospective and analytical study of 1206 patients discharged from hospital on postpartum day 1. For each patient we collected the epidemiological data, the course of pregnancy and childbirth.

Efficacy and safety of pelvic packing after emergency peripartum hysterectomy (EPH) in postpartum hemorrhage (PPH) setting.

Objectives: To study the safety and effectiveness of pelvic packing in the control of post emergency peripartum hysterectomy (EPH) bleeding in a postpartum hemorrhage (PPH) setting.

Study Design: From 39 patients with a severe PPH leading to an EPH (January 2010-December 2013), we identified a group of 17 patients requiring a pelvic packing (packing group) and a second group of 22 patients not requiring a pelvic packing (non-packing group). For each group, transfusion requirements were recorded from time of PPH diagnosis to end of the surgical procedure (P1: Period 1) and from that point to the end management in the SICU (P2: Period 2).

[Late reinterventions after repair of common arterial trunk].

Background: The common arterial trunk is a heart disease in witch a unique arterial trunk, with a unique ventriculo-arterial valve, exits from the ventricular mass and supply directly the coronary, the aortic and also the pulmonary arterial circulations. Its anatomic repair is now possible but necessitates the use of conduit in pulmonary position.

Aim: To evaluate the incidence and the causes of late reinterventions after repair of common arterial trunk.