The consequence of a monstrous and diffuse evolution of the usual epithelial hyperplasia of pregnancy, gravidic gigantomastia is a disabling pathology. Rarely, it poses a problem for management and its etiology is still undetermined. In spite of a benign condition, it is nonetheless a serious one because of the complications associated with excessive growth, the weight of the mammary gland and the compromise of breastfeeding function (through destruction of the nipple-areolar plate and surgery). We report a case of bilateral gravidic gigantomastia in a 31-year-old woman to discuss the diagnostic and therapeutic aspects.

Introduction: Contraceptive implants are one of the most effective methods of birth spacing. Jadelle ® implants consist of two strands that are easy to insert and remove. Although their effectiveness is no longer in question, their use (insertion) requires a surgical procedure with the corollary possibility of complications. These are mainly insertions that are too deep (in the arm muscle), vascular and nerve damage. Material and Methods: Our study focused on complications related to implant insertion. It was a descriptive and retrospective study over thirty-four months, from October 2016 to July 2019, and concerned all patients seen in consultation and who presented a complication related to the insertion of contraceptive implants in the Department of Gynecology and Obstetrics of the National Hospital of Pikine. Results: We collected nine complications managed at the Gynecology and Obstetrics Department of the Centre Hospitalier National de Pikine from 2016 to 2019. These were insertions that were too deep with sometimes nerve damage, infection or incident during anesthesia. The operative procedures were based on the type of complication. Conclusion: Although Jadelle ® has the advantage of having only 2 rods compared to its predecessor Norplant ® , its use is also conditioned by insertion and removal procedures which may experience complications.

The incidence of twin pregnancies, has increased due to assisted reproductive technologies [1]. We note a doubling between 1970 and 2010 from less than 8‰ to nearly 16‰ of pregnancies (Pison et al., 2014; Pison et al., 2015) in developed countries [2] and 17‰ to 20‰ in sub-Saharan Africa. Monozygotic twins are the product of fertilization of a single egg by a single sperm, with the egg splitting into two within the first few days after fertilization. If the division takes place after the 8 th day, the pregnancy is mono-chorionic mono-amniotic (less 1% of cases of monozygotic pregnancies) and represents 1 in 30,000 pregnancies. It is the development of two fetuses within the same amniotic sac, representing the rarest type of twin pregnancy (1% of monozygotic twin pregnancies) but being the one with the highest fetal and maternal morbidity. The main complication feared is coiling and knots of the umbilical cords responsible for abnormal heartbeat, fetal suffering and eventual fetal death. We report the case of in utero fetal death of twins from a mono choral mono amniotic pregnancy secondary to knots and coiling of the cord in order to discuss the diagnostic and therapeutic aspects.

Aneurysm of the abdominal aorta is the result of a weakening of the arterial wall and corresponds to abnormal dilatations of the arteries defined as an increase ≥ 50% of the arterial diameter compared to the normal segments. A long asymptomatic, abdominal aortic aneurysm can be a catastrophic maternal-fetal situation due to the high risk of rupture induced by pregnancy. A rare association between aneurysm and pregnancy poses a problem of diagnosis and standardized management. The lack of knowledge of this condition regularly leads to a delay in management, which is a source of excess mortality. We report the case of a patient with a progressive pregnancy of 12 weeks of amenorrhea who presented with a large sub renal abdominal aortic aneurysm with thrombosis and fissuring in order to discuss the diagnostic and management aspects of this association.