Les malformations artério-veineuses utérines sont une étiologie possible de métrorragies persistantes notamment en cas d´antécédent de fausses couches, de maladies trophoblastiques. Les auteurs rapportent les aspects diagnostiques et thérapeutiques de deux observations de malformations artério-veineuses utérines compliquant les suites du post-abortum à la maternité du Centre Hospitalier Universitaire de Pointe à Pitre en Guadeloupe. Les patientes ont présenté des métrorragies dans les suites d´un avortement traité par curetage. L´échographie couplée au Doppler a suspecté une malformation artério-veineuse. L´artériographie confirme le diagnostic et permet dans le même temps la réalisation d´un traitement conservateur par embolisation artérielle. Aucune complication n´est enregistrée. La méconnaissance des malformations artério-veineuse utérine peut avoir des conséquences délétères allant d´une hystérectomie d´hémostase par hémorragie cataclysmique au décès.
Objective: The objective of this work is to compare two gestational diabetes screening strategies. Patients and methods: We conducted a comparative randomized study that screened gestational diabetes on pregnant women who are between 24 th and 28 th weeks of amenorrhea. We conducted the trials either by measuring fasting glucose values or by a glucose tolerance test performed two hours after oral loading of 75 g glucose (WHO test). The study involved 580 pregnant women (290 for each type of trial) who came for antenatal appointment at the reference maternity hospital in Porto-Novo (Benin) between February 2 nd , 2015 and January 31 st , 2017. Results: We detected 26 cases (9%) of gestational diabetes by the "fasting glucose value measurement method" as compared to the 18 cases (6.2%) detected by the WHO test, leading to a p-value of 0.209. The two types of test were equally relevant: Sensitivity (59.09% vs. 40.91%), specificity (50.75% vs. 49.25%), positive predictive value (8.97% vs. 6.21%), and predictive value negative (93.79% vs. 91.03%). All pregnant women tested "negative" between their 24 th and their 28 th weeks of amenorrhea, were tested again during the 32 nd week of amenorrhea, using the WHO test method and no new case of gestational diabetes was detected. Conclusion: Fasting glucose value measurement method can be an alternative method for gestational diabetes screening in a population where the WHO test is not available.
Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 -3.20)] and ultrasound examination of cervical length <25 mm [RR 2.44 IC 95% (1.43 -4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.How to cite this paper: Ogoudjobi, O.M., Tshabu-Aguemon, C., Lokossou, M
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