Les premiers cas d'infection dus à un nouveau Coronavirus, le SARS-CoV-2 ont été enregistrés en Chine en décembre 2019. Cette maladie, désormais appelée COVID-19, a été déclarée comme pandémie par l'Organisation Mondiale de la Santé (OMS) trois mois après soit en mars 2020. Le plus souvent à l´origine d´un syndrome infectieux sans gravité, associant à différents degrés des symptômes bénins (fièvre, toux, myalgies, céphalées et éventuels troubles digestifs). Le SARS-CoV-2 peut être à l´origine de pathologies pulmonaires graves et parfois de décès. Les données sur les conséquences pendant la grossesse sont limitées. À l'heure actuelle, les données concernant l'infection par SARS-CoV-2 sont rassurantes et n'indiquent pas un nombre d'infection plus élevé ni un risque surajouté de complications chez la femme enceinte par rapport à la population générale. Quelques exceptionnels cas de mortalité maternelle existent, mais surviennent le plus souvent sur des terrains qui présentent d'autres pathologies, particulièrement la pré-éclampsie. L´objectif de notre travail est de rapporter les données cliniques, biologiques et évolutives materno-fœtales, à travers une étude rétrospective au sein de l´Hôpital Militaire Marocain COVID-19 de Benslimane, s´étalant sur une période de 3 mois allant du 21 juillet au 21 octobre 2020.
Cyclic vomiting syndrome (CVS) is defined by episodes of vomiting lasting from a few hours to several days, alternating with periods of no symptoms. Various symptoms can be associated with vomiting such as nausea, migraine or abdominal pain. Common triggers of CVS include infection, psychological stress and menstruation. CVS's diagnosis requires exclusion of alternative diseases particularly neurological and gastrointestinal. CVS shares many common features with catamenial migraine including treatment. We herein report a case of CVS in a 16 years old girl characterized by stereotypical vomiting attacks occurring in every menstrual period. Recurrent vomiting episodes began 2 years before admission. Given the negativity of paraclinical exams and the absence of response to different therapeutic approaches as well as the similarity with catamenial migraine, we treated our patient with permenstrual percutaneous oestrogen for six months. The evolution was marked by the disappearance of symptoms within the first month and the absence of their recurrence after treatment cessation during a follow-up of 6 years.
Minimally invasive gynecologic surgery such as hysteroscopy has a low risk of complications. Infections, however, are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease, and endometriosis. We report the case of a patient who underwent operative hysteroscopy without immediate complications and was admitted 2 days later to the emergency department in a severe state of septic shock. With multiple organ failures requiring admission to an intensive care unit, the patient died despite extensive antibiotic therapy and vasoactive drugs. Ascending infection can be a potentially fatal complication of hysteroscopy, even in the absence of known risk factors.
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