[Anatomical and histological study of the uterosacral ligament: practical surgical consequences] (original) (raw)
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European Journal of Obstetrics & Gynecology and Reproductive Biology, 2021
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Accouchement sur uterus cicatriel
Introduction: The occurrence of pregnancy on a scar uterus is characterized by its high incidence, multiple complications, high rate of morbidity and maternal-fetal mortality. The aim of this work was to evaluate the maternal prognosis during delivery on scar uterus in a poorly equipped environment. Methodology: This is a retrospective and descriptive study with exhaustive sampling carried out in 2 years. Our study's population was constituted by all pregnant women with previous caesarean section scarring uterus who gave birth in the obstetric department of Matanda Hospital in Butembo City. Results: Scarred uterus deliveries accounted for 20% of all deliveries; 26.8% of parturient had a antecedence of vaginal delivery; 39.6% of parturient had severe pelvic narrowing as an indication of anterior caesarean section; and 49.3% had uterus once scarred, 26.9% uterus twice scarred and 14.7% uterus thrice scarred. 72.8% of parturient had an inter-reproductive interval between 13 and 24 months; 98.1% had term pregnancies. Thirteen percent of parturient had a uterine test, among which 41.2% had given birth vaginally; 8.8% of cases of pre uterine rupture and 5.9% of cases had acute fetal distress. No maternal mortality were recorded. Early neonatal mortality was 1.5% of cases and half of the cause of death was acute fetal distress followed by respiratory distress and neonatal infections. Conclusion: The birth on scar uterus is common. The decision of the delivery modality to be proposed should take into account factors concerning the obstetrical antecedents, the data of the current pregnancy, but also the choice of the parturient after being informed of the risks and benefits of each delivery pathway. We propose here the application of the MOMAT score for the prediction of the failure of the uterine test.
[Anatomic study of the anterior patellar groove in the fetal period]
Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 2003
We performed a biometric analysis of the femoral trochlea in the fetus and compared our findings with those observed in adults in order to search for correlations with other biometric parameters of the femur. Twenty-two fetuses (44 knees) conserved in formol and free of known orthopedic disease were studied. Fetal age ranged from 26 to 40 weeks. After anatomic dissection, digitalized images were used to obtain angle measurements with a dedicated software. Measurements made on the distal epiphyseal view were: anteroposterior dimension of the condyles, medial and lateral protrusion of the trochlear borders, difference in condyle height, length of the trochleal borders, alpha angle of the trochlear groove, trochlear slope. Measurements made on the AP femoral view were: femoral anteversion, length of the femoral neck, neck-shaft angle. Spearman's test was used to search for correlations. Results were compared with measurements obtained under the same conditions in a series of 32 adu...
Compression médullaire thoracique secondaire à une ossification des ligaments jaunes
Revue du Rhumatisme, 2002
L'ossification du ligament jaune est une affection commune au Japon mais rare dans les pays occidentaux. Elle peut être responsable d'un tableau de myélopathie de gravité variable. L'étendue des lésions sur plusieurs segments rachidiens au niveau thoracique demeure exceptionnelle. Nous en rapportons un nouveau cas chez un patient de 50 ans présentant un tableau de compression médullaire lente à niveau ombilical. Le diagnostic a été possible grâce à la TDM et à l'IRM dorsales montrant des masses de tonalité calcique au contact des arcs postérieurs et bombant dans le canal rachidien en T5-6, T7-8, T9-10 et T10-11. Le bilan biologique est sans particularité. Une décompression chirurgicale par laminectomie et foraminotomie est à l'origine d'une évolution favorable. L'étude histologique retrouve de larges zones de métaplasie osseuse associées à des dépôts d'amas calciques. Sont rappelées les modalités diagnostiques et thérapeutiques et les orientations étiologiques de cette rare affection ossifiante des ligaments vertébraux à la lumière des données de la littérature. © 2002 Éditions scientifiques et médicales Elsevier SAS compression médullaire / rachis thoracique / ossification / ligament jaune / IRM Summary -Thoracic spinal cord compression by ligamentum flavum ossifications. Ossification of the ligamentum flavum is common in Japan but rare in Western countries. Myelopathy of variable severity is a possible complication. Extension of the lesions over several levels at the thoracic spine is exceedingly rare. We report a new case in a 50-year-old man who had slowly progressive spinal cord compression with a sensory level at the navel. Computed tomography (CT) and magnetic resonance imaging (MRI) of the thoracic spine showed calcium-density masses that were in contact with the neural arches and bulged into the spinal canal at T5/T6, T7/T8, T9/T10, and T10/T11. Laboratory test findings were unremarkable. Surgical decompression by laminectomy and foraminotomy was followed by a favorable outcome. Histology showed extensive areas of osseous metaplasia associated with calcific deposits. The diagnosis, treatment, and possible etiologies of this rare condition are discussed based on a literature review. © 2002 Éditions scientifiques et médicales Elsevier SAS spinal cord compression / thoracic spine / ossification / yellow ligament / MR imaging
Algodystrophie des membres inférieurs au cours de la grossesse
Annales de Réadaptation et de Médecine Physique, 2006
La survenue d'une algodystrophie (AD) des membres inférieurs au cours de la grossesse est rare et probablement méconnue. Ses mécanismes physiopathologiques restent discutés et apparaissent complexes et multifactoriels. Les auteurs rapportent dans cette étude rétrospective descriptive, six observations de patientes atteintes d'AD des membres inférieurs au cours de la grossesse, vues entre 1993 et 2004. L'analyse des résultats cliniques, radiologiques et évolutifs, comparés à la littérature, permet de dégager les principales caractéristiques de cette variété d'AD : installation progressive au deuxième ou au troisième trimestre, localisation préférentielle à la hanche gauche, associée ou non à d'autres régions articulaires des membres inférieurs qui peuvent aussi être atteintes isolément, et déminéralisation radiologique. L'IRM, sensible, spécifique et non invasive, est actuellement l'examen de choix dans le diagnostic précoce et différentiel. L'évolution est favorable en quelques mois avec guérison généralement sans séquelles.