J Gynecol Obst Bio R
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Willebrand's disease, the most frequent inborn coagulopathy, is defined as a deficiency in Willebrand's factor required for normal hemostasis as a mediator in platelet adhesion to the subendothelium and which also contributes to plasma coagulation pathway (by preserving the coagulating activity of factor VIII). Classically, Willebrand's disease improves somewhat during pregnancy. We followed 15 pregnancies in 12 patients with Willebrand's disease in an attempt to determine the best management strategy to reduce the risk of bleeding during delivery. ⋯ Antenatal diagnosis is possible in the most severe forms. Programmed delivery is recommended. Spinal analgesia is contraindicated.
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J Gynecol Obst Bio R · Jan 1996
[Mastectomy with immediate reconstruction for invasive breast cancer. Comments on indications and technique. A series of 112 cases].
A series of 112 mastectomies with immediate breast reconstruction performed in women with invasive cancer of the breast were followed for a mean of 30 months to determine cancer outcome, morbidity and aesthetic results of the different surgical techniques. The patients were divided into 3 groups according to indications: 49 cases with local recurrence after conservative treatment; 37 cases of large or multifocal tumours operated after chemotherapy and radiotherapy; 26 cases after tentative conservative surgery with incomplete tumourectomy. A total of 98 patients (87.5%) were irradiated before mastectomy with immediate breast reconstruction. ⋯ Integrated into a well-planned multidisciplinary protocol, mastectomy with immediate breast reconstruction does not appear to affect the cancer outcome. Immediate breast reconstruction is a complex procedure and requires experience in plastic surgery to reduce the number of complications and to improve aesthetic results. Reconstruction with a rectus abdominus flap appears as the superior technique.
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J Gynecol Obst Bio R · Jan 1995
[Cesarean section trends at the Toulouse University Hospital, from 1983 to 1993. Determinants and consequences].
To examine the factors accounting for the increase in rate of cesarean section, between 1983 and 1993 (from 13.0% to 19.5%) in Toulouse University Hospital, a tertiary level center. ⋯ The increased rate of cesarean sections has not led to any increase in maternal complications, and appears to have had a small favorable influence on infant morbidity.
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J Gynecol Obst Bio R · Jan 1995
Case Reports[Spontaneous rupture of an unscarred uterus during labor and epidural anesthesia].
We report a case of spontaneous rupture of unscarred uterus, during labour and under epidural analgesia in a 43 year-old patient at her third pregnancy and third delivery. The tear was vertical and took place on the left postero-lateral side of the uterus, occurring in the whole height of the lower segment and overlapping towards the uterine corpus and cervix. Analysis of medical, surgical, gynaecological and obstetrical past history has displayed no predisposing factors explaining this rare occurrence. This clinical case reminds us that spontaneous rupture is always possible even on an unscarred uterus.