J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Jan 1994
Case Reports[Subcapsular liver hematoma, a HELLP syndrome complication].
The authors report a case of unruptured subcapsular haematoma of the liver in a 31-year-old woman, para 2, in the 34th week of pregnancy, complicated by preeclampsia. Clinical signs of preeclampsia were associated with pain in the right hypocondrium and laboratory findings consistent with a true HELLP syndrome. ⋯ Regular X-ray follow-ups showed the regression of the hepatic lesion. This case confirms recent reports that patients with unruptured capsular haematoma should be treated conservatively but should receive careful monitoring.
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J Gynecol Obst Bio R · Jan 1994
Clinical Trial Controlled Clinical Trial[Home care services and postnatal care. The experience in Grenoble (1985-1993)].
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J Gynecol Obst Bio R · Jan 1993
Review[Delivery after 2 previous cesarean sections. A series of 41 uterine trials].
It has been possible to consider how delivery should be carried out in view of the progress that has been made handling scarred uteruses. Over 21 months 41 tests of uterine function have been authorized in our department out of 67 cases where there were two scars in the uterus (67%). 26 patients delivered vaginally (63.4%) and 5 had Caesarean sections because of failure of the test of the scar. When the relationship between the fetus and the pelvis was satisfactory, the fact that the cervix was not ripe and the presenting part was not engaged, did not prevent carrying out a trial of scar in 78% of cases. ⋯ Epidural anaesthesia was used in 90.2% of cases. A full obstetric team must be present throughout the whole labour so that the conduct of the labour can be observed, and if necessary corrected quickly if anything in its progress is becoming abnormal. It has become reasonable to carry out tests of uterine scars even after two scars have been made in the uterus because of the absence of any maternal or fetal complications in this series or in the literature.
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J Gynecol Obst Bio R · Jan 1993
Review Case Reports[A difficult diagnosis: pelvic-abdominal actinomycosis abscess].
A laparotomy for hysterectomy was performed in a 46-year-old nulliparous woman who had worn an intra-uterine sterilization device for 8 years. The patient was in poor general health and had had abdominal pain and repeated episodes of fever over the preceding 3 months. An abscess of the abdominal muscle was found peroperatively. ⋯ The frequency increases with the duration of insertion and the pathogenicity appears when the immune responses are deficient and/or when a cofactor is involved. Treatment relies on surgical exeresis and prolonged antibiotics (penicillin G or macrolides). Hyperbar treatment is sometimes used.