Mechaal Mourali

Osteoid Metaplasia of the Endometrium: A Case Report and Literature Review

Endometrial ossification is a rare condition. Most cases reported had a history of abortion. Clinical presentation may include abnormal vaginal bleeding or discharge, dysmenorrhea, pelvic pain and secondary infertility. Hysteroscopy appears to be the gold standard method to both diagnosis and treatment. We report a case of endometrial ossification in a woman who presented with pelvic pain. The patient had a pregnancy voluntarily terminated at an unknown gestational age. The diagnosis was suspected at Sonography. We insist on the fact that diagnosis must be considerate in a symptomatic or infertile woman with a history of both early and late abortion and illustrate the feasibility and safety of a hysteroscopic treatment for this condition.

Correlation between umbilical resistance index and fetal growth: Pilot study

To investigate normal pregnancies to determine whether there is a relationship between umbilical resistance and fetal growth.

Rupture of uterine artery pseudoaneurysm: role of ultrasonography in postpartum hemorrhage management

Uterine artery pseudoaneurysm (UAP) rupture should be considered in case of late genital bleeding without obvious cause and lead to perform a sonographic examination with Doppler-scan. We report two cases of late post-partum hemorrhage from UAP diagnosed as such using color Doppler US. In order to avert life-threatening bleeding, prompt and accurate diagnosis should be made using color Doppler US since the latter plays a significant role in demonstrating the vascular nature of this anechoic uterine lesion.

Diagnostic anténatal d’un hémangiome du membre supérieur

Nous rapportons le cas d’une patiente G3P3, adressee a notre Unite de diagnostic antenatal pour anasarque fœtoplacentaire a un terme de 31 SA associee a une rupture prematuree des membranes. L’echographie realisee montrait un fœtus en anamnios, une anasarque fœtale, une mesure du pic systolique de velocite au niveau de l’artere cerebrale moyenne >1.5 MoM et un epaississement cutane du membre superieur droit evoquant une tumeur fœtale vascularisee. Le doppler energie montrait le depart de vaisseaux de l’aorte communiquant avec l’artere sous claviere droite (A,B). Deux heures apres l’hospitalisation, la survenue d’une souffrance fœtale aigue a impose un accouchement par cesarienne. L’examen du nouveau-ne de sexe masculin montrait une tumeur vascularisee prenant et deformant tout le membre superieur droit, allant jusqu’a la partie haute du thorax (C,D). Un thrill a ete objective a la palpation, confirme par la presence d’un souffle au niveau de la tumeur, temoin de shunts arterio-veineux. Le deces du nouveau-ne est survenu 30 minutes apres la naissance malgre une reanimation neonatale active.We report the case of a G3P3 patient, referred to our Prenatal Diagnostic Unit with fetal and placental anasarca at 31w associated with premature rupture of membranes. Ultrasound showed anamnios, foetal anasarca, measurement of the peak systolic velocity of middle cerebral artery> 1.5 MoM and cutaneous thickening of the right upper limb suggesting vascularized fetal tumor. Power Doppler showed vessels depart from the aorta communicating with the right subclavian artery (A,B). Two hours after hospital admission, emergency cesarean section was performed due to acute fetal distress. Examination of the male newborn showed vascularized tumor involving and deforming the entire right upper limb, extending to the upper part of the thoracic region (C,D). Palpation detected a thrill confirmed by the presence of a murmur at the level of the tumor, sign of arteriovenous shunts. Newborn death occurred 30 minutes after the birth, despite active neonatal resuscitation.

Torsion d’annexe au second trimestre de la grossesse, à propos de deux cas

Acute pelvic pain during pregnancy makes the differential diagnosis more challenging. We here report two cases of adnexal torsion during the second trimester of pregnancy in order to draw attention to this diagnosis and to highlight the importance of early treatment to avoid irreversible damages due to ischemia which can be fertility-threatening. The first patient, G1P0, 20 weeks pregnant, initially presented with appendix syndrome. Exploration with a small McBurney incision showed a right ovarian necrosis, hence ovariectomy was performed. The postoperative course was uneventful. The second patient, G2P2, 26 weeks pregnant, presented to the emergency departments with acute left iliac fossa pain. Laparotomy revealed the torsion of a hydatid of Morgagni whose necrotic appearance due to twisting required hydatid ablation. No postoperative complications were noted in the two patients. Adnexal torsion is an emergency condition that should not be ignored in the case of acute pelvic pain in pregnant women. Conservative treatment represents the gold standard and proper management is necessary to avoid possible maternal and fetal complications.