Rim Ben Hmid

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.

Confrontation échographique et fœtopathologie après interruption thérapeutique de grossesse dans une maternité Tunisienne de référence

This study aims to evaluate the value of prenatal ultrasound diagnosis by comparing it with the results of the fetopathological examination in case of therapeutic interruption of pregnancy for fetal indication. We conducted a retrospective descriptive and analytical study carried out over a three-year period from January 2013 to December 2015. It involved 66 fetuses autopsied after therapeutic interruption of pregnancy for fetal indication. Fetopathological examination confirmed ultrasound results in 63 cases (95.4%). In 18 cases (27.2%) there was a full match between the results of the prenatal diagnosis and those of the autopsy. Nine percent of fetal malformations were detected in the first trimester. The majority of malformations (72%) were detected in the second timester. Neurological malformations were the most frequent (60%), dominated by hydrocephalus and anencephaly. This study shows that, in our clinical context, even if ultrasound diagnosis is often non-exhaustive, its signs indicating the need for interruptions of pregnancy are correct. Fetopathological examination is used, in this case, to detect unknown malformations, making it possible to specify the diagnosis and to implement a strategy for subsequent pregnancies.

La maladie cœliaque: une cause rare de fausses couches à répétition

La maladie cœliaque est un trouble auto-immun associé à une intolérance au Gluten qui a pour effet la destruction progressive des villosités de l’intestin grêle. Les symptômes de la maladie cœliaque sont très divers et peuvent se produire à tout âge. Parmi ces symptômes, la maladie abortive est une circonstance rare de découverte de la maladie cœliaque. Nous rapportons le cas d’une patiente ayant présenté 12 fausses couches successives dont l’étiologie a été enfin rattachée à une maladie cœliaque.Cœliac disease is an autoimmune disorder associated with Gluten intolerance resulting in progressive destruction of the villi of the small intestine. Symptoms are very diverse and can occur at any age. Abortive illness is a rare symptom leading to the detection of cœliac disease. We report the case of a patient with a history of 12 consecutive miscarriages whose etiology was finally related to cœliac disease.

L’ouverture de l’orifice interne du col prédit mieux l’issue de la maturation cervicale que le score de Bishop chez les nullipares à 41 semaines d’aménorrhée

INTRODUCTION The objectif was to evaluate ultrasound measurement of the opening of the internal cervical os in the prediction of cervical ripening and to compare it with Bishops score. METHODS We conducted a prospective study of 77 nulliparous women admitted to hospital in labor at 41w gestation, with Bishops Score < 6, over a 10-month period, between July 2012 and April 2013. The measurement of the opening of the internal cervical os was performed using transvaginal ultrasound and Bishops score was determined by clinical examination. All patients received prostaglandins for cervical ripening. RESULTS Cervical ripening was successful among 63 patients (81%). Bishops score and the opening of the internal cervical os were statistically associated with the success or failure of cervical ripening. The success rate of cervical ripening was 100% when the opening of the internal cervical os was equal to or greater than 5 mm (sensitivity: 54%, specificity: 86%). ROC curves showed that the measurement of the internal cervical os was more predictive of cervical ripening than Bishops score (area under the curve: 0.733 and 0.704 respectively). CONCLUSION Compared to Bishops score, echographic measurement of the opening of the internal cervical os is more predictive of the success of cervical ripening in nulliparous women at 41 weeks of pregnancy with an unfavourable cervix.