Posterior reversible encephalopathy syndrome and pregnancy: a Moroccan retrospective study of a patient’s oligo series

Posterior reversible encephalopathy syndrome (PRES) is an entity combining reversible central nervous system damages with characteristic magnetic resonance imaging (MRI) brain imaging, it can occur in peripartum regardless of any preexisting pathology. PRES in peripartum is a poorly understood phenomenon. Early diagnosis and management are essential to prevent irreversible neurological sequelae. We report 6 cases series of PRES, collected at obstetrics and gynecology department of the military hospital Mohamed V in Rabat, between 2000 and 2019, in order to describe and analyze epidemiological, clinical, paraclinical and therapeutic aspects. Average age was 27 years old. Found symptoms were: high blood pressure, seizures, headaches, visual disturbances, consciousness disorders, vivid osteotendinous reflexes, vertigo, nausea and vomiting. Associated complications were status epilepticus, eclampsia, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and acute lung edema. Radiologically, found lesions are suggestive of PRES. After management, evolution was favorable in all patients.

A case report of vasa previa incidentally discovered

Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to present one case of vasa previa diagnosed during the placenta examination after the caesarean indicated for triple uterus scar. A 26-year-old female was referred to our hospital at 30 weeks of gestation to provide a scheduled caesarean. Trans-abdominal ultrasound was performed; the placenta was positioned in the posterior side of the fundus. Fetal growth was found to be appropriate for gestational age. A healthy male infant weighing was successfully delivered via cesarean section at 38 weeks of gestation. This operation helped to prevent complications due to acute fetal bleeding. The identification and exclusion of vasa previa using trans-vaginal ultrasound are essential to ensure appropriate and timely treatment.Keywords: Vasa previa, fetal bleeding, Benckiser´s haemorrhag

Cardiomyopathie du péripartum

La cardiomyopathie du péri-partum (CMP-PP) ou syndrome de Meadows, est une cardiomyopathie dilatée survenue pendant ou au décours d'une grossesse, définie par une insuffisance cardiaque avec une fraction d'éjection systolique du ventricule gauche inférieure à 45%. Il s'agit d'une entité pathologique rare dont le mécanisme physiopathologique en cause reste mal élucidé. Sur le plan clinique il s'agit d'une insuffisance cardiaque inopinée d'installation rapide, d'évolution imprévisible avec risque de choc cardiogénique réfractaire justifiant une prise en charge en réanimation cardiovasculaire. La CMP-PP ne nécessite aucun traitement spécifique par rapport aux autres causes d'insuffisance cardiaque. Nous rapportons le cas d'une primigeste de 29 ans qui a consulté à 32 semaines d'aménorrhée dans un tableau d'insuffisance cardiaque congestive en rapport avec une cardiomyopathie du péri-partum. L'objectif de ce travail est de préciser les caractéristiques de cette cardiopathie, qui malgré son caractère exceptionnel ne doit pas être méconnu par l'obstétricien

Caesarean scar endometriosis: a case report

Endometriosis is a common disorder in women of reproductive age but is rarely observed in abdominal scar after caesarean section. The authors report a case of 35-year-old woman referred for a painful lump at caesarean scar. Preoperative diagnosis of caesarean scar endometriosis was made on the basis of clinical examination and radiological imaging and confirmed histologically after large surgical excision of the mass. Increasing awareness of this rare entity among clinicians can help in early diagnosis and appropriate treatment

Vertical transmission of SARS-CoV-2: a brief literature review

As COVID-19 virus is still spreading, more infections in pregnant women are likely to be seen. At this time, very little is known about vertical transmission of SARS-COV-2 from infected pregnant woman to her infant. Authors reviewed the risk of vertical transmission of COVID-19 by using data of published articles and official websites up to May 11, 2020. The searches revealed 16 articles (12 case reports/series and 4 retrospective studies) collectively comprising 194 infected pregnant women with COVID-19. 140 cases of neonates delivered from pregnant women with COVID-19 were collected. The SARS-COV-2 nucleic acid test, in day 2, was positive in 4 newborns. Based on limited data, there is no evidence for vertical transmission of COVID-19. Some studies suggestive of maternal-fetal transmission deserve careful evaluation before a definitive finding

Giant placental chorioangioma discovered at 29 weeks’ gestation: a case report

Chorioangiomas are the commonest non-trophoblastic tumors of placenta with an estimated incidence of 1%. The majority of them are small, asymptomatic and only found by careful pathologic examination of the placenta. Occasionally, they can attain a large diameter (≥ 4-5cm) resulting in what is termed ‘giant chorioangioma’ with a high feto-maternal morbidity and mortality rates. We report a case of giant chorioangioma discovered accidentally during a routine obstetric ultrasound. Expectant management was adopted. Ultrasound follow-up revealed several fetal complications; an elective caesarean section was made giving birth to a premature new-born with enormous hepatosplenomegaly, died on the first day of life. Diagnosis and management of chorioangioma represents a stringent challenge for obstetricians due to its potentially serious antenatal complications

Pemphigoïde gestationis et aplasie cutanée congénitale: à propos d’un cas

La pemphigoïde gestationis est une dermatose gravidique apparaissant en général entre la 28ème et la 32ème semaine d’aménorrhée. L’éruption cutanée est prurigineuse, bulleuse ou vésiculopapuleuse et de topographie  péri-ombilicale. Outre la clinique, son diagnostic repose sur la biopsie cutanée avec analyse en  immunofluorescence directe. Elle se caractérise par sa tendance à récidiver. Le traitement habituel nécessite des dermocorticoïdes. Les conséquences peuvent être maternelles (menace d’accouchement prématuré), foetales (retard de croissance intra-utérin), et néo-natales (éruption cutanée). Nous rapportons un cas de pemphigoïde gestationis associé à une aplasie cutanée congénitale type 2. S’agit il d’une association fortuite?Key words: Pemphigoïde gestationis, aplasie cutanée congénitale, cas cliniqu

COVID-19 during pregnancy: vertical transmission, diagnosis and maternal-fetal complications

The current pneumonia outbreak of COVID-19 has been declared a pandemic by the World Health Organization on March 11, 2020. With its indiscriminate spread across continents, authors are likely to see women with COVID-19 canvassed across all trimesters of pregnancy. To date, few reports have provided information about this disease in pregnant patients. Authors conducted a literature review to summarize the results concerning intrauterine transmission, diagnostic challenges and maternal-fetal outcomes of pregnant women with COVID-19 pneumonia

Posterior reversible encephalopathy syndrome in patient of severe preeclampsia with Hellp syndrome immediate postpartum

Posterior reversible encephalopathy syndrome (PRES) is a rare clinico-neuroradiologic condition, not commonly reported in the literature. PRES is an uncommon complication of severe preeclampsia/eclampsia. We report the management of one patient with postpartum preeclampsia as an association of HELLP syndrome presenting with status-epileptics. Early diagnosis along with timely supportive therapy resulted in the successful management of this challenging case. Recent understanding on the pathophysiology of this uncommon condition is discussed. We highlight the importance to obstetricians, intensive-care physicians and anesthesiologists of recognizing such cases.Pan African Medical Journal 2015; 2

Tumeur desmoïde de la glande Bartholin: à propos d’un cas

Les tumeurs desmoides sont les tumeurs rares, bénignes mais fréquemment agressives d'origine  mésenchymateuse, ils sont extrêmement rares en localisation Vulvaire. Nous rapportons le cas d'une patiente âgée de 32 ans présentant un fibrome desmoïde de la glande de Bartholin prise pour un simple kyste au début. Le traitement consiste en une excision chirurgicale de la lésion et nous discutons la possibilité de traitement adjuvent pour éviter une éventuelle récidive post-opératoire.Key words: Fibrome desmoïde, tumeur vulvaire, pathologie de la glande Bartholi