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This article presents a retrospective study conducted in Tunis hospitals to assess the impact of COVID-19 on hospitalized pregnant women. The study population consisted of women aged 28-38 years with diverse educational backgrounds. Most women had no significant medical history, but some had controlled asthma or a prior pregnancy loss. Vaccination rates were high, with the majority receiving prenatal care. Common COVID-19 symptoms were reported in 73% of women, and most cases were mild with no maternal deaths. However, COVID-19 infection was associated with an increased risk of preterm delivery, respiratory distress, and miscarriage. Psychological distress was observed in all women. Delivery outcomes were significantly impacted, with a rise in Caesarean sections and a high preterm birth rate. Neonatal COVID-19 infection occurred in 6% of cases, but most newborns had good Apgar scores. The study emphasizes the importance of continued vaccination efforts and close monitoring throughout pregnancy. [Extracted from the article]

This article discusses a rare pregnancy complication called hemolytic uremic syndrome (HUS), which has microangiopathy as a key characteristic. The case study presented involves a 38-year-old pregnant woman at 17 weeks gestation who experienced symptoms such as headache, vomiting, and visual blur. The patient had a history of prior miscarriages, an ectopic pregnancy, and a previous Caesarean section. Physical examination and laboratory findings indicated microangiopathic hemolytic anemia, low platelet count, and elevated creatinine levels, leading to a suspected diagnosis of HUS. The importance of early diagnosis in pregnant women with anemia, thrombocytopenia, and acute renal failure is emphasized due to the potential for severe maternal complications. [Extracted from the article]

The purpose of our study is to identify the contribution of MRI as a complementary examination to ultrasound in order to optimise the characterisation of ovarian mass characterisation. In cases where pelvic ultrasonography could not contribute substantially to the diagnosis, we completed the exploration with a pelvic MRI. [Extracted from the article]

Laparoscopic surgical exploration in our patients most often found gonads reduced to two fibrous bands. This study includes the analysis of epidemiological, clinical, biological and ultrasound data plus intraoperative findings, treatment histological result and subsequent follow up of patients with Pure gonadal dysgenesis (PGD) also known as SWYER syndrome. However, all patients presented primary amenorrhea. [Extracted from the article]

To evaluate fertility results after laparoscopic distal tuboplasty. Methods All the distal tuboplasties performed between 2018 and 2019 were included, laparoscopic distal tuboplasty was carried out on 20 patients. The patients were classified according to the French cooperative tubal scoring system: stage 1: 7 patients, stage II: 13 patients, stage III: 22 patients, stage IV: 12 patients; 17 patients underwent a fimbrioplasty whereas 3 patients underwent a neosalpingostomy. [Extracted from the article]

Therefore, Ultrasonography and MRI represent complementary diagnostic tools for antenatal diagnosis of placenta accreta. EP44.20: Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population To compare accuracy of ultrasonography and MRI for prenatal diagnosis of placenta accreta. [Extracted from the article]

The study objective is to study the intraoperative and postoperative complications of laparotomic myomectomy and patients' characteristics influencing this risk. Conclusions Odds ratio computed to estimate the risk of complications in relation to the patient characteristics showed that the probability of complications significantly rises with an increase in the number (more than 3 myomas) and with the intramural or the intraligamentous location of myomas whereas the myoma size seems to influence particularly the risk of major complications. Patients undergoing myomectomies should be carefully selected, due to the high rate of complications, other alternatives should be also considered such as laparoscopic myomectomy; uterine embolisation. [Extracted from the article]

All patients underwent midline laparotomy straddling the umbilicus. Methods Retrospective study spanning seven years from January 1, 2015 to December 31, 2021 on five patients treated for primary pelvic hydatid cyst in the Department of Obstetrics and Gynecology "A" at Charles Nicolle's Hospital. All patients underwent an abdominopelvic ultrasound showing multi-partitioned cystic formations whose size varied between 8 and 18 cm. Hydatid serology was performed in all cases and came back positive in two cases. [Extracted from the article]

We emphasise the imaging and histology appearance of this tumour; as well as on the interest of evoking this diagnosis for surgery adapted to sarcomas. Transvaginal sonography showed a retrocervical tumour of 112 × 163 × 100 mm in diameter at the dorsal uterine wall without signs of intratumoural necrosis. [Extracted from the article]

Introduction: Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association., Case Presentation: We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma., Conclusions: Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.

Objectives: The aim of this study was to determine the prevalence, the main features and the potential risk factors of LBP in pregnant women., Methods: This cross-sectional study included 173 pregnant women in the third trimester. Non-inclusion criteria were severe mental disability and known previous history of musculoskeletal diseases. The participants were categorised into two groups: women with pregnancy-related LBP and pain-free women. Demographic, socio-professional, clinical and obstetrical data were compared between the two groups using the appropriate statistical tests., Results: The mean age was 32.2 ± 5.4 years [17-45]. Among them, 108 (62.4%) reported one or more episodes of LBP during at least 7 days, mostly in the third semester (n = 71). The presence of LBP was significantly associated with history of LBP in previous pregnancies and jobs requiring prolonged standing. Active jobs and the presence of gestational complications were significantly more common in pain-free women. In the multivariate analysis, LBP was independently predicted by the history of LBP in previous pregnancies and the absence of gestational complications., Conclusions: The association of LBP with gestational complications as a protective factor has not yet been reported in previous studies. These complications are a common cause of hospitalisation, which represents a period of relative rest during pregnancy. Our results revealed that history of LBP in previous pregnancies, sedentary lifestyle prior to pregnancy and prolonged standing are the main risk factors of LBP. In contrast, rest and avoidance of physical overstrain during pregnancy may be protective factors., (© 2023 John Wiley & Sons Ltd.)

Introduction. Candida spp. may cause opportunistic infections called vulvovaginal candidiasis (VVC), which is estimated to be the second most common cause of vaginitis worldwide. Gap Statement. Under various circumstances, VVC could compromise pregnancy outcomes. Emerging data suggests that VVC during pregnancy may be associated with increased risk of complications and congenital cutaneous candidiasis. Aim. To assess the prevalence of Candida spp. in asymptomatic pregnant women and determine the susceptibility of the isolates to antifungal drugs. Methodology. In a prospective cohort, 65 high vaginal swab samples of consented pregnant women. Candida isolates were identified using both microbiological and molecular tools and drug susceptibilities were profiled. Results. The prevalence of VVC among our study participants was 37 %, 24 of the 65 asymptomatic pregnant women show Candida spp. colonization. C. albicans was the most common species 61 %, followed by C. glabrata 39 %. In addition, a significant fraction of the isolated colonies showed resistance to Fluconazole, with a ratio of 63 % for C. albicans isolates and 16 % for Candida glabrata isolates. Moreover, relative quantification of genes related to resistance to fluconazole, CDR1, ERG11 as well as HWP1, showed a significant change compared to controls. Conclusion. Monitoring of vaginal Candida c olonization before the third trimester of pregnancy, that could reduce congenital Candida colonization and risk of pregnancy complications.

Methylene blue is used to check tubal patency during laparoscopy. We report the case of a 28-year-old patient who presented a blue coloring of the skin, mucous membranes and nails after methylene blue test during laparoscopy for infertility.  The oxygen saturation was 82%. The patient was hospitalized for 48 hours in the intensive care unit and spectrophotometric analysis revealed a methemoglobin level of 8.9%, thus confirming the diagnosis of methemoglobinemia. The suites were simple with normalization of the saturation. It is important to know the complications of the injection of methylene blue in order to prevent them and ensure adequate monitoring for the patients.

Solitary fibrous tumors of the female genital tract are extremely rare. We report the case of a 78-year old patient presenting with a pelvic mass. Surgical exploration showed parauterine tumor. Anatomo-pathological examination confirmed the diagnosis of malignant solitary fibrous tumor. The evolution was marked by the death of the patient. It is important to be able to detect these tumors whose evolution can be poor. Long-term follow-up of patients with resectable tumor should be recommended., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêt.

Objective: To compare clinical data and transperineal ultrasound results for the diagnosis of fetal head engagement., Methods: The present prospective longitudinal study enrolled 100 term women attending the Mongi Slim Hospital, La Marsa, Tunisia, between July and September 2012. The clinical assessment of fetal engagement was compared with ultrasound measurements. Ultrasound examination was performed in the delivery room. The probe was placed on the ano-vulvar area. The measure used was the distance between the perineum and external table of fetal skull., Results: The ultrasound measures of the perineum to external table of fetal skull ranged from 13 to 75mm. The measures of the perineum to succedaneum bump ranged from 22 to 68mm. A threshold of 55mm was determined as the perineum to fetal head distance above which a diagnosis of engagement would be reversed. This proposed threshold had a positive predictive value of 98.6%, a sensitivity of 86.7%, and a specificity of 94.1%., Conclusion: Transperineal ultrasound is a simple, rapid, and reproducible method for the diagnosis of fetal head engagement. It can be used in the delivery room in addition to clinical examination and when the latter is hampered by a succedaneum bump., (Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)