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3. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS.

Author

Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, and Brahmi N

Published
2023

4. What are the prognostic factors in the delivery of the second twin?

Author

Mekki D, Mourali M, Mekaouer L, Hemila F, and El Fekih C

Subjects
Apgar Score, Female, Humans, Infant, Infant Mortality, Infant, Low Birth Weight, Infant, Newborn, Pregnancy, Prognosis, Retrospective Studies, Time Factors, Twins, Birth Weight physiology, Delivery, Obstetric methods, Pregnancy Outcome, Pregnancy, Twin
Abstract

Objective To evaluate the prognosis of the second twin according to different criteria (presentation, mode of delivery , term, weight, weight difference between twins ,twin to twin delivery time interval, studying the Apgar scores at birth and neonatal morbidity and mortality. Materials and Methods This is a retrospective study of 183 parturients carrying twin pregnancies collected at the department of Obstetrics-Gynecology in Mahmoud Matri Hospital (Ariana) over a period of 9 years ( 1st January 2001 to 31st December, 2009 ) . Results We recorded 357 live births ( 181 J1 and J2 176 ) and 9 stillbirths . The relationship between the order of the twin and the modality of delivery on the one hand, and between the order of twin and type of presentation was considered significant (p < 0.001). We found no significant difference in Apgar score at 1 minute and 5 minutes between the 1st and the 2nd twins. A term ≤ 34 weeks was a poor prognostic factor for the Apgar score at the first and the fifth minute for the 2 twins but no significant difference between the 1st and 2nd twins (  1st min p=0.4623 ; 5th min p = 0.2899 ). Low birth weight ≤ 1500g were significantly more at risk of foetal suffering (p < 0.001). A birth weight discordance of 25% or more was observed 36 cases (19.7 %). The Apgar score was significantly influenced by the birth weight difference only in the first minute (p = 0.043 ). Thereafter, this difference disappears in the 5th minute. The type of presentation and methods of delivery did not influence significantly the second twin morbidity. A time interval between the birth of the first and second twin greater than 15 minutes was a bad prognostic factor for the Apgar score in the 1st min ( p = 0.001) and 5th min ( p = 0.019) . Transfer rate in neonatology and neonatal distress was 31.2 %.The term of birth ( before 34 weeks ), low birth weight ( ≤ 1500 g ) , and twin-to-twin delivery time interval (≥ 15 min) are parameters that influenced significantly the rate of neonatal distress and transfer to pediatric health care unit (p <0.001 , p<0.001, p = 0.004) . We found a significant increase in the transfer to pediatrics when the birth weight difference was larger than 25% ( p = 0.005). However, no significant difference was found concerning the neonatal respiratory distress (p = 0.22). The different modes of delivery and the type of presentation of the second twin did not significantly alter the rate of neonatal respiratory distress (p = 0.28 , p = 0.53) and transfer Pediatrics (p = 0,63, p = 0.38 ). Among the live births, 5 twins had died in labor room : 1st twin in two cases and in 2nd twin in 3 cases and there was no significant correlation between neonatal mortality and the twin's order (p = 0.629 ) . Conclusion A term ≤ 34 weeks, a low birth weight ≤ 1500g and a delay of more than 15 mn were factors that influenced significantly the Apgar score at 1st and 5th minute, and were responsible for more neonatal distress and transfer in pediatrics. A birth weight difference larger than 25% between the two twins influenced the Apgar score at the first minute and was responsible for an increase in the transfer rate.

Published
2016

5. [Management of ovarian endometriomas: intraperitoneal cystectomy versus fenestration and coagulation].

Author

Mourali M, Mekki D, Fitouhi L, Mkaouar L, Hmila F, Binous N, and El Fekih C

Subjects
Adult, Electrocoagulation methods, Electrocoagulation statistics & numerical data, Endometriosis epidemiology, Female, Fertility Preservation statistics & numerical data, Gynecologic Surgical Procedures statistics & numerical data, Humans, Infertility, Female epidemiology, Laparoscopy statistics & numerical data, Ovarian Diseases epidemiology, Peritoneal Cavity surgery, Recurrence, Retrospective Studies, Tunisia epidemiology, Endometriosis surgery, Gynecologic Surgical Procedures methods, Ovarian Diseases surgery
Abstract

Background: Ovarian endometriomas is a common condition among women of reproductive age and represents a major cost in terms of public health. Despite these implications for public health, it remains difficult to arrive at a consensus on the optimal surgical treatment., Aims: To study the clinical and paraclinical characteristics of this pathology and to compare two major surgical techniques: the intraperitoneal cystectomy and fenestration -coagulation in terms of recurrence and prognosis for future fertility., Methods: A retrospective study of 31 patients who underwent surgical treatment for ovarian endometrioma histologically proved. The study period covers 10 years from January 2000 to December 2009., Results: Laparoscopy was performed in 27 patients. The endometrioma was located to the left side in 64% of cases. The main strategy performed is intraperitoneal cystectomy in 18 patients (58.8%). In second place we find the fenestration-coagulation. The mean duration of postoperative follow-up is 10.3 months. The recurrence of the cyst and the persistence of pain symptoms were significantly less frequent in the group of patients who underwent intraperitoneal cystectomy., Conclusion: The laparoscopic surgery remains the first line approach in terms of ovarian endometrioma.Cystectomy offers performance equal or superior to the fenestration-coagulation technique, and exposes to fewer recurrences. For these reasons, it should be recommended. The fenestration-coagulation is possible in case the cystectomy is difficult or incomplete.

Published
2013

6. [Delivery in breech presentation: what way should we choose?].

Author

Mourali M, Kawali A, Fitouhi L, Hadroug L, Gharsa A, Hmila F, Binous N, Ben Zineb N, and El Fekih C

Subjects
Adult, Female, Humans, Pregnancy, Retrospective Studies, Breech Presentation therapy, Delivery, Obstetric methods
Abstract

Background: The breech delivery is considered dangerous because of the higher rates of perinatal mortality and morbidity which become attached to it, consequences of obstetric traumas bound to the obstetric operations. What way of delivery is it necessary to privilege? What are the arguments which we have to support our choice?, Aim: To assess the maternal and fetal outcome according to the way of delivery., Methods: In this retrospective study, 194 women with a singleton pregnancy in a breech presentation delivered at term in our maternity unit in Ariana's Hospital from January 2007 to December 2009., Results: Breech presentation was noticed in 2, 59%. The main factors favoring this presentation are: the primipara, the uterine deformations, the pathological ponds, the abnormalities of the amniotic liquid, the fetal weight and the fetal deformations. Vaginal delivery was accepted in 57,7% of women and 75% from them delivered in natural way. The rate of caesarians was 56,7 %. Among these patients, 74, 5 % were indications in a cold caesarian (scar womb, pathological pond, RPM > 12 hours, estimated (esteemed) fetal weight > 3800g). The Apgar's score was superior to seven in 97.6% of cases. There was no significant difference in fetal morbidity, Apgar's score or in the need of transfer in intensive care unit., Conclusion: When the acceptance conditions of the vaginal delivery are combined and when the surveillance of the labour is rigorous, it seems that there is no excess of neonatal risk by the natural ways.

Published
2013

7. Selective salpingography and tubal catheterization in infertile women.

Author

El Fekih C, Ouerdiane N, Mourali M, Oueslati S, Binous N, Chaabane M, and Ben Zineb N

Subjects
Adult, Cohort Studies, Elective Surgical Procedures, Fallopian Tube Diseases complications, Fallopian Tube Patency Tests, Female, Follow-Up Studies, Humans, Hysterosalpingography, Infertility, Female etiology, Pregnancy, Pregnancy Rate, Retrospective Studies, Treatment Outcome, Catheterization methods, Fallopian Tube Diseases surgery, Gynecologic Surgical Procedures methods, Infertility, Female surgery
Abstract

Background: Use of selective salpingography (SS) and fallopian tube catheterization (TC) has revolutionized the diagnosis and treatment of proximal tubal infertility., Aim: To evaluate results of women treated for proximal tubal obstruction by selective salpingography and tubal catherization., Methods: Selective salpingography was performed in women with proximal bilateral tubal obstructions. Follow-up ranged from 4 to 12 months., Results: twelve patients had been shown to have bilateral proximal obstruction of the fallopian tube. After SS/TC, patency was achieved in 8 cases. Spontaneous conceptions occurred in 4 women., Conclusion: SS and TC should be used more widely because it is simple and effective in case of proximal tubal blockage.

Published
2012

8. [Ovarian drilling for the treatment of infertility with dystrophic ovaries].

Author

Mourali M, Kawali A, Fitouhi L, Bekri S, Hmila F, Binous N, Ben Zineb N, and El Fekih C

Subjects
Adult, Electrocoagulation, Female, Humans, Infertility, Female etiology, Laparoscopy, Pregnancy, Pregnancy Rate, Retrospective Studies, Infertility, Female surgery, Ovarian Diseases surgery, Ovary surgery
Abstract

Background: Dystrophic ovaries represent the main cause of female infertility in Tunisia., Aim: To assess the contribution of ovarian drilling in the treatment of infertility in patients with ovarian dystrophy., Methods: A retrospective study of 23 patients with dystrophic ovaries that have benefited through their subfertility of laparoscopic ovarian drilling, in the gynecology-obstetrics hospital Mahmoud EL Matri, Ariana, Tunisia. Our study spans a period of 3 years from January 2004 to December 2006., Results: Among the 23 patients who underwent drilling for clomiphene citrate resistance, 9 have been pregnant. The average age of patients having had a pregnancy after ovarian drilling was 29.6 years, the average delay was 7.1mois. Regarding prognostic factors, only infertility's duration lower than 3 years was predictive of a good result., Conclusion: Ovarian drilling is an interesting alternative to induction by FSH for patients with dystrophic ovaries.

Published
2012

9. Maternal and fetal outcomes of large fetus delivery: a comparative study.

Author

El Fekih C, Mourali M, Ouerdiane N, Oueslati S, Hadj Hassine A, Chaabene M, and Ben Zineb N

Subjects
Delivery, Obstetric, Female, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Outcome, Retrospective Studies, Fetal Macrosomia
Abstract

Aim: To review the deliveries of macrosomic babies, weighing over than 4000g and their obstetrical and neonatal outcomes., Methods: Retrospective study involving a total of 209 deliveries at term of macrosomic babies between Marsh 2006 and February 2007 in the Maternity Hospital of Mahmoud ELMATRI, Tunis. The study concerned risk factors, mode of delivery and the incidence of maternal and perinatal complications.We compared data in the study group to a control group of normal weight infants delivered at the same period., Results: Macrosomia occurred in 9.2% of all deliveries. The main risk factors of macrosomia were maternal age over 30 years (p=0,017), multiparty (p<0.001), diabetes mellitus (p=0.012) and prolonged term of delivery (p=0.02). These risk factors were statistically significant compared to control group. Caesarian delivery was achieved in 24.4% in macrosomy group and in 13.7% in control group (p=0,003) the major part occurred during labor. Among vaginal deliveries in macrosomia group, shoulder dystocia was noted in 1,9%, fetal respiratory failure and admission in intensive care unit was noted in 4,8% of the cases and hypoglycemia complicated 15,8% of deliveries. Maternal complications were dominated by post partum hemorrhage documented in 1.2% of the cases and perineal tears noted in 8,2% of vaginal deliveries., Conclusion: Vaginal delivery is the most frequent mode of delivery for a fetus weighing in excess of 4 kg and vaginal delivery should be attempted in the absence of contraindications and there is no need for elective systematic caesarian. However, shoulder dystocia remains the main complication of vaginal delivery for macrosomic fetuses and requires experienced obstetricians to manage these deliveries.

Published
2011

10. Prenatal diagnosis of esophageal atresia.

Author

Mourali M, Essoussi-Chikhaoui J, Fatnassi A, El Fekih C, Ghorbel S, Ben Zineb N, and Oueslati B

Subjects
Adult, Female, Humans, Infant, Newborn, Pregnancy, Esophageal Atresia diagnosis, Prenatal Diagnosis
Published
2011

11. First trimester diagnosis of Pallister-Killian syndrome in a fetus with suggestive abnormalities.

Author

Mourali M, El Fekih C, Dimassi K, Fatnassi A, Zineb NB, and Oueslati B

Subjects
Adult, Chromosomes, Human, Pair 12, Craniofacial Abnormalities diagnostic imaging, Female, Hernia, Diaphragmatic diagnostic imaging, Humans, Nuchal Translucency Measurement, Pregnancy, Pregnancy Trimester, First, Prenatal Diagnosis, Chromosome Disorders diagnosis
Abstract

Background: Pallister-Killian Syndrome is a rare, sporadic chromosomal disorder characterized by a tetrasomy 12p often in mosaic. It is only in 2000 that the first case of PKS was diagnosed in the first trimester further to an increased nuchal translucency., Aim: Report a new case., Case Report: To our knowledge, we present the first case of early prenatal diagnosis of Pallister Killian Syndrome due to the presence of an increased nuchal translucency, a diaphragmatic hernia, a typical facial dysmorphism and a micromelia of a predominantly rhizomelic type . A chorionic cells biopsy showed a normal karyotype. The diagnosis was revealed on cytogenetic analysis of amniotic fluid sampling., Conclusion: The main ultrasound indicators of PKS seem to be: Hydramnios, congenital diaphragmatic hernia (CDH) and a micromelia of a rhizomelic type. The Hydrops fetalis, hygroma coli or increased nuchal translucency (INT), fetal overgrowth, ventriculomegaly and presence of a sacral appendix are less common. The amniocentesis with the study of the karyotype on amniotic cells is considered to be the gold standard for the diagnosis of PKS. A good morphological study during the first trimester in search of ultrasound abnormalities highly suggestive of PKS is able to direct the cytogenetic study.

Published
2010

12. [Unexpected diagnosis of a cystic pelvic mass: benign mesothelioma of the uterus: case report].

Author

Mourali M, Kedous Z, El Fekih C, Ben Haj Hassine A, Ayadi A, and Zineb NB

Subjects
Adult, Female, Humans, Immunohistochemistry, Immunophenotyping, Prognosis, Treatment Outcome, Ultrasonography, Mesothelioma, Cystic diagnosis, Mesothelioma, Cystic diagnostic imaging, Mesothelioma, Cystic pathology, Mesothelioma, Cystic surgery, Uterine Neoplasms diagnosis, Uterine Neoplasms diagnostic imaging, Uterine Neoplasms pathology, Uterine Neoplasms surgery
Abstract

Background: Benign mesothelioma is a rare tumour mostly found in the genital tract., Case: We report the case of 30-years old woman presenting pelvic pain. The ultrasound scan revealed a cystic pelvic mass. Laparoscopic exploration showed a uterine posterior formation. The resection of the dome was performed. Histologic exam and immnunochemistry concluded to a benign cystic mesothelioma., Conclusion: The benign mesothelioma of the uterus is usually discovered in histology, differential diagnosis for solid forms can be made with leiomyoma or adenomyoma, whereas the cystic forms can be discussed essentially with the ovarian cysts. The presence of mesothelial immunophenotype in immunochemistry improves diagnosis. Clinical outcome is always favourable without recurrence or malignant transformation.

Published
2010

13. [Immature teratoma of the ovary and pregnancy].

Author

Mourali M, Ben Haj Hassine A, El Fekih C, Essoussi-Chikhaoui J, Binous N, Ben Zineb N, Ayadi M, and Mezni F

Subjects
Adult, Female, Humans, Ovarian Neoplasms diagnosis, Ovarian Neoplasms surgery, Pregnancy, Young Adult, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Complications, Neoplastic surgery, Teratoma diagnosis, Teratoma surgery
Abstract

Background: Composing of less than 1% of all ovarian cancers, immature teratoma is a malignancy that mainly affects the young. Immature teratoma of the ovary together with pregnancy is rare. To our knowledge, this association was reported only in twelve cases., Aim: We Report two cases of immature teratoma of the ovary diagnosed during pregnancy and their respective issue., Observation: 1st case. A 28 years old woman gravida 1 with an immature teratoma of the ovary discovered during delivery by caesarean section. The treatment was conservative including salpingo-oophorectomy, omentectomy, aortic lymph node dissection and appendectomy. This patient had a second pregnancy with a good outcome. She delivered by caesarean section in order to perform radical treatment: hysterectomy and oophorectomy of the remaining ovary. 2nd case. A 22 years old woman gravida 1 with adnexal mass diagnosed during an ultrasonography exam at 15 weeks gestation. A conservative treatment was indicated, including salpingo-oophorectomy, omentectomy, aortic lymph node dissection, appendectomy and biopsy of the remaining ovary. The patient had a normal vaginal delivery., Conclusion: Immature teratoma is graded from 1 to 3. The management of this association is discussed, but it takes in consideration the surgical staging, the grade and the secretion of aFP. Conservative treatment without associating chemotherapy can be tempted in tumours with a stade AI and a low grade.

Published
2010

14. [Prenatal diagnosis and management of fetal megacystis].

Author

El Fekih C, Ouerdiane N, Mourali M, Oueslati S, Oueslati B, Binous N, Chaabène M, and Ben Zineb N

Subjects
Abortion, Induced, Adult, Female, Humans, Pregnancy, Ultrasonography, Prenatal Diagnosis, Urinary Bladder abnormalities, Urinary Bladder diagnostic imaging
Abstract

Background: Prenatal diagnosis of fetal megacystis particularly in the first trimester requires assessement of pronostic and aetiologycal criteria., Aim: Report a new case., Case: we report a case of severe megacystis in female fetus diagnosed at 23 weeks of gestation. There are no other associated ultrasound findings. Fetal karyotyping was normal (46XX). Termination of pregnancy for medical indications was realised because of progressive enlargement of the fetal bladder. Post-mortem examination shown megacystis-microcolon-intestinal hypoperistalsis syndrome., Conclusion: Fetal megacystis is a severe condition when diagnosed early in pregnancy. Ultrasonography follow-up and fetal karyotyping are important to evaluate prognosis.

Published
2009

15. [Premature rupture membrane at term with unfavourable cervix].

Author

El Fekih C, Ouerdiane N, Mrezguia C, Mourali M, Douagi M, Abdennebi M, and Ben Zineb N

Subjects
Adolescent, Adult, Cervix Uteri physiology, Cesarean Section, Female, Humans, Infant, Newborn, Labor, Obstetric, Parity, Pregnancy, Prognosis, Prostaglandins administration & dosage, Randomized Controlled Trials as Topic, Time Factors, Cervical Ripening, Fetal Membranes, Premature Rupture diagnosis, Labor, Induced
Abstract

Background: Between expectant attitude in hospital and labour induction, management of and premature rupture membrane at term stay controversial., Aim: The aim of our study was to evaluate the management rupture of the membranes at term with unfavourable cervix., Material and Methods: We conducted a retrospective study. An expectant delay of 24 hours had been followed by induction labour in women with favourable Bishop. Maturation by prostaglandins E2 (PGE2) was performed in case of unfavourable cervix. We administrate one dose each 24 hours (3 doses maxima). Over, labour induction by ocytocine was started. The prescription of antibioprophylaxis is systematic until delivery., Results: We included 137 patients. 51% of patients had a spontaneous labour during the expectant delay. There was no significant difference in neonatal and maternal morbidity in case of expectant management of premature rupture membrane at term., Conclusion: Based on our findings and a review of the literature, an expectative of 24 hours is interesting in case if unfavourable conditions. Prostaglandin E2 maturations can be performed in unfavourable cervixes.

Published
2009

16. [Hereditary hemorrhagic telangiectasia in pregnancy].

Author

Mrazguia C, Chauveaud A, El Fekih C, Ouerdiane N, and Ben Zineb N

Subjects
Adult, Female, Humans, Pregnancy, Pregnancy Complications, Cardiovascular therapy, Pregnancy Complications, Hematologic therapy, Telangiectasia, Hereditary Hemorrhagic therapy
Published
2008

17. [Early HELLP syndrome: a case report in 18 weeks of pregnancy].

Author

Mrazguia C, Chauveaud A, El Fekih C, Ftouh M, and Ben Zineb N

Subjects
Abortion, Therapeutic, Adult, Dexamethasone therapeutic use, Female, Glucocorticoids therapeutic use, Humans, Pregnancy, HELLP Syndrome diagnosis, HELLP Syndrome therapy, Pregnancy Trimester, First
Published
2008

18. [Ovarian hyperstimulation: a complication of a single spontaneous pregnancy].

Author

Mrozguia C, Chouveaud A, El Fekih C, Ben Aziza H, and Ben Zineb N

Subjects
Adult, Female, Humans, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Ultrasonography, Prenatal, Ovarian Hyperstimulation Syndrome diagnostic imaging, Pregnancy Complications diagnostic imaging
Published
2008

19. [Effects of drilling on ovarian volume and follicle count in polycystic ovary syndrome].

Author

Mrazguia C, Chevalier N, and El Fekih C

Subjects
Adult, Clomiphene therapeutic use, Drug Resistance, Electrocoagulation instrumentation, Estrogen Antagonists therapeutic use, Female, Fertility Agents, Female therapeutic use, Humans, Organ Size drug effects, Ovarian Follicle drug effects, Ovarian Follicle pathology, Ovarian Follicle surgery, Ovary drug effects, Ovary pathology, Polycystic Ovary Syndrome drug therapy, Prospective Studies, Electrocoagulation methods, Ovary surgery, Polycystic Ovary Syndrome surgery
Abstract

Aim: To evaluate the effects of drilling on the reduction of the ovarian volume and on the count of antral follicles in case of resistance to clomifene citrate induction,, Methods: We carried a prospective study over two years (2004-2005) in Antoine Beclère hospital. We compared two groups of patients, the first, including 20 patients with PCOS and undergoing an ovarian drilling, the second group involving 19 patients with PCOS and without any medical help to procreate., Results: From our study, the ovarian drilling seems to reduce the number of antral follicles, as well as the ovarian volume., Conclusion: the ovarian drilling, easy and reproducible procedure reduces the number of antral follicles and ovarian volume, leading to normalization of ovarian functioning and thus better results on fertility.

Published
2007

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