[Normal twin delivery].
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Biomedical subjects
Publications and source records attributed to P Houlné.
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The authors report three cases of jaundice which developed during pregnancy and which rapidly resulted in the death of the patients. One case was a fulminant case of cytomegalovirus hepatitis and the other two were cases of acute steatosis of pregnancy. The clinical features are marked by the rapid development of a neurological syndrome resulting in coma and the association of blood dyscrasias due to major hepato-cellular failure resulting in DIC. The rapid progression of the disease generally results in the death of the mother and the child. However, there are some reports of survival with total cure after rapid extraction of the foetus, which justify an active therapeutic attitude.
In a series of 28 cases of retroplacental haematoma, 12 presented an incomplete clinical syndrome (absence de shock--absence of contracture--presence of foetal heart sounds), usually with an association of back pain and vaginal bleeding. These apparently minor forms can be diagnosed on the basis of the vascular context, their development at the 3rd trimester of pregnancy and by the inevitable repercussions on the foetus. They differ from the typical forms by the lower frequency and severity of this foetal distress, provided these atypical and incomplete symptoms have been correctly interpreted allowing early appropriate intervention. One of the elements of an improved overall prognosis for retroplacental haematomas consists of more effective detection of incomplete, and therefore misleading, forms, which have a high incidence (42.8% of all retroplacental haematomas in our series).