[Diagnostic echography of a molar pregnancy with embryo].
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Biomedical subjects
Publications and source records attributed to Y Darbois.
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The authors report 189 case histories of pregnant women who had a neurological disorder, which either existed before the pregnancy or were discovered during the pregnancy. The most frequent aetiological conditions were, epilepsy, psychoses, vascular accidents, tumours and disseminated sclerosis. Pregnancy and neuropathology are an association for which the prognosis as a whole is good and linked to the time in the pregnancy when the neurological condition, whether it is stable or not, is discovered. The combination is absolutely compatible with the normal progress of pregnancy so long as the appropriate treatment is continued during the pregnancy. Cerebral vascular accidents that occur in pregnancy make the prognosis very much worse. In these circumstances neurosurgery may give some hope. This applies also for cerebral tumours, among which pituitary adenoma is becoming more and more frequent. Psychopathies can be a very baffling chapter when they are combined with pregnancy. Finally disseminated sclerosis, once it has been stabilised, is perfectly compatible with the normal outcome for a pregnancy.
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The authors report a new case where a women of 28 years of age started periods spontaneously in spite of having the phenotype of Turner's syndrome and a 45 X karyotype in her lymphocytes and fibroblasts. When she had been stimulated with Clomiphene it was even possible to prove that she had ovulated and produced a functional corpus luteum. No Barr bodies were to be found in the cells from her ovaries and the karotype did not suggest a mosaic which would normally explain this sort of state. All the same, it is difficult to see how any part of the basic follicles can persist in cases of monosomy 45 X if there is no mosaicism.
The authors studied the literature for similar findings in order to try to classify the different types of pneumoperitoneum when they had a case of pneumoperitoneum of genital origin. They then went on to study the mechanism by which these rare cases of genital pneumoperitoneum occurred: the insufflation or aspiration of air through the tubes, tubal antiperistalsis and uterine or vaginal perforations. From the clinical angle it is essential to eliminate pneumoperitoneum secondary to perforation of a hollow organ, and then to look for signs of peritonitis which only occur in genital pneumoperitoneum due to uterine perforation. The case usually cures spontaneously but recurrences are not uncommon. If there are no signs of peritonitis expectant treatment should usually be undertaken.
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The authors report a case of amenorrhoea with galatorrheoa due to a prolactin adenoma secondary to an inducer of ovulation (HMG and HCG) and in which pregnancy occurred. There was sudden progression of the adenoma with formation of a haematoma and the necessity for emergency surgery. In the light of this case, the risks and indications of inducers of ovulation in the sterile woman complaining of amenorrhoea with galactorrhoea are discussed.
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