[Antenatal diagnosis and contribution of fetopathologic examination in the management of omphalocele]

The omphalocele is an average coelosomie, frequency of which is estimated at 1/5000 births. We confront diagnosis antenatal with the exam foetopathologic in purpose of 41 cases of omphalocele brought together over a period going from January 1, 1991 till December, 2000 in the unity of foetopathologie from the CMNT. The frequency of omphaloceles is 4.88% of the children malformed and of 1.64% of the set (group) of the performed an autopsy children. An association malformative was found in 85.4% of cases and a karyotype typical aberration trisomie 13.18 and 21 was identified in 17% of cases. The preview of the children bearers of this deformation is especially bound (connected) to the existence and to the gravity of associated abnormalities. The omphalocele required a multidisciplinary making coverage intervernir obstetriciens, néonatologistes, surgeons pediatre and foetopathologistes.

[Medical termination of pregnancy. Indications, techniques and complications. Report of 55 cases]

We tried through this study to reassemble the cases of medical termination of pregnancy for foetal or maternal anomalies and analyse the epidemiological characteristics of our population and the procedures of induction of labour. We report a retrospective study about 55 cases of medical termination of pregnancy during 20 months indexed in service "C" of the centre of maternity and neonalogy in collaboration with the service of fetopathology. 12.73% of our patients were older than 38 years. The incidence of medical termination of pregnancy during the same period was about 1.90 cases/100 deliveries. Maternal indications was reported in 34.55% of cases and neurological malformations dominate the foetal anomalies (47.22%). Extra-amniotic saline infusion was used in 52.72% of cases and was responsible of all the complications observed (16.36%).

[Fetal pathology study of 88 cases of letal spina bifida]

Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.

[Fetal pathology aspects of 97 cases of anencephaly. CMNR Tunisian study]

So, the epidemiologic study done for 8 years at CMNR Tunis has shown that the incidence is 1.15@1000 births (between 0.52 and 1.66@1000 per year). This anomaly is more frequent in female sex (sex linked = 0.59). The antenatal echographic diagnosis is efficient in 90.5%. This anomaly is more shown at low socio-economic group. The improvement of the socio-economic level and specially the daily uptake of acid folic in periconceptionnel time decrease the frequency of this congenital malformation.

[Oligohydramnios and fetal malformation association]

L'Oligaminos is sometimes discovered during echographic exploration in obstetrics. Etiology is dominated by renal malformations, obstructive myopathies and polymalformatives syndromes therapeutic interruption of pregnancy needs to be discussed in case of bilateral renal malformation.