Cabinet de Gynécologie Docteur Khaled Boudhraa

18/05/2024

La congélation des ovocytes est un droit pour les femmes !تجميد البويضات حق

16/05/2024

La congélation des ovocytes est un droit !تجميد البويضات حق

27/08/2023

AJOG Expert Review in Labor: A critical evaluation of the external and internal maneuvers for resolution of shoulder dystocia - McRoberts maneuver
A, Hyperflexion of the hips is more effective by pressing at the back of the thigh (blue arrow). The accoucheur can also lean in the same direction (red arrow) to assist hyperflexion. A successful McRoberts position should lead to pelvic cephaloid rotation (curved orange arrow), evident by the lifting up of the maternal buttocks (black arrow). B, A commonly adopted method used to hyperflex the hip, as illustrated in textbooks, is to hold the maternal foot and around the knee and push toward the maternal head (blue arrow). However, it is less effective and cause discomfort at the ankle. https://ow.ly/lYr450PB52f

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - Stepwise uterine devascularization
AbdRabbo has proposed a stepwise uterine devascularization in 5 steps, with each step being performed only if the preceding step did not stop the hemorrhage within 10 minutes: unilateral and then bilateral ligation of the uterine arteries (1+2), stepwise low ligation of both uterine arteries (3), unilateral and then bilateral ligation of the suspensory ligaments of the o***y (4+5). We advised against steps 4 and 5 because of the risk of subsequent ovarian failure. https://ow.ly/shmc50PCNhT

27/08/2023

Care plan for individuals at risk for preeclampsia: shared approach to education, strategies for prevention, surveillance, and follow-up - Cardiovascular disease assessment in pregnant and postpartum women https://ow.ly/y1ap50PEiRI

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - Technique of hemostatic multiple square suturing by Cho et al
Suturing the serosa of the anterior wall to the serosa of the posterior wall in square 4-stitch sutures.Making this multistitch square suture requires the placement of 4 suture points by a straight needle with No. 0 polyglactin 910:

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The first stitch (1) penetrates the anterior and then the posterior wall of the uterus.
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The second stitch (2) retransfixes the posterior wall to the anterior wall on the same horizontal line 2 to 3 cm from the first suture point to its left.
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The third (3) is performed by penetrating the anterior then posterior walls of the uterus, along the same vertical line 2 to 3 cm away from and below the second suture point.
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The fourth stitch (4) penetrates first the posterior and then the anterior wall on the same horizontal line at 2 to 3 cm from the third suture point, but toward the first point, that is, to the right of the third suture point, thus forming a square.
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Finally, both suture ends, from points 1 and 4 are tied together to make a square. https://ow.ly/shmc50PCNhT

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - A proposed algorithm of surgical technique to control postpartum hemorrhage refractory to medical treatment: The superscript letter a denotes this is only a proposal. The choice, in particular for the first uterine-sparing surgical procedure, between uterine artery ligation and uterine compression sutures depends mainly on the operator’s preference. The superscript letter b denotes uterine artery ligation or Tsirulnikov’s triple ligation or stepwise uterine devascularization. The superscript letter c denotes B-Lynch or Cho suturing techniques. https://ow.ly/shmc50PCNhT

27/08/2023

AJOG Expert Review in Labor: Uterine-sparing surgical procedures to control postpartum hemorrhage - B-Lynch’s technique of uterine compression by plication
A, Diagram. The technique described here begins on the left side:
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The needle crosses the anterior wall of the uterus approximately 3 cm under the still open, unsutured incision to 3 cm from the left lateral edge of the left uterus.
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It goes back through the anterior wall of the uterus and emerges 3 cm above the incision, still approximately 3 cm from the left lateral edge of the uterus. Steps (1) and (2) describe the first “passage” of the needle.
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The suture travels up the anterior wall of the uterus, crosses the top of the fundus, and descends down the left posterolateral wall.
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The needle pierces the posterior wall and enters the uterine cavity at the same level of the preceding suture point (3 cm above the incision), that is, in the superior portion of the uterine body-isthmus junction, always approximately 3 cm from the left lateral edge of the uterus.
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The needle again pierces the posterior wall at the same horizontal level as the previous suture point, but this time, at approximately 3 cm from the right lateral edge (the other side) of the uterus. Steps (4) and (5) describe the second passage of the needle.
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The suture, now on the posterior wall of the uterus, moves up toward the uterine fundus along the right lateral edge of the uterus, to descend down the right anterolateral wall.
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It returns back through the anterior wall of the uterus and emerges 3 cm above the incision, still approximately 3 cm from the right lateral edge of the uterus.
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The needle again crosses the anterior wall of the uterus, this time approximately 3 cm above the (still unsutured) incision. Steps (7) and (8) describe the third passage of the needle.
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The incision is then sutured according to the usual technique.
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Both ends of the suture (straight needle, No. 0 polyglactin 910) are then put under tension, helped by the assistant's manual compression, to be able to press one wall against the other. Both sutures are then tied at a lower level of the lower segment, under the now sutured incision.

B, Intraoperative view of myometrial brace compression by B-Lynch https://ow.ly/shmc50PCNhT

01/05/2023

07/01/2023

Suivi de la grossesse متابعة الحمل

26/11/2022

Grossesse extra-utérine
الحمل خارج الرحم