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Objective: The objective of this retrospective study is to compare two types of antimicrobial management used to treat premature rupture of membranes in pregnancy. This study evaluates both duration and the type of antibiotic therapy used for treatment., Patients and Methods: The antimicrobials used to treat premature rupture of membranes include a first generation cephalosporin in one group and amoxicillin in the other group. Cephalosporin was used over a 7-day period to treat 38 cases, whereas amoxicillin was used through delivery in 52 cases. Emergence of multidrug-resistant Gram negative bacteria (GNB) on maternal of neonatal sampling was the primary outcome., Results: Emergence of antibiotic resistant GNB can be seen under both antibiotic regimens and appears to be linked to the duration of latency, and to duration of antibiotic treatment. Other outcomes (duration of latency period, gestational age at delivery, maternal and neonatal complications) were similar in both groups., Conclusion: Antibiotic treatment in PPROM favors a selection of GNB. This emergence is positively linked with the duration of latency between rupture of membranes and delivery and with the length of antibiotic administration. The extension of antibiotherapy does not alter other maternal or neonatal parameters., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: Medical tools to determine the imminence of unplanned out-of-hospital birth have not been validated. The main goal of this study was to analyze assessments of the imminence of these deliveries, by methods such as the Manilas score and the need to push., Patients and Methods: All calls made to the Emergency Medical Aid Service in Guadeloupe concerning risks of unplanned delivery between January 1st and June 30th 2011 were reviewed retrospectively, and 69 of the 85 cases cared for by the hospital mobile emergency unit were included., Results: Risks of unplanned out-of-hospital deliveries represented 1.9% of the calls during the study period. The Malinas score was used for dispatching in only 13% and was not used for intervention in any case. It was estimated that the need-to-push feeling was used for 58% (dispatching) and 54.5% (intervention) of patients. Its sensitivity, specificity and predictive values were higher than those of the Malinas score in dispatching and substantially higher in intervention., Conclusion: These results argue for the development of tools for estimating the imminence of unplanned delivery. Such tools should be applicable in extra-hospital emergency situations to ensure their use in practice., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: In Guadeloupe (French West Indies), fecondity rate of teenagers is higher than in mainland France. The aim of our study was to analyze sociodemographic characteristics and perinatal indicators among underage girls and to compare them to those of a previous study also conducted in our maternity unit in 1993 and 1994., Materials and Methods: The sociodemographic, medical, obstetrical and neonatal data of 163 underage pregnant girls delivered from 2009 to 2010 at the University hospital of Pointe-à-Pitre/Abymes were collected retrospectively and compared with the previous study., Results: In 16 years, in contrast to perinatal indicators, which did not significantly evolve, the sociodemographic characteristics of this population have changed. In addition, the increase of neonatal morbidity seems to be related to late initiation of obstetrical care, which also still remains insufficient., Conclusion: Our results are close to those described in the other French regions and have hardly evolved since our previous study. The differences found for the obstetric and perinatal risks seem to be related to sociodemographic factors surrounding these underage pregnancies. Those factors should be taken into consideration in any approach aiming to reduce incidence and prevent complications of pregnancies among teenagers., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: The aim of this study was to describe the typical profile, and to assess the motivations of women who underwent illegal abortion with misoprostol in Guadeloupe (French West Indies)., Materials and Methods: We conducted a 1-year prospective study on women who consulted after failure or complication of an illegal abortion with misoprostol., Results: Fifty-two cases of illegal abortion with misoprostol were recorded. The most common profile was an unemployed woman, who was unmarried, foreign-born, had no medical insurance, and a low level of education; the median age was 28 (range 17 to 40). The justifications given were that the legal procedure was considered to be too slow, the young age of the woman, the ease of the self-medication procedure, a history of illegal abortion by misoprostol in the woman's country of origin, ignorance of the legal process, and financial and/or administrative problems., Conclusion: The problem of illegal abortion is probably underestimated in Guadeloupe and possibly France. This description of the profile of the population concerned and the justifications for choosing illegal abortion by misoprostol provides elements allowing better focus of education concerning abortion, contraception and family planning. Access to legal abortion centers should also be improved., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objectives: Guadeloupe is the second highest French area for diagnosis and prevalence of HIV infection and AIDS. In October 2009, the French High Health Authority has published guidelines for a more systematic HIV screening. The goal of this study is to identify the limitations in HIV testing prescription by the Guadeloupian prescribers according to these new recommendations., Materials and Methods: Data were collected with a questionnaire submitted to physicians and midwives after random selection., Results: Among 285 randomly selected prescribers, 67 midwives and 40 physicians participated from August to December 2010. The main limitations to HIV testing prescription were: a consultation for another purpose, patient or his life style were known, and lack of HIV infection symptoms. Some characteristics of more easily screened patient did not match with those who had been newly diagnosed in Guadeloupe. Finally, both quantitative and qualitative knowledge of these new recommendations was insufficient., Conclusion: Implementation of these new testing recommendations should give emphasis to the systematic and annual nature of HIV testing for whole population. It should also insist on distinction between HIV testing and diagnosis of a symptomatic patient., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

The authors report a case of pregnancy in a rudimentary horn diagnosed by laparotomy. The location could not be suspected by any clinical sign. This pregnancy stopped at 19 weeks of amenorrhoea. Any attempts of induction of labour failed. Laparotomy was necessary to assess the diagnosis and to allow the resection of the uterine horn. The authors present a review of literature.