Systemic lupus (LS) is an autoimmune disease mainly affecting young women of childbearing age, The occurrence of pregnancy with lupus has become a usual situation, active lupus in the 6 months preceding or at the beginning of pregnancy has more risk of having an attack, the lupus known preceding the pregnancy must make this last programmed.Maternal mortality is multiplied by 20 in lupus patients, this seems to be essentially linked to the activity of LS, the occurrence of pre-eclampsia, the presence of anti-phospholipid antibodies and the side effects of therapies, in particular infectious.Fetal and perinatal risks are linked to prematurity, the presence of maternal anti-phospholipid or anti- SSA antibodies and the side effects of treatment.The most common situation is the knowledge of lupus before pregnancy. Our case treats an unrecognized lupus triggered by pregnancy, monitoring and management must be multidisciplinary, including regular clinical, biological and ultrasound evaluation.The treatment of relapses varies according to the severity and the type of organ affected and remains similar to the treatment outside pregnancy subject to the compatibility of the treatments with this one: hydroxy chloroquine, corticosteroid bolus if necessary then orally with the lowest possible dose, which markedly improved the prognosis.

Hereditary angioedema is a recently identified inherited entity. Schematically, the C1 inhibitor (C1Inh) sees its function decrease with estrogens, an event associated with a semiology made up of edema attacks. Classically, this clinical form is aggravated by synthetic estrogens, and improved by natural estrogens. We report the case of a woman who successfully led a pregnancy, despite the various crises observed throughout the pregnancy with functional repercussions.

Carbon monoxide poisoning during pregnancy is a rare and potentially serious condition. Fetal complications are uncommon, related to anoxic lesions. The severity of these complications does not depend on the level of maternal COHb.We report the case of 25-year-old woman 2 months pregnant and half accidentally exposed to domestic gas who was received in a state of unconsciousness with medium abundant bleeding in gynecology and obstetrics emergencies of the maternity souissi CHU in Rabat where we have seen an abortion in progress with expulsion of the product of conception.

The systematization of ultrasound in the 1st trimester with a search for the nuchal translucency has made it possible to detect numerous pathologies, in particular cystic hygroma, the prevalence of which can reach 2%, and which is defined as having a retro and laterocervical poly cystic mass, These cystic formations are composed of multiple compartments of varying size and containing a liquid; and they are microscopically defined as new cavities formed in the connective tissue and lacking a classic cystic wall, that is to say, they are pseudo-cysts without an internal coating, hence the interest in differentiating them from cervical cystic lymphangioma which has a lymphatic endothelial type coating of variable volume, related to sequestration of lymphatic fluid in the nuchal connective tissue. And which is generally unilateral left anterolateral, and can also involve the shoulder.And also differentiating them from the occipital meningocele by the demonstration of a defect of the bone closure at the level of the cervical spine.Cystic hygroma is often associated with karyotype abnormalities of up to 80% made of monosomy X or trisomy 21 or others, as well as other morphological abnormalities; cardiac, diaphragmatic, skeletal or a set of syndrome. A good knowledge of the factors of poor prognosis makes it possible to inform prenatal counseling and set up correct management.

It is estimated that more than 2% of pregnant women have hypothyroidism and that the incidence of treated hypothyroidism prior to pregnancy is around 0.3% of pregnancies. In the majority of cases, hypothyroidism is mild and is due to an autoimmune mechanism, as evidenced by the presence of anti-TPO or antithyroglobulin antibodies. Pregnancy may be indicative of a fruste form, related to asymptomatic autoimmune thyroiditis, which is unable to increase its hormone production to meet the specific needs of pregnancy. It can also be the consequence of moderate or severe iodine deficiency. Moreover, thyroid balance during pregnancy is essential for good fetal brain development. In fact, several studies have shown that children born to mothers who are not or insufficiently substituted for hypothyroidism have lower intelligence quotients than the general population. In addition, other maternal consequences (gravid hypertension, pre-eclampsia, etc.) and fetal consequences (IUGR, intellectual deficit) of hypothyroidism during pregnancy have been described. Although current recommendations suggest targeted screening of patients at risk of hypothyroidism, it is desirable that, in the near future, this screening becomes systematic as soon as the diagnosis of pregnancy is confirmed. L-thyroxine treatment should then be rapidly initiated (or adapted in the case of known hypothyroidism prior to pregnancy) with the aim of achieving a TSH of less than 2.5 mIU/l. In all cases, iodine supplementation should be offered from the preconceptional period through to breastfeeding.

Cornual pregnancy is a rare form of ectopic pregnancy, involving the uterine horn. It constitutes a gynecological emergency due to the major risk of cataclysmic uterine rupture which can jeopardize the maternal vital prognosis. Its seriousness lies mainly in the diagnosis. The management of this formerly exclusively surgical pathology has evolved to medical treatment, or even the abstention from any therapy. Our main objective is to assess the effectiveness of the different types of care offered to these two patients.

Subcapsular hepatic haematoma is a rare complication of preeclampsia occurring mainly in the context of HELLP syndrome, it is associated with a high mortality or morbidity rate. An early diagnosis before the break point of the hematoma and a multidisciplinary proper care is mandatory.We report one case of cracked subcapsular hematoma liver collected at the Hospital of Maternity Souissi Rabat, with a favourable evolution that was observed after surgical management limited to hepatic packing and transfusion.

Ovarian vein thrombophlebitis is a rare complication that must be evoked and sought, Paticularly in front of the persistance of a febrile abdomonal pain syndrome, before childbirth, postpartum and also in postabortum.The imaging means, we currently have, especially the doppler echo, computed tomography (TDM) and magnetic reasoning imagin (IRM) allow us to make this diagnosis and choose the most suitable treatment.

Interstitial pregnancy is a rare form of ectopic pregnancy. It is characterized by its implantation in the intra-myometrial part of the fallopian tube. It constitutes a gynecological emergency since its rupture can lead to morbidity and mortality. Its diagnosis remains difficult, and is based on four ultrasound criteria which are not always found. In the absence of rupture, conservative medical treatment is used more and more because it allows anatomical integrity to be preserved. We report a case of interstitial pregnancy successfully treated with a single injection of Methotrexate intramuscularly.

Postpartum hemorrhage is a main cause of maternal death, it can be primary or secondary depending on the time of onset. Although less frequent, secondary haemorrhages keep a high morbidity and mortality rate, which is accentuated by the difficulty of diagnosis and determination of the etiologies especially in rare causes like the pseudo-aneurism of the uterine artery, a vascular abnormality in most cases caused by a traumatic lesion of the blood vessel most often during cesarean section. The diagnosis is examined in front of clinical and ultrasound elements, and confirmed by CT scan, MRI, or angiography which also allows therapeutic treatment thanks to embolization. We report the case of a 27-year-old patient who presented with late postpartum hemorrhage secondary to a pseudoaneurysm of the uterine artery, suspected by ultrasound and confirmed by CT scan, the patient underwent embolization with good evolution. Despite its rarity, pseudoaneurysm of the uterine artery is a potentially fatal complication and must be taken into account in the differential diagnosis of secondary postpartum hemorrhage allowing adequate and rapid management.

The spontaneous rupture of uterine varicose veins during pregnancy and more particularly in the third trimester, is an exceptional cause of hemorrhagic shock by hemoperitoneum. Its diagnosis is difficult due to its rarity and the absence of specific signs. Maternal-fetal care must be immediate in order to reduce high fetal mortality and limit maternal morbidity.

Ovarian carcinosarcoma also known as mixed mesodermal tumor or mixed Mullerian tumor is a rare gynecological tumor that accounts for less than 2% of ovarian cancers. It is an aggressive tumor which combines a carcinomatous component with a sarcomatous component. In the genital tract, it most often sits in the uterus. The ovary, cervix or vagina are more rarely affected. Carcinosarcoma interests women rather between 60 and 70 years of age. The main prognostic factor found is the initial stage, most often advanced: At diagnosis, more than 90% of ovarian carcinosarcomas have an extra-ovarian extension.Surgical management is a determining factor for the survival of patients. Carcinosarcoma is an aggressive tumor, the median survival is 7 to 27 months for ovarian carcinosarcomas. Relapses mainly occur in the first year. The FIGO stage is the most important prognostic factor.Complete surgery, advanced age, the grade of the sarcomatous component and adjuvant chemotherapy are found in the rare published retrospective studies. The response rate to chemotherapy is approximately 20%.

Uterine fibroids or leiomyomas are benign myometrial tumors. They are found in 20% of women of reproductive age. Outer uterine localization is rare and of poorly understood pathophysiology, and poses a diagnostic problem. Only the pathological examination can establish the diagnosis. We report two cases of ectopic localization, the ovary and the broad ligament, the diagnosis of which was not made in the first place.

The twin-to-twin transfusion syndrome (TTTS) is a specific complication of monochorionic twin pregnancies. The diagnosis is often established in the second trimester of pregnancy and is based on a set of ultrasound arguments. The management of this complication is conditioned by the gestational age of onset and by the hemodynamic tolerance of the two fetuses. Severe and early forms (<26 weeks of amenorrhea) are treated by laser coagulation of placental vascular anastomoses.

Osteoid metaplasia of the endometrium is a rare and little-known entity that corresponds to the presence of bone tissue in the endometrium and is responsible for secondary infertility. It is often found in young women of childbearing age with a history of abortion. The physiopathology remains incompletely understood. Ultrasound, hysteroscopy and biopsy allow diagnosis. Operative hysteroscopy represents the ideal therapeutic means for obstetrical prognosis and for restoring fertility.

The Ovarian Carcinosarcoma also known as malignant mixed Müllerian tumor is a rare malignant neoplasm that histologically contain both epithelial and stromal components. This aggressive tumor is found not only in the ovary but also in other organs of the genito-urinary tract, including uterus. It is usually diagnosed at older age and advanced stage. The Ovarian Carcinosarcoma patients have very poor prognosis. Surgical treatment is a determining factor for the survival of patients. The response rate to chemotherapy is about 20 %. We illustrate the article with a clinical case reporting the positive diagnosis of ovarian carcinosarcoma.

The Belly Prune Syndrome is an extremely rare and complex anatomo-radiological entity with a clear male predominance. It is characterized by hypoplasia of the abdominal musculature, abnormalities of the urinary tract and bilateral cryptorchidism forming the classic triad of the syndrome. This pathology is associated in 75% of cases with pulmonary, skeletal, cardiac and gastrointestinal malformations. Nous illustrons l’article par un cas clinique rapportant le diagnostic positif du syndrome de Prune Belly.

We illustrate a rare association of a primitive cancer of the breast and the lung primitive cancer by the case of a 67-year-old woman, a fortuitous discovery during a balance sheet operating meadow in particular of extension of a nodule of the left breast classified radiologically BIRADS 4. This exceptional known association imposes a search for the genetic factors, and the factors which favor the arisen of the cancer. But especially, she requires a multidisciplinary coverage seen the difficulty of the therapeutic decision.

Conjoined twins (JC) represent a malformative abnormality that concerns monozygotic twin pregnancies, it is a rare entity that poses a real diagnostic and therapeutic challenge. We report a case of Conjoined twins through which we will expose the various difficulties encountered during the management of this type of anomalies.

Ovarian pregnancy (GO) is rare. Unlike other types of GEU, GO remains an isolated and exceptional phenomenon in a woman's life, independent of the usual risk factors and the exact mechanism leading to a GO remains poorly understood. The anatomopathological study authenticates the diagnosis, sometimes referred to intraoperatively. . We report the case of ovarian pregnancy met at the Souissi maternity hospital in Rabat and the different stages of care.

The diagnosis of rectal cancer during pregnancy remains difficult today. This association is rare. the diagnostic problem is mainly therapeutic and is not yet the subject of a consensus. Indeed, the care need a multidisciplinary team to be able to remedy this pathological situation. We report two cases of rectal cancer discovered during pregnancy, with the management of the disease, the outcome of the patients, and a review of the literature.

Idiopathic granulomatous mastitis is a chronic inflammatory benign mastopathy of the young woman. It is quite rare and his etiology remains poorly known. The clinic can sometimes be confused with a carcinomatous lesion, so the diagnosis is essentially histological, and the treatment is based on the use of anti-inflammatories, corticosteroids or colchicine to allow healing and avoid repetitive surgical mutilations. We report two cases of idiopathic granulomatous mastitis, one having been treated with colchicine and the other by corticosteroid with favorable evolution, while analyzing the clinical, radiological and therapeutic aspects.

The subcapsular hematoma of the liver (HSCF) is a rare complication of pregnancy with high maternal-fetal mortality. This therefore requires rapid diagnosis and appropriate care. His secondary rupture is one of the most serious obstetric complications. Maternal mortality is 50% to 75%, that of the fetus is 60% to 80%. We illustrate the article with a clinical case reporting the management of a subcapsular hematoma of the liver.

Metaplastic breast carcinomas are rare tumors, represent less than 1% of invasive breast cancers, and constitute a heterogeneous group of tumors defined by the World Health Organization as infiltrating ductal carcinoma but with zones of metaplastic rearrangements of Epidermoid, fusiform, chondroid, bone or mixed type. Histopathology combined with immunohistochemistry makes it possible to make the diagnosis. Treatment combines surgery, and chemotherapy, radiotherapy is discussed and hormone therapy has no place. Their prognosis is bleak and the evolution is marked by locoregional recurrences and distant metastases. We report two cases of metaplastic breast carcinoma diagnosed by histology supplemented by immunohistochemistry, the treatment consisted of a mastectomy with axillary dissection supplemented by chemotherapy.

Angiosarcoma of the breast is a very rare conjunctive tumor. It is a primitive malignant proliferation of the endothelial cells of the vascular tissue of the gland. It occurs in both a primary form without a known precursor, and a secondary form that has been associated to a history of irradiated breast tissue. Both forms have a malignant behavior and a poor prognosis. We report a case of breast angiosarcoma diagnosed by histology and treatment consisting of a mastectomy supplemented by chemotherapy and radiotherapy.

Mammary tuberculosis is a rare disease even in endemic countries, accounts for 0.07℅ of all tuberculous sites and 0.025℅ to 4.5℅ of all breast tumor diseases. There is renewed interest in the spread of AIDS in developed countries. We report three cases of mammary tuberculosis, the diagnosis of which could only be based on the histology seen in the multiplicity and non-specificity of its clinical and radiological aspects.