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.
Malignant melanoma of the female genital tract is rare, and its localization in the cervix is exceptional, it represents 3% of malignant melanomas of the female genital tract, At the initial stage of malignant melanoma of the cervix, the disease is limited to the cervical mucosa, subsequently it spreads locally via direct diffusion to adjacent organs, Clinically there are asymptomatic cases diagnosed during a routine examination, However, more often one has the presence of symptoms, because the cervix ulceration expands easily and become infected. The most common symptom is vaginal bleeding. Macroscopically, primary malignant melanoma presents variable appearances, The spectrum of cellular characteristics is broad, Immunohistochemical markers may be positive in primary cervical malignant melanoma such as S-100, HMB-45, Melan-A, Vimentin, and SOX10, Differential Diagnosis of Primary Malignant Melanoma of the Cervix requires the exclusion of metastatic malignant melanoma, or other primary neoplastic site, mainly dermal, Once the diagnosis of malignant melanoma of the cervix is confirmed, the full staging of the disease should be establishment. This is based on performing a tomography (whole-body CT) or a positron emission tomography (PET / CT), the determination of serum lactate dehydrogenase.The therapeutic approach is not standardized but is rather individualized according to the characteristics of the disease and the patient.
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.