Reports about uterine rupture in pregnancy subsequent to previous laparoscopic surgery are not frequent. This may be due to the lack of long term follow up of patients who had undergone this surgery rather than the rarity of this complication. A case of uterine rupture subsequent to laparoscopic myomectomy is reported. An increasing rate of the occurrence of this complication is reviewed in current literature, thus reiterating the need for more stringent selection criteria for patients who benefit from this surgical technique.

A case i s pr esented of pr egnancy and del i ver y of tr i pl ets fol l ow i ng i ntr acytopl asmi c sper m i njecti on (I CSI) ther apy. A l though the outcome w as sati sfactor y, w i th the bi r th of nor mal chi l dr en fr ee fr om any mal for mati on, most of the obstetr i c and par ti cul ar l y the neonatal compl i cati ons that can be associated with this therapy are illustrated in this case. In addition, from point of view of medi cal costs, concer ns ar e r ai sed about the cur r ent pol i cy of mul ti pl e embr yo tr ansfer w hi ch i s di r ectl y r esponsi bl e for the hi gh r ate of mul ti pl e gestati ons obser ved i n the I VF/I CSI pr ogr amme. The author s consequentl y r ecommend a pol i cy of tr ansferring not more than two embryos per tr eatment cycl e. Twin Research (2000) 3, 76-79.

A case is presented of pregnancy and delivery of triplets following intracytoplasmic sperm injection (ICSI) therapy. Although the outcome was satisfactory, with the birth of normal children free from any malformation, most of the obstetric and particularly the neonatal complications that can be associated with this therapy are illustrated in this case. In addition, from point of view of medical costs, concerns are raised about the current policy of multiple embryo transfer which is directly responsible for the high rate of multiple gestations observed in the IVF/ICSI programme. The authors consequently recommend a policy of transferring not more than two embryos per treatment cycle.

We report on a series of 146 cases of vaginal delivery after previous Caesarean section conducted between 1993 and 2002 at the University Teaching Hospital, Yaounde (Cameroon). During the period under review 945 cases of Caesarean section were done out of a total of 9 439 deliveries (10 %). Delivery was spontaneous in 141 cases whereas in 5 cases it was assisted by vacuum extraction. In 13 cases Caesarean section was carried out after failure of trial of labour. Maternal mortality, resulting from pulmonary embolism, was observed in 1 case. We conclude that strict selection of patients who had previous Caesarean section for trial of labour renders vaginal delivery a safe alternative to Caesarean section.