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Affronti G, Agostini V, Brizzi A, Bucci L, De Blasio E, Frigo MG, Giorgini C, Messina M, Ragusa A, Sirimarco F, Svelato A. The daily-practiced post-partum hemorrhage management: an Italian multidisciplinary attended protocol. Clin Ter 2017; 168:e307-e316. [PMID: 29044353 DOI: 10.7417/t.2017.2026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Postpartum hemorrhage (PPH) is one of the most frequent causes of mortality and morbidity in the obstetric population globally, causing about a quarter of maternal deaths yearly, and is the leading cause of maternal death worldwide. The management of PPH remains a topic of great debate, even in view of new diagnostic and therapeutic possibilities in recent years, for which, however, the body of evidence available thus far is still scarce, as the standard values are lacking. The protocol hereby presented was developed after a literature review and during several meetings of an Italian multidisciplinary task group of specialists adopting a modified Delphi method, and is the result of the synthesis of therapeutic operational protocols for the treatment of PPH applied by the different specialties within the team. This protocol is intended to represent a practical proposal to support clinicians in the management of a particularly complex event that requires the intervention of a multidisciplinary team and the implementation of dedicated management protocols.
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Affiliation(s)
- G Affronti
- Past direttore SC Ostetricia e Ginecologia, Ospedale S. Maria della Misericordia, AOU, Perugia
| | - V Agostini
- UO Servizio Immunoematologia e Medicina Trasfusionale, Cesena-Forlì, Officina Trasfusionale Pievesestina; Medicina Trasfusionale Ospedale M. Bufalini, Cesena
| | - A Brizzi
- Anestesia generale e locoregionale, Clinica S. Maria, Bari
| | - L Bucci
- Anestesia e Rianimazione 1, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - E De Blasio
- UOC Anestesia e Rianimazione, Azienda Ospedaliera G. Rummo, Benevento
| | - M G Frigo
- UOS Anestesia e Rianimazione in Ostetricia, Ospedale Fatebenefratelli S. Giovanni Calibita, Roma
| | - C Giorgini
- SC Anestesia e Rianimazione, Ospedale S. Maria della Misericordia, Azienda Ospedaliero-Universitaria di Perugia
| | - M Messina
- Immunoematologia e medicina trasfusionale, Azienda Ospedaliera OIRM-Sant'Anna, Torino
| | - A Ragusa
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
| | - F Sirimarco
- UO SC Ostetricia e Ginecologia, Azienda Ospedaliera Cardarelli, Napoli, Italia
| | - A Svelato
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
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Di Donato P, Giulini NA, Bacchi Modena A, Cicchetti G, Comitini G, Gentile G, Cristiani P, Careccia A, Esposito E, Gualdi F, Golinelli S, Bergamini E, Masellis G, Rastelli S, Gigli C, Elia A, Marchesoni D, Sticotti F, Del Frate G, Zompicchiatti C, Marino L, Costa MR, Pinto P, Dodero D, Storace A, Spinelli G, Quaranta S, Bossi CM, Ollago A, Omodei U, Vaccari M, Luerti M, Repetti F, Zandonini G, Raspagliesi F, Dolci F, Gambarino G, De Pasquale B, Polizzotti G, Borsellino G, Alpinelli P, Natale N, Colombo D, Belloni C, Viani A, Cecchini G, Vinci GW, Samaja BA, Pasinetti E, Penotti M, Ognissanti F, Pesando P, Malanetto C, Gallo M, Dolfin G, Tartaglino P, Mossotto D, Pistoni A, Tarani A, Rattazzi PD, Rossaro D, Campanella M, Arisi E, Gamper M, Salvatores D, Bocchin E, Stellin G, Meli G, Azzini V, Tirozzi F, Buoso G, Fraioli R, Marsoni V, Cetera C, Sposetti R, Candiotto E, Pignalosa R, Del Pup L, Bellati U, Angeloni C, Buonerba M, Garzarelli S, Santilli C, Mucci M, Di Nisio Q, Cappa F, Pierangeli I, Cordone A, Falasca L, Ferrante D, Serra GB, Cirese E, Todaro PA, Romanini C, Spagnuolo L, Lanzone A, Donadio C, Fabiani M, Baldaccini E, Votano S, Bellardini P, Favale W, Monti V, Bonomo A, Boninfante CE, Pietrobattista P, Massacesi L, Donini G, Del Savio F, Palombi L, Procaccioli P, Romani A, Romagnoli G, Genazzani AR, Gambacciani M, Scarselli G, Curiel P, De Leo V, Melani A, Levi D'Ancona V, Giarrè G, Di Gioia E, Ceccarelli P, Massi GB, Cosci S, Gacci G, Cascianini A, Donati Sarti C, Bircolotti S, Pupita P, Mincigrucci M, Spadafora A, Santeufemia G, Marongiu G, Lai GR, Lai R, Dessole S, D'Andrea SA, Chiantera A, Arienzo R, Pastore AR, Tamburrino A, Cardone A, Colacurci N, Izzo S, Tesauro R, Pascarella A, De Silvio MG, Di Prisco L, Lauda N, Sirimarco F, Agrimi C, Casarella G, Senatore G, Ronzini S, Ruccia G, De Carlo G, Pisaturo G, Carlomagno F, Fasolino A, Fiorillo F, Sorrentino R, Ercolano VB, Panariello S, Brun A, Tropea P, Stigliano CM, Amoroso A, Vadalà P, Coco A, Galati G, Barese G, Masciari G, Pirillo P, Gioffrè T, Mastrantonio P, Cardamone A, D'Angelo N, Valentino G, Barretta R, Ferraro G, Ferruccio C, Agostinelli D, Corrado G, Scopelliti A, Schonauer S, Trojano V, Bongiovanni F, Tinelli F, Poddi ER, Scarpello F, Colonna L, Fischetti G, Doria R, Trombetta G, Cocca EB, D'Amore A, Di Masi M, Liguori R, Dimaggio A, Laneve MR, Maolo MC, Gravina G, Nacci G, Nocera F, Lupo A, Giannola C, Graziano R, Mezzatesta M, Vegna G, Giannone G, Palumbo G, Cancellieri F, Mondo A, Cordopatri A, Carrubba M, Mazzola V, Cincotta L, D'Asta S, Bono A, Li Calsi L, Cavallaro Nigro S, Schilirò S, Repici A, Gullo D, Orlando A, Specchiale F, Papotto A, Giulia FV, Adige TA, D'Aosta V, Massacesi A, Chiantera A, Donati Sarti C, De Aloysio P, Omodei U, Ognissanti F, Campagnoli C, Penotti M, Gambacciani A, Graziottin A, Baldi C, Colacurci N, Corrado Tonti G, Parazzini F, Chatenoud L. Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study. Climacteric 2009; 8:287-93. [PMID: 16397927 DOI: 10.1080/13697130500196866] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause. SUBJECTS Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. METHODS Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year. RESULTS Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73). CONCLUSIONS This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.
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Di Donato P, Giulini NA, Bacchi Modena A, Cicchetti G, Comitini G, Gentile G, Cristiani P, Careccia A, Esposito E, Gualdi F, Golinelli S, Bergamini E, Masellis G, Rastelli S, Gigli C, Elia A, Marchesoni D, Sticotti F, Del Frate G, Zompicchiatti C, Marino L, Costa MR, Pinto P, Dodero D, Storace A, Spinelli G, Quaranta S, Bossi CM, Ollago A, Omodei U, Vaccari M, Luerti M, Repetti F, Zandonini G, Raspagliesi F, Dolci F, Gambarino G, De Pasquale B, Polizzotti G, Borsellino G, Alpinelli P, Natale N, Colombo D, Belloni C, Viani A, Cecchini G, Vinci GW, Samaja BA, Pasinetti E, Penotti M, Ognissanti F, Pesando P, Malanetto C, Gallo M, Dolfin G, Tartaglino P, Mossotto D, Pistoni A, Tarani A, Rattazzi PD, Rossaro D, Campanella M, Arisi E, Gamper M, Salvatores D, Bocchin E, Stellin G, Meli G, Azzini V, Tirozzi F, Buoso G, Fraioli R, Marsoni V, Cetera C, Sposetti R, Candiotto E, Sposetti R, Candiotto E, Pignalosa R, Del Pup L, Bellati U, Angeloni C, Buonerba M, Garzarelli S, Santilli C, Mucci M, Di Nisio Q, Cappa F, Pierangeli I, Cordone A, Falasca L, Ferrante D, Cirese E, Todaro PA, Spagnuolo L, Lanzone A, Donadio C, Fabiani M, Baldaccini E, Votano S, Bellardini P, Favale W, Pietrobattista V, Massacesi L, Donini G, Del Savio F, Palombi L, Procaccioli P, Romani A, Romagnoli G, Genazzani AR, Gambacciani M, Scarselli G, Curiel P, De Leo V, Melani A, Levi D'Ancona V, Giarrè G, Di Gioia E, Ceccarelli P, Massi GB, Cosci S, Gacci G, Cascianini A, Donati Sarti C, Bircolotti S, Pupita P, Mincigrucci M, Spadafora A, Santeufemia G, Marongiu G, Lai GR, Lai R, Dessole S, D'Andrea SA, Chiantera A, Arienzo R, Pastore AR, Tamburrino A, Cardone A, Colacurci N, Izzo S, Tesauro R, Pascarella A, De Silvio MG, Di Prisco L, Lauda N, Sirimarco F, Agrimi C, Casarella G, Senatore G, Ronzini S, Ruccia G, De Carlo G, Pisaturo G, Carlomagno F, Fasolino A, Fiorillo F, Sorrentino R, Ercolano VB, Panariello S, Brun A, Tropea P, Stigliano CM, Amoroso A, Vadalà P, Coco A, Galati G, Barese G, Masciari G, Pirillo P, Gioffrè T, Mastrantonio P, Cardamone A, D'Angelo N, Valentino G, Barretta R, Ferraro G, Ferruccio C, Agostinelli D, Corrado G, Scopelliti A, Schonauer S, Trojano V, Bongiovanni F, Tinelli F, Poddi ER, Scarpello F, Colonna L, Fischetti G, Doria R, Trombetta G, Cocca EB, D'Amore A, Di Masi M, Liguori R, Dimaggio A, Laneve MR, Maolo MC, Gravina G, Nacci G, Nocera F, Lupo A, Giannola C, Graziano R, Mezzatesta M, Vegna G, Giannone G, Palumbo G, Cancellieri F, Mondo A, Cordopatri A, Carrubba M, Mazzola V, Cincotta L, D'Asta S, Bono A, Li Calsi L, Cavallaro Nigro S, Schilirò S, Repici A, Gullo D, Orlando A, Specchiale F, Papotto A, Massacesi A, Chiantera A, De Aloysio P, Omodei U, Ognissanti F, Campagnoli C, Penotti M, Gambacciani A, Graziottin A, Baldi C, Colacurci N, Tonti GC, Parazzini F, Chatenoud L, Donati Sarti C. Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy. Maturitas 2005; 52:181-9. [PMID: 16257609 DOI: 10.1016/j.maturitas.2005.01.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2004] [Revised: 01/14/2005] [Accepted: 01/18/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. METHODS Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. RESULTS The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. CONCLUSIONS This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.
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Affiliation(s)
- P Di Donato
- Associazione Osterici Ginecologi Italiani Via Abamonti, I Milano 20100, Italy
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