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Guglielmini G, Falcinelli E, Piselli E, Mezzasoma AM, Tondi F, Alfonsi L, De Luca C, Fino V, Favilli A, Parrettini S, Minuz P, Torlone E, Gresele P, Gerli S. Gestational diabetes mellitus is associated with in vivo platelet activation and platelet hyperreactivity. Am J Obstet Gynecol 2024:S0002-9378(24)00505-2. [PMID: 38582292 DOI: 10.1016/j.ajog.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is associated with obstetrical and long-term cardiovascular complications. While platelet hyperresponsiveness in type-2 diabetes mellitus has been well-characterized and shown to play a crucial role in cardiovascular complications, this aspect has been little studied in GDM. We aimed to evaluate platelet reactivity, in vivo platelet activation, and endothelial function in GDM compared with normal pregnancy. RESEARCH DESIGN AND METHODS Prospective case-control study including 23 GDM and 23 healthy pregnant (HP) women studied at 26-28, 34-36 weeks of gestation and 8 weeks post-partum. Platelet reactivity and in vivo platelet activation, including light transmission aggregometry, PFA-100®, platelet activation antigen expression, platelet adhesion under flow, platelet Nitric Oxide (NO) and reactive oxygen species production, as well as endothelial dysfunction markers, were assessed. RESULTS The study of platelet function showed a condition of platelet hyperreactivity in GDM compared with HP women at enrollment, further enhanced at the end of pregnancy, which tended to decrease 2 months after delivery but remained still higher in GDM. In vivo platelet activation was also evident in GDM, especially at the end of pregnancy, in part persisting upto 8 weeks after delivery. Finally, GDM women showed defective platelet NO production and endothelial dysfunction compared with HP. CONCLUSIONS Our data show that GDM generates a condition of platelet hyperreactivity that in part persists upto two months after delivery. Impaired platelet sensitivity to NO and reduced platelet and endothelial NO production may contribute to the platelet hyperreactivity condition. Platelet hyperreactivity may play a role in the long-term cardiovascular complications of GDM women.
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Affiliation(s)
| | | | | | | | | | - Luisa Alfonsi
- Division of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine
| | - Caterina De Luca
- Division of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine
| | - Valeria Fino
- Division of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine
| | - Alessandro Favilli
- Division of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine
| | - Sara Parrettini
- Division of Endocrinology and Metabolism, S. Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy and
| | - Pietro Minuz
- Unit of General Medicine for the Study and Treatment of Hypertensive Disease, University of Verona, Verona, Italy
| | - Elisabetta Torlone
- Division of Endocrinology and Metabolism, S. Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy and
| | | | - Sandro Gerli
- Division of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine
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Etrusco A, Laganà AS, Chiantera V, Gerli S, Carugno J, Sorrentino F, Riemma G, Vitagliano A, Favilli A. Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini-resectoscope: A systematic review. Int J Gynaecol Obstet 2024. [PMID: 38317479 DOI: 10.1002/ijgo.15393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 11/30/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Hysteroscopy represents the gold standard for the diagnosis and treatment of intrauterine pathologies. The advent of the mini-resectoscope heralded a new era in intrauterine surgery, both in inpatient and outpatient settings. OBJECTIVES To evaluate the effectiveness, safety, and feasibility of the mini-resectoscope for the treatment of intrauterine pathologies. SEARCH STRATEGY Electronic databases were searched for English-language trials describing surgical procedures for uterine pathologies performed with a mini-resectoscope until 30 April 2023. SELECTION CRITERIA Retrospective or prospective original studies reporting the treatment of uterine pathologies with mini-resectoscope were deemed eligible for the inclusion. DATA COLLECTION AND ANALYSIS Data about study features, characteristics of included populations, surgical procedures, complications, and results/outcomes were collected. RESULTS Seven papers that met the inclusion criteria were included in this systematic review. Quantitative analysis was not possible due to data heterogeneity. A descriptive synthesis of the results was provided accordingly to the pathology hysteroscopically removed/corrected: polyps and myomas, uterine septum, intrauterine synechiae, and isthmocele. CONCLUSIONS The mini-resectoscope is poised to play a leading role in hysteroscopic surgery for many pathologies, both in inpatient and outpatient settings. Since some applications of the mini-resectoscope have not yet been thoroughly investigated, future studies should address current knowledge gaps, designing high-quality comparative trials on specific applications.
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Affiliation(s)
- Andrea Etrusco
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute - IRCCS - Fondazione "G. Pascale", Naples, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Jose Carugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, Minimally Invasive Gynecology Division, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Felice Sorrentino
- Department of Medical and Surgical Science, Institute of Obstetrics and Gynaecology, University of Foggia, Foggia, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Amerigo Vitagliano
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Vitagliano A, Cicinelli E, Viganò P, Sorgente G, Nicolì P, Busnelli A, Dellino M, Damiani GR, Gerli S, Favilli A. Isthmocele, not cesarean section per se, reduces in vitro fertilization success: a systematic review and meta-analysis of over 10,000 embryo transfer cycles. Fertil Steril 2024; 121:299-313. [PMID: 37952914 DOI: 10.1016/j.fertnstert.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/14/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
IMPORTANCE Previous reviews have shown that a history of cesarean section (CS) is associated with a worse in vitro fertilization (IVF) prognosis. To date, whether the decline in the IVF chances of success should be attributed to the CS procedure itself or to the presence of isthmocele remains to be clarified. OBJECTIVE To summarize the available evidence regarding the impact of isthmocele on IVF outcomes. DATA SOURCES Electronic databases and clinical registers were searched until May 30, 2023. STUDY SELECTION AND SYNTHESIS Observational studies were included if they assessed the effect of isthmocele on IVF outcomes. Comparators were women with isthmocele and women without isthmocele with a previous CS or vaginal delivery. Study quality was assessed using the modified Newcastle-Ottawa Scale. MAIN OUTCOMES The primary outcome was the live birth rate (LBR). The effect measures were expressed as adjusted odds ratios (aORs) and unadjusted odds ratios (uORs) with 95% confidence intervals (95% CIs). The body of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation working group methodology. RESULTS Eight studies (n = 10,873 patients) were included in the analysis. Women with isthmocele showed a lower LBR than both women with a previous CS without isthmocele (aOR, 0.62; 95% CI, 0.53-0.72) and those with a history of vaginal delivery (aOR, 0.55; 95% CI, 0.42-0.71). The LBRs in women with a previous CS without isthmocele and those with a history of vaginal delivery were similar (aOR, 0.74; 95% CI, 0.47-1.15). Subgroup analysis suggested a negative effect of the intracavitary fluid (ICF) in women with isthmocele on the LBR (uOR, 0.36; 95% CI, 0.18-0.75), whereas the LBRs in women without ICF and those without isthmocele were similar (uOR, 0.94; 95% CI, 0.61-1.45). CONCLUSION AND RELEVANCE We found moderate quality of evidence (Grading of Recommendations Assessment, Development and Evaluation grade 3/4) supporting a negative impact of isthmocele, but not of CS per se, on the LBR in women undergoing IVF. The adverse effect of isthmocele on IVF outcomes appears to be worsened by ICF accumulation before embryo transfer. CLINICAL TRIAL REGISTRATION NUMBER CRD42023418266.
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Affiliation(s)
- Amerigo Vitagliano
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Ettore Cicinelli
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuseppe Sorgente
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Pierpaolo Nicolì
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Andrea Busnelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Miriam Dellino
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Gianluca Raffaello Damiani
- 1(st) Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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Ianni F, Carotti A, Protti M, Favilli A, Gerli S, Furlanetto S, Mercolini L, Sardella R. Chiral high-performance liquid chromatography analysis of mono-, di-, and triacylglycerols with amylose- and cellulose-phenylcarbamate-based stationary phases. J Pharm Biomed Anal 2023; 236:115720. [PMID: 37729743 DOI: 10.1016/j.jpba.2023.115720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/22/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
The ever-increasing technological advancement in the (ultra)high-performance liquid chromatography tandem (high-resolution) mass spectrometry platforms have largely contributed to steeply intensify the interest towards lipidomics research. However, mass spectrometers alone are unable to distinguish between enantiomers. This obstacle is especially evident in the case of glycerolipids analysis due the prochiral nature of glycerol. Until a couple of decades ago, the stereoselective analysis of triacylglycerols (TAGs) was performed on the end products generated either from their enzymatic or chemical hydrolysis, namely on mono- or diacyl-sn-glycerols (MAGs and DAGs, respectively). These were then mostly analyzed with Pirkle-type chiral stationary phases (CSPs) after dedicated multi-step derivatization procedures. One of the most significant drawbacks of these traditional methods for enantioselective TAGs analysis (actually of the produced MAGs and DAGs, often investigated as target species per se) was the difficulty to totally abolish the migration of fatty acyls between glycerol positions. This made difficult to control and keep unaltered the stereochemistry of the original molecules. Over the last two decades, it has been widely demonstrated that the enantioselective analysis of intact TAGs as well as of non-derivatized MAGs and DAGs can be efficiently obtained using polysaccharide-based CSPs incorporating either amylose- or cellulose-phenylcarbamate derivatives chiral selectors. In this paper, the enantioselective methods developed with these CSPs for the enantioselective direct LC analysis of MAGs, DAGs and TAGs embedding different types of fatty acid residues are comprehensively reviewed.
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Affiliation(s)
- Federica Ianni
- Department of Pharmaceutical Sciences, University of Perugia, Via Fabretti 48, 06123 Perugia, Italy
| | - Andrea Carotti
- Department of Pharmaceutical Sciences, University of Perugia, Via Fabretti 48, 06123 Perugia, Italy
| | - Michele Protti
- Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum - University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Alessandro Favilli
- Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06132 Perugia, Italy
| | - Sandro Gerli
- Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06132 Perugia, Italy; Center for Perinatal and Reproductive Medicine, University of Perugia, Santa Maria della Misericordia University Hospital, 06132 Perugia, Italy
| | - Sandra Furlanetto
- Department of Chemistry "U. Schiff", University of Florence, Via U. Schiff 6, 50019 Florence, Italy
| | - Laura Mercolini
- Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum - University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy.
| | - Roccaldo Sardella
- Department of Pharmaceutical Sciences, University of Perugia, Via Fabretti 48, 06123 Perugia, Italy; Center for Perinatal and Reproductive Medicine, University of Perugia, Santa Maria della Misericordia University Hospital, 06132 Perugia, Italy.
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Favilli A, Mazzon I, Etrusco A, Dellino M, Laganà AS, Tinelli A, Chiantera V, Cicinelli E, Gerli S, Vitagliano A. The challenge of FIGO type 3 leiomyomas and infertility: Exploring therapeutic alternatives amidst limited scientific certainties. Int J Gynaecol Obstet 2023. [PMID: 38009829 DOI: 10.1002/ijgo.15260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/28/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
Uterine leiomyomas (ULs) are non-cancerous tumors composed of smooth muscle cells that develop within the myometrium and represent the most prevalent pathological condition affecting the female genital tract. Despite the volume of available research, many aspects of ULs remain unresolved, making it a "paradoxical disease" where the increase in available scientific literature has not been matched by an increase in solid evidence for clinical management. Fertility stands at the top of the list of clinical issues where the role of ULs is still unclear. The leiomyoma subclassification system, released by the International Federaion of Gynecology and Obstetrics (FIGO) in 2008, introduced a new and more effective way of categorizing uterine fibroids. The aim was to go beyond the traditional classification "subserosal, intramural and submucosal", facilitating a detailed examination of individual ULs impact on the female reproductive system. The "type 3 UL" is a special type of myoma, characterized by its complete myometrial development while encroaching the endometrium. It is a unique "hybrid" between a submucous and an intramural UL, that may exert a detrimental "double hit" mechanism, which is of particular interest in patients wishing pregnancy. To date, no robust evidence is available regarding the management of type 3 ULs. The aim of this narrative review is to provide a comprehensive overview of the physiopathological mechanisms that type 3 UL may exert on fertility, and to present new perspectives that may help us to better understand both the need for and the methods of treating this unique type of fibroid.
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Affiliation(s)
- Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Center of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | | | - Andrea Etrusco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Miriam Dellino
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Andrea Tinelli
- Department of Obstetrics and Gynecology, CERICSAL (CEntro di RIcerca Clinico SALentino), Veris delli Ponti Hospital, Scorrano, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute - IRCCS - Fondazione "G. Pascale", Naples, Italy
| | - Ettore Cicinelli
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Center of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Amerigo Vitagliano
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
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Favilli A, Etrusco A, Chiantera V, Laganà AS, Cicinelli E, Gerli S, Vitagliano A. Impact of FIGO type 3 uterine fibroids on in vitro fertilization outcomes: A systematic review and meta-analysis. Int J Gynaecol Obstet 2023; 163:528-539. [PMID: 37183601 DOI: 10.1002/ijgo.14838] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/08/2023] [Accepted: 04/16/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND The effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain. OBJECTIVES To evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic review and meta-analysis (CRD42022379700). SEARCH STRATEGY Electronic databases were searched until November 15, 2022. SELECTION CRITERIA Studies evaluating the effects of FIGO type 3 myomas on IVF outcome. DATA COLLECTION AND ANALYSIS Pooled results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using Higgins I2 . Sources of heterogeneity were explored with sensitivity and subgroup analyses. MAIN RESULTS In total, 1020 patients were included: 324 with FIGO type 3 myomas and 696 controls (without myomas). A pooled data analysis showed a significantly lower live birth rate (OR 2.16, 95% CI 1.55-3.01, I2 = 0%, P < 0.00001), clinical pregnancy rate (OR 2.06, 95% CI 1.52-2.81, I2 = 0%, P < 0.00001), and implantation rate (OR 1.77, 95% CI 1.35-2.32, I2 = 0%, P < 0.00001) in women with untreated myomas compared with controls. The number and size of fibroids correlated with a worsening of IVF outcomes. CONCLUSIONS FIGO type 3 myomas are significantly associated with a lower implantation rate, cumulative pregnancy rate, and live birth rate. Furthermore, their deleterious effect on the outcome of IVF increases further with increasing size and number. Nevertheless, no firm conclusions could be drawn about the potential benefits of surgery for FIGO type 3 uterine fibroids on IVF outcomes.
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Affiliation(s)
- Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Andrea Etrusco
- Unit of Gynecologic Oncology, ARNAS "Civico - Di Cristina - Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS "Civico - Di Cristina - Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico - Di Cristina - Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Ettore Cicinelli
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, Policlinico, Bari, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Amerigo Vitagliano
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, Policlinico, Bari, Italy
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Gerli S, Papaleo E, Ferrari A, Di Renzo GC. Retraction Note: Randomized, double blind placebo-controlled trial: effects of Myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci 2023; 27:8323. [PMID: 37782148 DOI: 10.26355/eurrev_202309_33752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The article "Randomized, double blind placebo-controlled trial: effects of Myo-inositol on ovarian function and metabolic factors in women with PCOS", by S. Gerli, E. Papaleo, A. Ferrari, G.C. Di Renzo, published in 2007; 11 (5): 347-354-PMID: 18074942 has been retracted by the Editor in Chief for the following reasons. The paper has been recently issued on PubPeer as multiple textual overlaps have been detected between this article and a previous article published by the same group of authors in 2003 (S. Gerli, M. Mignosa, G.C. Di Renzo. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003; 7 (6): 151-159. PMID-15206484). After having informed the Editor in Chief of a possible duplicate publication, the corresponding author was contacted to clarify this issue according to the policies of the journal. The corresponding author admitted that the 2007 paper had been written by an uncredited student, who adapted the 2003 paper and submitted it as novel work without the consent of the authors. Therefore, given the evidence, the Editor in Chief decided to withdraw the manuscript. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/458.
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Affiliation(s)
- S Gerli
- Department of Obstetrics and Gynecology, Monteluce Hospital, University of Perugia, Perugia, Italy
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Etrusco A, Laganà AS, Chiantera V, Vitagliano A, Cicinelli E, Mikuš M, Šprem Goldštajn M, Ferrari F, Uccella S, Garzon S, Gerli S, Favilli A. Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review. J Clin Med 2023; 12:4953. [PMID: 37568356 PMCID: PMC10419844 DOI: 10.3390/jcm12154953] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/16/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The latest classification from the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) has reclassified type 3 myomas, changing their classification from intramural to submucosal. While hysteroscopic myomectomy is considered the gold standard treatment for patients experiencing symptoms from submucosal myomas, there are currently no specific guidelines available for managing type 3 myomas, and the optimal surgical approach remains uncertain. Methods: The search for suitable articles published in English was carried out using the following databases (PROSPERO ID CRD42023418602): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Health Technology Assessment Database, Web of Science and search register. Only original studies reporting data on hysteroscopic myomectomy of type 3 myoma were considered eligible. The main outcomes investigated were the effectiveness and feasibility of hysteroscopic myomectomy and reproductive outcomes after surgical treatment. Results: Two hundred and sixty-one studies were screened and nineteen of these were read for eligibility. Three studies encompassing 56 patients in total were included. Among the overall population studied, three patients needed an additional procedure to completely remove the myoma and five cases of post-surgical synechiae were recorded. No complications were reported. Of 42 patients wishing for pregnancy, the cumulative live birth rates before and after the hysteroscopic myomectomy were 14.3% and 42.9%, respectively. Conclusions: Hysteroscopic myomectomy appears to be a safe and feasible approach. Nevertheless, data reported in the literature are extremely scarce and based on studies with few patients enrolled. New evidence is needed to assess the safety and effectiveness of hysteroscopic treatment for FIGO type 3 myomas.
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Affiliation(s)
- Andrea Etrusco
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | - Amerigo Vitagliano
- 1st Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncological Science (DIMO), University of Bari, 70121 Bari, Italy; (A.V.); (E.C.)
| | - Ettore Cicinelli
- 1st Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncological Science (DIMO), University of Bari, 70121 Bari, Italy; (A.V.); (E.C.)
| | - Mislav Mikuš
- Clinical Hospital Center Zagreb, Department of Obstetrics and Gynecology, 1000 Zagreb, Croatia;
| | - Marina Šprem Goldštajn
- Clinical Hospital Center Zagreb, Department of Obstetrics and Gynecology, 1000 Zagreb, Croatia;
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy;
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37129 Verona, Italy; (S.U.); (S.G.)
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37129 Verona, Italy; (S.U.); (S.G.)
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (S.G.); (A.F.)
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (S.G.); (A.F.)
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9
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Aisa MC, Cappuccini B, Favilli A, Datti A, Nardicchi V, Coata G, Gerli S. Biochemical and Anthropometric Parameters for the Early Recognition of the Intrauterine Growth Restriction and Preterm Neonates at Risk of Impaired Neurodevelopment. Int J Mol Sci 2023; 24:11549. [PMID: 37511307 PMCID: PMC10380875 DOI: 10.3390/ijms241411549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND S100B and Tau are implicated with both brain growth and injury. Their urinary levels in 30-to-40-day-old full-term, preterm, IUGR, and preterm-IUGR subjects were measured to investigate their possible relationship with future delayed neurodevelopment. METHODS Values were related to the neuro-behavioral outcome at two years of age, as well as to brain volumes and urinary NGF assessed at the same postnatal time point. RESULTS Using the Griffiths III test, cognitive and motor performances were determined to establish subgroups characterized by either normal or impaired neuro-behavior. The latter included preterm, IUGR, and preterm-IUGR individuals who exhibited significantly higher and lower S100B and Tau levels, respectively, along with markedly reduced cerebral volumes and urinary NGF, as previously demonstrated. Contrary to NGF, however, Tau and S100B displayed a weak correlation with brain volumes. CONCLUSIONS Delayed cognitive and motor performances observed in two-year-old preterm and IUGR-born individuals were also found to be associated with anomalous urinary levels of S100B and Tau, assessed at 30-40 days of the postnatal period, and their changes did not correlate with brain growth. Thus, our data suggests that, in addition to cerebral volumes and NGF, urinary S100B and Tau can also be considered as valuable parameters for the early detection of future neurodevelopmental abnormalities.
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Affiliation(s)
- Maria Cristina Aisa
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, 06129 Perugia, Italy
- GeBiSa, Research Foundation, 06129 Perugia, Italy
- Centre of Perinatal and Reproductive Medicine, University of Perugia, 06129 Perugia, Italy
| | | | - Alessandro Favilli
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, 06129 Perugia, Italy
- GeBiSa, Research Foundation, 06129 Perugia, Italy
- Centre of Perinatal and Reproductive Medicine, University of Perugia, 06129 Perugia, Italy
| | - Alessandro Datti
- Department of Agricultural, Food and Environmental Sciences, University of Perugia, 06121 Perugia, Italy
| | | | - Giuliana Coata
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, 06129 Perugia, Italy
- Centre of Perinatal and Reproductive Medicine, University of Perugia, 06129 Perugia, Italy
| | - Sandro Gerli
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, 06129 Perugia, Italy
- GeBiSa, Research Foundation, 06129 Perugia, Italy
- Centre of Perinatal and Reproductive Medicine, University of Perugia, 06129 Perugia, Italy
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10
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Favilli A, Mattei Gentili M, De Paola F, Laganà AS, Vitagliano A, Bosco M, Cicinelli E, Chiantera V, Uccella S, Parazzini F, Gerli S, Garzon S. COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies. J Pers Med 2023; 13:1035. [PMID: 37511648 PMCID: PMC10381390 DOI: 10.3390/jpm13071035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered. Ongoing assessment of the safety and effectiveness of pharmacological therapies is crucial in clinical practice. This narrative review summarizes the evidence-based therapeutic strategies for pregnant women with COVID-19, considering over three years of pandemic experience. The review discusses the safety and effectiveness of various drug regimens (antivirals, anticoagulants, corticosteroids, immunoglobulins, monoclonal antibodies, and therapeutic gases) and procedures (prone positioning and extracorporeal membrane oxygenation). Drugs with contraindications, inefficacy during pregnancy, or unknown adverse effects were excluded from our evaluation. The aim is to provide healthcare professionals with a comprehensive guide for managing pregnant women with COVID-19 based on lessons learned from the pandemic outbreak.
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Affiliation(s)
- Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Marta Mattei Gentili
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Francesca De Paola
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Amerigo Vitagliano
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, 70121 Bari, Italy
| | - Mariachiara Bosco
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
| | - Ettore Cicinelli
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, 70121 Bari, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Stefano Uccella
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
| | - Fabio Parazzini
- Department of Clinic and Community Science, Mangiagalli Hospital, University of Milan, 20122 Milan, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Simone Garzon
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
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11
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Mazzon I, Etrusco A, Laganà AS, Chiantera V, Di Angelo Antonio S, Tosto V, Gerli S, Favilli A. Training in Diagnostic Hysteroscopy: The "Arbor Vitae" Method. Medicina (Kaunas) 2023; 59:1019. [PMID: 37374222 PMCID: PMC10302144 DOI: 10.3390/medicina59061019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Diagnostic hysteroscopy is the gold standard in the diagnosis of intrauterine pathology and is becoming an essential tool in the daily practice of gynecology. Training programs for physicians are necessary to ensure adequate preparation and learning curve before approaching patients. The aim of this study was to describe the "Arbor Vitae" method for training in diagnostic hysteroscopy and to test its impact on the knowledge and skills of trainees using a customized questionnaire. Materials and Methods: A three-day hysteroscopy workshop combining theory and practical "hands on "sessions with dry and wet labs has been described. The aim of the course is to teach indications, instruments, the basic principles of the technique by which the procedure should be performed, and how to recognize and manage the pathologies that can be identified by diagnostic hysteroscopy. To test this training method and its impact on the knowledge and skills of the trainees, a customized 10-question questionnaire was administered before and after the course. Results: The questionnaire was administered to 34 participants. All trainees completed the questionnaire, and no missing responses were recorded. Regarding the characteristics of the participants, 76.5% had less than 1 year of experience in performing diagnostic hysteroscopy and 55.9% reported performing fewer than 15 procedures in their career. For 9 of the 10 questions embedded in the questionnaire, there was a significant improvement in the scores between pre- and post-course, demonstrating a perceived significant improvement in theoretical/practical skills by the trainees. Conclusions: The Arbor Vitae training model is a realistic and effective way to improve the theoretical and practical skills required to perform correct diagnostic hysteroscopy. This training model has great potential for novice practitioners to achieve an adequate level of proficiency before performing diagnostic hysteroscopy on live patients.
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Affiliation(s)
- Ivan Mazzon
- Arbor Vitae Endoscopic Centre, 00191 Rome, Italy; (I.M.); (S.D.A.A.)
| | - Andrea Etrusco
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.E.); (A.S.L.); (V.C.)
| | | | - Valentina Tosto
- Centre for Research in Perinatal and Reproductive Medicine, University of Perugia, 06123 Perugia, Italy;
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, 06123 Perugia, Italy;
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, 06123 Perugia, Italy;
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12
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Tosto V, Ceccobelli M, Lucarini E, Tortorella A, Gerli S, Parazzini F, Favilli A. Maternity Blues: A Narrative Review. J Pers Med 2023; 13:jpm13010154. [PMID: 36675815 PMCID: PMC9863514 DOI: 10.3390/jpm13010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Puerperium is a period of great vulnerability for the woman, associated with intense physical and emotional changes. Maternity blues (MB), also known as baby blues, postnatal blues, or post-partum blues, include low mood and mild, transient, self-limited depressive symptoms, which can be developed in the first days after delivery. However, the correct identification of this condition is difficult because a shared definition and well-established diagnostic tools are not still available. A great heterogenicity has been reported worldwide regarding MB prevalence. Studies described an overall prevalence of 39%, ranging from 13.7% to 76%, according to the cultural and geographical contexts. MB is a well-established risk factor for shifting to more severe post-partum mood disorders, such as post-partum depression and postpartum psychosis. Several risk factors and pathophysiological mechanisms which could provide the foundation of MB have been the object of investigations, but only poor evidence and speculations are available until now. Taking into account its non-negligible prevalence after childbirth, making an early diagnosis of MB is important to provide adequate and prompt support to the mother, which may contribute to avoiding evolutions toward more serious post-partum disorders. In this paper, we aimed to offer an overview of the knowledge available of MB in terms of definitions, diagnosis tools, pathophysiological mechanisms, and all major clinical aspects. Clinicians should know MB and be aware of its potential evolutions in order to offer the most timely and effective evidence-based care.
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Affiliation(s)
- Valentina Tosto
- Department of Obstetrics and Gynecology, Giannina Gaslini Children’s Hospital, 16147 Genova, Italy
| | - Margherita Ceccobelli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
| | - Emanuela Lucarini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, Medicine and Surgery Faculty, University of Milano, 20122 Milano, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
- Correspondence:
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13
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Favilli A, Laganà AS, Chiantera V, Uccella S, Gerli S, Garzon S. COVID-19 and Pregnancy: Have We Gotten through the Darkest Hour? J Pers Med 2022; 12:jpm12121987. [PMID: 36556208 PMCID: PMC9782586 DOI: 10.3390/jpm12121987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 12/02/2022] Open
Abstract
On December 2019, a new Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) was isolated and identified in Wuhan (China) [...].
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Affiliation(s)
- Alessandro Favilli
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Correspondence:
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Stefano Uccella
- Unit of Obstetrics and Gynecology—Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona—University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
| | - Sandro Gerli
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Simone Garzon
- Unit of Obstetrics and Gynecology—Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona—University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
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14
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Giannini A, D’Oria O, Bogani G, Di Donato V, Vizza E, Chiantera V, Laganà AS, Muzii L, Salerno MG, Caserta D, Gerli S, Favilli A. Hysterectomy: Let's Step Up the Ladder of Evidence to Look Over the Horizon. J Clin Med 2022; 11:jcm11236940. [PMID: 36498515 PMCID: PMC9737634 DOI: 10.3390/jcm11236940] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Hysterectomy is one of the most common non-obstetric gynecological surgical procedures carried out in Western countries [...].
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Affiliation(s)
- Andrea Giannini
- Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, Italy
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Ottavia D’Oria
- Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, Italy
- Obstetrics and Gynecological Unit, Department of Woman’s and Child’s Health, San Camillo-Forlanini Hospital, 00152 Rome, Italy
| | - Giorgio Bogani
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCSS-Regina Elena National Cancer Unit Institute, 00144 Rome, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), ARNAS “Civico-Di Cristina-Benfratelli”, University of Palermo, 90133 Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), ARNAS “Civico-Di Cristina-Benfratelli”, University of Palermo, 90133 Palermo, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Giovanna Salerno
- Obstetrics and Gynecological Unit, Department of Woman’s and Child’s Health, San Camillo-Forlanini Hospital, 00152 Rome, Italy
| | - Donatella Caserta
- Department of Medical and Surgical Sciences and Translational Medicine, Gynecology Division, Sant’Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
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15
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Ricci E, Ciccarelli S, Mauri P, Gerli S, Favilli A, Cipriani S, Fedele F, Roncella E, Esposito G, Parazzini F, Vignali M. Periodontitis, female fertility and conception (Review). Biomed Rep 2022; 17:86. [PMID: 36237287 PMCID: PMC9500491 DOI: 10.3892/br.2022.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022] Open
Abstract
Periodontal disease (PD) has been shown to increase the risk of preterm birth, preeclampsia and low birth weight. These observations have suggested that PD may also affect the early phase of pregnancy, including conception. The present study aimed to evaluate whether an association exists between oral health status and the chance of clinical pregnancy, according to the currently published literature, by performing a systematic review. The PubMed and EMBASE databases were searched from their start dates to October 2021 using the following keywords: ‘Infertility’ OR ‘conception’ OR ‘pre-pregnancy’ OR ‘time-to-pregnancy’ AND ‘periodontitis’ OR ‘periodontal disease’ OR ‘dental infection’ OR ‘gingivitis’ OR ‘odontogenic infection’ (limits: Full article, English, Human). A total of 6 papers reporting observational information on PD and spontaneous (4 studies) or medically induced conception (2 studies) were retrieved. As such, there were limited studies with different designs (randomized controlled trials and observational studies) and different settings. Moreover, in the selected studies, the ethnicity of the women was heterogeneous. According to the limited published literature, oral health might affect fertility in women. However, only results from prospective randomized trials, comparing PD treatment vs. no treatment in women seeking pregnancy, may clarify the real effectiveness of treatment in improving the conception rate.
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Affiliation(s)
- Elena Ricci
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Simone Ciccarelli
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Paola Mauri
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, University of Perugia, S.M. Della Misericordia Hospital, I‑06156 Perugia, Italy
| | - Alessandro Favilli
- Department of Obstetrics and Gynecology, University of Perugia, S.M. Della Misericordia Hospital, I‑06156 Perugia, Italy
| | - Sonia Cipriani
- Department of Woman, Newborn and Child, Gynaecology Unit, ‘Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico’, I‑20122 Milan, Italy
| | - Francesco Fedele
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Elena Roncella
- Department of Woman, Newborn and Child, Gynaecology Unit, ‘Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico’, I‑20122 Milan, Italy
| | - Giovanna Esposito
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, School of Medicine and Surgery, University of Milan, I‑20122 Milan, Italy
| | - Michele Vignali
- Department of Biomedical Sciences for Health, University of Milan, I‑20133 Milan, Italy
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16
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Martorana E, Cristina Aisa M, Grisanti R, Santini N, Maria Pirola G, Datti A, Gerli S, Bonora A, Burani A, Battista Scalera G, Scialpi P, Di Blasi A, Scialpi M. Lesion Volume in a Bi- or Multivariate Prediction Model for the Management of PI-RADS v2.1 Score 3 Category Lesions. Turkish Journal of Urology 2022; 48:268-277. [PMID: 35913442 PMCID: PMC9612700 DOI: 10.5152/tud.2022.22038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: This study aimed at improving the discrimination of Prostate Imaging – Reporting and Data System version 2.1 (PI-RADS v2.1) score 3 suspicious prostate cancer lesions using lesion volume evaluation. Material and methods: Two hundred five PI-RADS v2.1 score 3 lesions were submitted to transperineal MRI/TRUS fusion-targeted biopsy. The lesion volumes were estimated on diffusion-weighted imaging sequence and distributed in PI-RADS 3a (LV < 0.5 mL) and PI-RADS 3b (LV ≥ 0.5 mL) subcategories, using a 0.5 mL cutoff value. Data were retrospectively matched with histopathological findings from the biopsy. Assuming that lesions with LV < or ≥ 0.5 mL were respectively not eligible (benign and indolent PCa lesions) or eligible for biopsy (significant PCa lesions), the diagnostic accuracy of lesion volume in determining clinically significant PCa at biopsy was evaluated using a bi- or multivariate model. Results: About 55.1% and 44.9% of lesions were distributed in subcategories 3a and 3b, respectively. The overall PI-RADS score 3 detection rate was 273%. 3.5% (1.95% of total), and 25% (11.7% of total) significant PCa were found in PI-RADS 3a and 3b subcategory, respectively. The method showed 85.2% sensitivity, 61.2% specificity, 25% positive predictive value, and 96.5% negative predictive value and avoided 55.1% of unnecessary biopsies. The diagnostic accuracy in determining significant PCa at biopsy was 73.2% or 86.5% depending on whether lesion volume was used alone or in combination with prostate volume and patient age in a multivariate model. Conclusion: 0.5 mL lesion volume cutoff value significantly discriminates fusion-targeted biopsy need in PI-RADS v2.1 score 3 lesions and its diagnostic accuracy improves when it combines with prostate volume and age in a multivariate model.
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Affiliation(s)
- Eugenio Martorana
- Department of Urology, New Civilian Hospital of Sassuolo, Modena, Italy
- Corresponding authors: Eugenio Martorana or Maria Cristina AisaE-mail: or
| | - Maria Cristina Aisa
- Division of Gynaecology, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
- Corresponding authors: Eugenio Martorana or Maria Cristina AisaE-mail: or
| | - Riccardo Grisanti
- Department of Urology, New Civilian Hospital of Sassuolo, Modena, Italy
| | - Nicola Santini
- Department of Radiology, New Civilian Hospital of Sassuolo, Modena, Italy
| | | | - Alessandro Datti
- Division of Biochemistry, Department of Agricultural, Food, and Environmental Sciences, Perugia University, Perugia, Italy
| | - Sandro Gerli
- Division of Gynaecology, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
| | | | - Aldo Burani
- Department of Radiology, New Civilian Hospital of Sassuolo, Modena, Italy
| | - Giovanni Battista Scalera
- Division of Diagnostic Imaging, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, Italy
| | - Pietro Scialpi
- Division of Urology, Portogruaro Hospital, Venice, Italy
| | - Aldo Di Blasi
- Division of Radiology, Tivoli Hospital, Tivoli, Italy
| | - Michele Scialpi
- Division of Radiology 2, Department of Medicine and Surgery, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
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17
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Favilli A, Mattei Gentili M, Raspa F, Giardina I, Parazzini F, Vitagliano A, Borisova AV, Gerli S. Effectiveness and safety of available treatments for COVID-19 during pregnancy: a critical review. J Matern Fetal Neonatal Med 2022; 35:2174-2187. [PMID: 32508168 PMCID: PMC7284138 DOI: 10.1080/14767058.2020.1774875] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND COVID-19 is a pandemic disease caused by the SARS-CoV-2 and it spread globally in the last few months. The complete lack of specific treatment forced clinicians to use old drugs, chosen for their efficacy against similar viruses or their in vitro activity. Trials on patients are ongoing but the majority of information comes from small case series and single center reports. We aimed to provide a literature review on the putative effectiveness and safety of available treatments for COVID-19 in pregnant women. METHODS We reviewed all the available literature concerning the drugs that have been used in the treatment of COVID-19 during pregnancy and whose safe assumption during pregnancy had been demonstrated by clinical studies (i.e. including studies on other infectious diseases). Drugs contra-indicated during pregnancy or with unknown adverse effects were not included in our review. RESULTS AND CONCLUSIONS Clinical trials are not often conducted among pregnant patients for safety reasons and this means that drugs that may be effective in general population cannot be used for pregnant women due to the lack of knowledge of side effects in this category of people .The choice to use a specific drug for COVID-19 in pregnancy should take into account benefits and possible adverse events in each single case. In the current situation of uncertainty and poor knowledge about the management of COVID-19 during pregnancy, this present overview may provide useful information for physicians with practical implications.
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Affiliation(s)
| | - Marta Mattei Gentili
- Department of Surgical and Biochemical
Sciences, Centre of Perinatal and Reproductive Medicine, University of
Perugia, Perugia, Italy
| | - Francesca Raspa
- Department of Surgical and Biochemical
Sciences, Centre of Perinatal and Reproductive Medicine, University of
Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Surgical and Biochemical
Sciences, Centre of Perinatal and Reproductive Medicine, University of
Perugia, Perugia, Italy
| | - Fabio Parazzini
- Fondazione IRCCS Cà Granda, Dipartimento
Materno-Infantile, Ospedale Maggiore Policlinico, Università degli Studi di Milano,
Dipartimento di Scienze Cliniche e di Comunità, Universita' di Milano,
Milan, Italy
| | - Amerigo Vitagliano
- Department of Women’s and Children’s Health,
University of Padua, Padova, Italy
| | - Anna V. Borisova
- Department of Obstetrics and Gynecology with
the Course of Perinatology, Peoples Friendship University of Russia (RUDN
University), Moscow, Russian Federation
| | - Sandro Gerli
- Department of Surgical and Biochemical
Sciences, Centre of Perinatal and Reproductive Medicine, University of
Perugia, Perugia, Italy
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18
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Favilli A, Uccella S, Gerli S, Mazzon I. Letter: Pay Attention to the False Myths. Journal of Obstetrics and Gynaecology Canada 2022; 44:472-474. [DOI: 10.1016/j.jogc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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19
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Parazzini F, Gerli S, Favilli A, Vignali M, Ricci E, Cipriani S, Chiaffarino F, Dell'acqua A, Harari S, Bianchi S. mTOR inhibitors and risk of ovarian cysts: a systematic review and meta-analysis. BMJ Open 2021; 11:e048190. [PMID: 34561260 PMCID: PMC8475133 DOI: 10.1136/bmjopen-2020-048190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To summarise the available evidence on frequency of ovarian cyst development during mammalian target of rapamycin inhibitors (mTORi) treatment. METHODS PubMed/Medline and EMBASE databases were searched, from 1990 up to March 2020, using the following keywords: 'tacrolimus', 'sirolimus', 'temsirolimus', 'everolimus', 'deforolimus', 'mTOR' and 'ovarian cysts' (Limit: Human, English, full article). Studies were selected for the review if they met the following criteria: clinical studies, studies reporting original data, studies reporting the number of patients using mTORi, studies reporting the number of patients with ovarian cysts.We selected 7 of 20 retrieved studies. Study design, population, sample size, criteria for diagnosis of ovarian cysts, drug doses and follow-up length were extracted. Pooled estimate of incidence was calculated for ovarian cysts as a percentage, with 95% CI. RESULTS Four hundred-six women were included in the selected studies. The pooled incidence was 37.0% (95% CI 16.0% to 58.1%) for all ovarian cysts, and 17.3% (95% CI 5.6% to 29.1%) for clinically significant ovarian cysts. Based on two articles, comparing mTORi and non-mTORi for immunosuppression, pooled OR for ovarian cyst incidence was 4.62 (95% CI 2.58 to 8.28). CONCLUSION Ovarian cyst development is a common adverse event during immunosuppression treatment with mTORi. These cysts are benign conditions, but they require pelvic ultrasound follow-up and in some cases hospital admission and surgery.
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Affiliation(s)
- Fabio Parazzini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, S.M. Della Misericordia Hospital, Perugia, Italy
| | - Alessandro Favilli
- Department of Obstetrics and Gynecology, S.M. Della Misericordia Hospital, Perugia, Italy
| | - Michele Vignali
- Department of Biomedical Sciences for Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
| | - Elena Ricci
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
| | - Sonia Cipriani
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Chiaffarino
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Dell'acqua
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
| | - Sergio Harari
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
| | - Stefano Bianchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Facoltà di Medicina e Chirurgia, Milano, Lombardia, Italy
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20
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Di Buò A, Moretti P, Menculini G, Minuti A, Valentini E, Cerasoli I, Mancini N, Moro B, Radici S, Gerli S, Tortorella A. Antepartum Distress during COVID-19 Pandemic: an Observational Study. Psychiatr Danub 2021; 33:137-141. [PMID: 34559792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The present study investigates the impact of the Coronavirus diseases 2019 (Covid-19) pandemic on the subjective experience of pregnant women, as well as the impact of the pandemic on this population in terms of psychopathological correlates. SUBJECTS AND METHODS Pregnant women referring to the Section of Obstetrics and Gynecology of the General Hospital of Perugia, Italy, were recruited from 1st May, 2021 to 15th June, 2021. Socio-demographic and clinical data was collected, as well as information regarding the Covid-19 pandemic impact on the subjective experience of pregnancy. Psychopathology was evaluated by means of the State-Trait Anxiety Inventory Form Y (STAI-Y), the Symptom Checklist-90 (SCL-90) and the Prenatal Distress Measure (Pre-DM). Descriptive analyses were performed. Significant associations between distress symptoms and the collected sociodemographic and clinical variables were assessed by using the Pearson correlation (p<0.05). RESULTS 25 women were included in the study. Among these, 18 (72%) reported that the Covid-19 pandemic negatively impacted their experience of pregnancy. Were detected an average Pre-DM total score of 7.28±4.33 and an average state anxiety scale value of 35.56±9.21 and an average trait anxiety scale value of 34.04±7.44 at the STAI-Y. A global severity index > 1 at SCL-90 was detected in 8.3% of the sample. CONCLUSIONS The identification of antepartum distress and the early treatment of perinatal psychopathology represent a priority during the Covid-19 pandemic era.
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Affiliation(s)
- Agata Di Buò
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132, S. Andrea delle Fratte, Perugia, Italy
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21
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Aisa MC, Barbati A, Cappuccini B, Clerici G, Gerli S, Borisova A, De Rosa F, Kaptilnyy VA, Ishenko AI, Renzo GCD. 3-D Echo Brain Volumes to Predict Neurodevelopmental Outcome in Infants: A Prospective Observational Follow-up Study. Ultrasound Med Biol 2021; 47:2220-2232. [PMID: 33994230 DOI: 10.1016/j.ultrasmedbio.2021.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/10/2021] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
Prematurity and intra-uterine growth restriction (IUGR) are risk factors for long-term poor neurodevelopmental outcomes and are associated with reductions in regional brain volumes. In this study, the aim was to determine the possible role of 3-D ultrasonography (3-DUS) volumes of whole brain, thalamus, frontal cortex and cerebellum, measured at postnatal days 30-40, as early predictors of long-term risk for neurobehavioral disorders. To this purpose, a heterogeneous population of full-term, preterm, IUGR and preterm IUGR (pre-IUGR) born individuals (n = 334), characterized by gestational age and birth weight in the ranges 24-41 wk and 860-4000 g, respectively, was followed from postnatal days 30-40 to the second year of life. At enrollment, brain volumes were measured using 3-DUS, whereas neurodevelopment was assessed at 2 y using the Griffiths III test. Cerebral volumes were strictly and significantly lower in infants characterized by a negative outcome and had excellent diagnostic accuracy. The 3-DUS volume of whole brain, thalamus, frontal cortex or cerebellum may be an early predictor of neonates at major risk for neurobehavioral disorders in later life.
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Affiliation(s)
- Maria Cristina Aisa
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy.
| | - Antonella Barbati
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Graziano Clerici
- Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy; Department of Obstetrics and Gynecology, No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Anna Borisova
- Department of Obstetrics and Gynecology with the Course of Perinatology, People's Friendship University of Russia (RUDN University), Moscow, Russia
| | | | - Vitaly Alexandrovich Kaptilnyy
- Department of Obstetrics and Gynecology, No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anatoly Ivanovich Ishenko
- Department of Obstetrics and Gynecology, No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Gian Carlo Di Renzo
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy; Second Department of Obstetrics and Gynecology, I. M. Sechenov First State Medical University, Moscow, Russia
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22
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Gerli S, Della Morte C, Ceccobelli M, Mariani M, Favilli A, Leonardi L, Lanti A, Iannitti RG, Fioretti B. Biological and clinical effects of a resveratrol-based multivitamin supplement on intracytoplasmic sperm injection cycles: a single-center, randomized controlled trial. J Matern Fetal Neonatal Med 2021; 35:7640-7648. [PMID: 34338114 DOI: 10.1080/14767058.2021.1958313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Resveratrol display's positive effects on follicle growth and development in preclinical studies while there is scantly information from clinical trials. The aim of this study was to evaluate the biological and clinical impact of a resveratrol-based multivitamin supplement on intracytoplasmatic sperm injection (ICSI) cycles. METHODS A randomized, single-center controlled trial conducted at the University Center of Assisted Reproductive Technologies involving 101 women infertile women undergoing ICSI cycles was conducted. A pretreatment with a daily resveratrol based nutraceutical was administered to the Study Group; Control Group received folic acid. The primary outcomes were the number of developed mature follicles (>16 mm), total oocytes and MII oocytes recovered, the fertilization rate and the number of cleavage embryos/blastocysts obtained. Secondary endpoints were the duration and dosage of gonadotropins, the number of embryos for transfer, implantation, biochemical, clinical pregnancy rates, live birth and miscarriage rates. RESULTS A significantly higher number of oocytes and MII oocytes were retrieved in the Study Group than in Control Group (p = .03 and p = .04, respectively). A higher fertilization rate (p = .004), more cleavage embryos/patient (p = .01), blastocytes/patients (p = .01) and cryopreserved embryos (p = .03) were obtained in the Study Group. No significant differences in biochemical or clinical pregnancy, live birth, and miscarriage rates were revealed, but a trend to a higher live birth rate was revealed in the Study Group. CONCLUSIONS A 3 months period of dietary supplementation with a resveratrol-based multivitamin nutraceutical leads to better biological effects on ICSI cycles. TRIAL REGISTRATION NUMBER ClinicalTrials.gov registration identifier: NCT04386499.
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Affiliation(s)
- Sandro Gerli
- Department of Medicine and Surgery, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Chiara Della Morte
- Department of Medicine and Surgery, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Margherita Ceccobelli
- Department of Medicine and Surgery, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Monica Mariani
- Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | | | - Lucio Leonardi
- Department of R&D, S&R Farmaceutici S.p.A Bastia Umbra, Perugia, Italy
| | - Alessandro Lanti
- Department of R&D, S&R Farmaceutici S.p.A Bastia Umbra, Perugia, Italy
| | | | - Bernard Fioretti
- Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy.,Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy
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23
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Tinelli A, Kosmas IP, Carugno JT, Carp H, Malvasi A, Cohen SB, Laganà AS, Angelini M, Casadio P, Chayo J, Cicinelli E, Gerli S, Palacios Jaraquemada J, Magnarelli G, Medvediev MV, Metello J, Nappi L, Okohue J, Sparic R, Stefanović R, Tzabari A, Vimercati A. Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study. Int J Gynaecol Obstet 2021; 157:76-84. [PMID: 34197642 DOI: 10.1002/ijgo.13810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/23/2021] [Accepted: 06/30/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. METHODS Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. RESULTS Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. CONCLUSION Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.
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Affiliation(s)
- Andrea Tinelli
- Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), "Veris delli Ponti Hospital", Scorrano, Lecce, Italy.,Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy.,Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Veris delli Ponti Hospital, Scorrano & Vito Fazzi Hospital, Lecce, Italy
| | - Ioannis P Kosmas
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Hatzikosta, University of Ioannina, Ioannina, Greece
| | - Jose Tony Carugno
- MIGS/Robotics Division Director, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Howard Carp
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Antonio Malvasi
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - Shlomo B Cohen
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Marta Angelini
- Department of Obstetrics and Gynecology, Medical School, University of Udine, Udine, Italy
| | - Paolo Casadio
- Department of Obstetrics and Gynecology, Medical School, University of Bologna, Bologna, Italy
| | - Jenifer Chayo
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Ettore Cicinelli
- Department of Obstetrics and Gynecology, Medical School, University of Bari, Bari, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, Medical School, University of Perugia, Perugia, Italy
| | - Josè Palacios Jaraquemada
- Department of Obstetrics and Gynecology, Medical School, University of Buenos Aires, Buenos Aires, Argentina
| | - Giulia Magnarelli
- Department of Obstetrics and Gynecology, Medical School, University of Bologna, Bologna, Italy
| | - Mykhailo V Medvediev
- Department of Obstetrics and Gynecology, University of Dnepropetrovsk medical academy of Health Ministry of Ukraine, Dnepropetrovsk, Ukraine
| | - Josè Metello
- Centro de Infertilidade e Reprodução Medicamente Assistida, Hospital Garcia de Orta, Almada, Portugal
| | - Luigi Nappi
- Department of Obstetrics and Gynecology, Medical School, University of Foggia, Foggia, Italy
| | - Jude Okohue
- Department of Obstetrics and Gynecology, Madonna University Teaching Hospital, Port Harcourt, Nigeria
| | - Radmila Sparic
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
| | - Radomir Stefanović
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
| | - Avinoam Tzabari
- Department of Obstetrics and Gynecology, Hospital Mayane Hayeshua Medical Center, Bnei Brak, Israel
| | - Antonella Vimercati
- Department of Obstetrics and Gynecology, Medical School, University of Bari, Bari, Italy
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Abstract
Pregnant women were excluded from the initial phase 3 clinical trials of COVID-19 vaccines resulting in limited data on their efficacy and safety during pregnancy and postpartum. As a result, since December 2020, there has been conflicting advice from public health, governmental, and professional authorities on this matter. From the end of 2020 up to now, some consensus guidance has been published with a prevalent precautionary approach on the administration of vaccines in pregnant women, in breastfeeding ones, or for those who are planning a pregnancy (either spontaneously or with assisted technologies). After the first few months of vaccine administration in some countries, more permissiveness seems to prevail, although with inconsistencies. Some little indicative advice, their inconsistency around the world and their changes in a short time have probably disoriented both women and their health care providers and placed the burden of decision making upon women and their health care providers without information to assist in making an informed choice. We reviewed the COVID-19 vaccination guidance for pregnant and breastfeeding women published to date and evidence from cases of unplanned pregnancy during the course of vaccine trials, preclinical experimental and observational clinical studies, and discuss their implications. In this way, we have tried to identify the safety of COVID-19 vaccines for pregnant or breastfeeding women, and their offspring.
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Affiliation(s)
- Eleonora Brillo
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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25
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Abstract
AIM To identify whether COVID-19 vaccines should be administered in pregnant and breastfeeding women by reviewing the guidance and other evidence. METHODS We reviewed the COVID-19 vaccination guidance for pregnant and breastfeeding women published to date and evidence from preclinical experimental and observational clinical studies, and discuss their implications. RESULTS Pregnant women were excluded from the initial phase 3 clinical trials of COVID-19 vaccines resulting in limited data on their efficacy and safety during pregnancy and postpartum. As a result, since December 2020, there has been conflicting advice from public health, governmental, and professional authorities on this matter. From the end of 2020 up to now, some consensus guidance has been published with a prevalent precautionary approach on the administration of vaccines in pregnant women, in breastfeeding ones, or for those who are planning a pregnancy (either spontaneously or with assisted technologies). After the first few months of vaccine administration in some countries, more permissiveness seems to prevail, although with inconsistencies. At the moment, the results obtained by preclinical experimental and observational clinical studies suggest that the risks of the maternal COVID-19 outweigh the undocumented and hypothetical risks of the COVID-19 vaccines in pregnancy. Also, until two viral vector COVID-19 vaccines were associated with very rare thromboembolic events, all guidance had agreed that all approved COVID-19 vaccines could be administered in pregnancy. Actually, some concern has been expressed. CONCLUSION COVID-19 vaccines administered in pregnancy can reduce the risk of severe COVID-19 and their serious consequences for mothers and their offspring. However, many aspects remain to be clarified.
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Affiliation(s)
- Eleonora Brillo
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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26
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Favilli A, Tosto V, Ceccobelli M, Parazzini F, Franchi M, Bini V, Gerli S. Risk factors for non-adherent retained placenta after vaginal delivery: a systematic review. BMC Pregnancy Childbirth 2021; 21:268. [PMID: 33789611 PMCID: PMC8015016 DOI: 10.1186/s12884-021-03721-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background Retained placenta represents a cause of maternal morbidity and mortality affecting 0.5–3% of all vaginal deliveries. The unpredictability of this condition makes difficult to develop predictive and preventive strategies to apply in clinical practice. This analysis collected and analyzed all known risk factors related to this obstetric complication. Methods A systematic literature review for all original research articles published between 1990 and 2020 was performed. Observational studies about retained placenta risk factors published in English language were considered eligible. Conference abstracts, untraceable articles and studies focused on morbidly adherent placenta were excluded. The included articles were screened to identify study design, number of enrolled patients and retained placenta risk factors investigated. All stages of the revision followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results Thirty-five studies met the inclusion criteria. The reported retained placenta prevalence ranged from 0.5 to 4.8%. Maternal age, previous cesarean sections, previous dilation and curettage, previous retained placenta, labor induction, resulted as the most recurrent, independent risk factors for retained placenta. Previous estro-progestins therapy, morphological placental features (weight, shape, insertion of umbilical cord, implantation site), endometriosis, Assisted Reproductive Technologies, Apgar score are fascinating new proposal risk factors. Conclusions Old and new data are not enough robust to draw firm conclusions. Prospective and well-designed studies, based on a well agreed internationally retained placenta definition, are needed in order to clarify this potential dramatic and life-threatening condition. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03721-9.
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Affiliation(s)
- Alessandro Favilli
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Valentina Tosto
- Department of Medicine and Surgery, Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine, Santa Maria della Misericordia Hospital, University of Perugia, 06156, Perugia, Italy
| | - Margherita Ceccobelli
- Department of Medicine and Surgery, Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine, Santa Maria della Misericordia Hospital, University of Perugia, 06156, Perugia, Italy
| | - Fabio Parazzini
- Department of Clinic and Community Science, Mangiagalli Hospital, University of Milan, 20122, Milan, Italy
| | - Massimo Franchi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Vittorio Bini
- Department of Medicine and Surgery, Santa Maria della Misericordia Hospital, University of Perugia, 06156, Perugia, Italy
| | - Sandro Gerli
- Department of Medicine and Surgery, Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine, Santa Maria della Misericordia Hospital, University of Perugia, 06156, Perugia, Italy.
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Favilli A, Mazzon I, Zorzato PC, Uccella S, Gerli S. OHIA syndrome: Stop before it is too late! Taiwan J Obstet Gynecol 2021; 60:385-386. [PMID: 33678354 DOI: 10.1016/j.tjog.2021.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Alessandro Favilli
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy.
| | - Ivan Mazzon
- "Arbor Vitae" Endoscopic Centre, Rome, Italy
| | - Pier Carlo Zorzato
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
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Ragonese F, Monarca L, De Luca A, Mancinelli L, Mariani M, Corbucci C, Gerli S, Iannitti RG, Leonardi L, Fioretti B. Resveratrol depolarizes the membrane potential in human granulosa cells and promotes mitochondrial biogenesis. Fertil Steril 2021; 115:1063-1073. [PMID: 33487442 DOI: 10.1016/j.fertnstert.2020.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 08/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To study the biological effects of resveratrol on the growth, electrophysiology, and mitochondrial function of human granulosa cells (h-GCs). DESIGN Preclinical study. SETTING Electrophysiology laboratory and in vitro fertilization unit. PATIENT(S) This study included h-GCs from seven infertile women undergoing assisted reproductive techniques. INTERVENTION(S) Human ovarian Granulosa Cell Tumor (GCT) cell line COV434 and h-GCs obtained after oocyte retrieval were cultured in the absence or presence of resveratrol. MAIN OUTCOME MEASURE(S) Granulosa cells were evaluated for cell viability and mitochondrial activity. Electrophysiological recordings and evaluation of potassium current (IKur) and Ca2+ concentration were also performed. RESULT(S) Resveratrol induced mitochondrial activity in a bell-shaped, dose-effect-dependent manner. Specifically, resveratrol treatment (3 μM, 48 hours) increased ATP production and cell viability and promoted the induction of cellular differentiation. These biological changes were associated with mitochondrial biogenesis. Electrophysiological recordings showed that resveratrol reduced the functional expression of an ultra rapid activating, slow inactivating, delayed rectifier potassium current (IKur) that is associated with a plasma membrane depolarization and that promotes an increase in intracellular Ca2+. CONCLUSION(S): The effects of resveratrol on potassium current and mitochondrial biogenesis in h-GCs could explain the beneficial effects of this polyphenol on the physiology of the female reproductive system. These findings suggest there are therapeutic implications of resveratrol in a clinical setting.
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Affiliation(s)
- Francesco Ragonese
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy
| | - Lorenzo Monarca
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy; Department of Experimental Medicine, Perugia Medical School, University of Perugia, Perugia, Italy
| | - Antonella De Luca
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy
| | - Loretta Mancinelli
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy
| | - Monica Mariani
- Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Cristina Corbucci
- Centre of Assisted Reproductive Technologies, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Sandro Gerli
- Department of Surgical and Biomedical Sciences, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | | | | | - Bernard Fioretti
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, Perugia, Italy.
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29
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Aisa MC, Barbati A, Cappuccini B, De Rosa F, Gerli S, Clerici G, Kaptilnyy VA, Ishenko AI, Di Renzo GC. Urinary Nerve Growth Factor in full-term, preterm and intra uterine growth restriction neonates: Association with brain growth at 30-40 days of postnatal period and with neuro-development outcome at two years. A pilot study. Neurosci Lett 2020; 741:135459. [PMID: 33223047 DOI: 10.1016/j.neulet.2020.135459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
Nerve Growth Factor (NGF) and Brain Derived Neurotrophic Factor (BDNF) are crucial for the peripheral and central nervous system development, respectively, and differential brain and blood levels in Intra Uterine Growth Restriction (IUGR) and prematurity have been found. As reduced growth of brain regions, measured at 30-40 days of postnatal period, has been demonstrated in preterm and IUGR neonates who showed impaired neuro-development at two years of age, in this study, the levels of NGF and BDNF were evaluated in the urine samples of 30-40 day-old subjects who were full-term, preterm and IUGR and showed a normal or an abnormal neuro-development at follow up after two years. Neurotrophins were measured concurrently with volumes of whole brain, thalamus, frontal cortex and cerebellum. Values were then correlated with later neuro-developmental outcome. Biochemical parameters and cerebral volumes were assessed using colorimetric ELISA kits and three-dimensional ultra-sonography (3DUS), respectively. Neuro-development was estimated using the Griffiths-II test. Urinary NGF and brain volumes significantly correlated and were lower in preterm and IUGR subjects characterized by poor neuro-development. No differences were seen in the case of BDNF. The present investigation demonstrates, for the first time, the strong and direct association of NGF with brain growth at the initial phase of the postnatal period and with neuro-developmental outcome in later life. Remarkably, urinary NGF may be suggested as an early prognostic indicator of high long-term risk of motor and cognitive impairment in IUGR and preterm neonates.
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Affiliation(s)
- Maria Cristina Aisa
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy.
| | - Antonella Barbati
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | | | | | - Sandro Gerli
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Department of Obstetrics and Gynecology No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Graziano Clerici
- Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy; Department of Obstetrics and Gynecology No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Vitaly Alexandrovich Kaptilnyy
- Department of Obstetrics and Gynecology No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anatoly Ivanovich Ishenko
- Department of Obstetrics and Gynecology No. 1 of the Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Gian Carlo Di Renzo
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Second Department of Obstetrics and Gynecology, I. M. Sechenov First State Medical University, 119992 Moscow, Russia; Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
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Abstract
Endometriosis is a disease that has a profound impact on the quality of life of women, due to the associated chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. However, even getting long-awaited pregnancy (often after assisted reproductive technologies), patients with endometriosis have a high risk of obstetric complications, such as miscarriage, preterm birth, preeclampsia, placental abnormalities, hemorrhage in labor, birth of small for gestational age infants, stillbirth and higher cesarean section rate. In addition, during pregnancy acute complications of endometriosis may occur, such as spontaneous hemoperitoneum, which is rare but life-threatening conditions that in most cases require surgical intervention. The mechanisms of the observed complications in pregnant women with endometriosis are not fully understood. This review presents literature data and personal considerations on the effect of endometriosis on pregnancy outcome and the occurrence of complications, as well as their possible underlined mechanisms. Based on this, we proposed ways to reduce the risk of obstetric complications in pregnant women with a history of endometriosis.
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Affiliation(s)
- Anna V Borisova
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Setonde Romeo D Konnon
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Valentina Tosto
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Viktor E Radzinsky
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
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31
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Schiuma N, Costantino A, Bartolotti T, Dattilo M, Bini V, Aglietti MC, Renga M, Favilli A, Falorni A, Gerli S. Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women. J Endocrinol Invest 2020; 43:779-786. [PMID: 31845191 PMCID: PMC7230049 DOI: 10.1007/s40618-019-01163-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. METHODS This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland-n = 22) or no treatment (n = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. RESULTS The mean baseline fasting blood homocysteine was above the normal limit of 12 μMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. CONCLUSIONS In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.
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Affiliation(s)
- N Schiuma
- Centro Demetra ARTeBIOS, Via Giardini 11, Lugo, RA, Italy
| | - A Costantino
- Centro Demetra ARTeBIOS, Via Giardini 11, Lugo, RA, Italy
| | - T Bartolotti
- Centro Demetra ARTeBIOS, Via Giardini 11, Lugo, RA, Italy
| | - M Dattilo
- Parthenogen, Piazza Indipendenza 11, Lugano, Switzerland.
| | - V Bini
- Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy
| | - M C Aglietti
- Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy
| | - M Renga
- Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy
| | - A Favilli
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - A Falorni
- Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy
| | - S Gerli
- Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
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Parazzini F, Bortolus R, Mauri PA, Favilli A, Gerli S, Ferrazzi E. Delivery in pregnant women infected with SARS-CoV-2: A fast review. Int J Gynaecol Obstet 2020; 150:41-46. [PMID: 32271947 PMCID: PMC9087752 DOI: 10.1002/ijgo.13166] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/04/2020] [Accepted: 04/08/2020] [Indexed: 01/08/2023]
Abstract
Background Few case reports and clinical series exist on pregnant women infected with SARS‐CoV‐2 who delivered. Objective To review the available information on mode of delivery, vertical/peripartum transmission, and neonatal outcome in pregnant women infected with SARS‐CoV‐2. Search strategy Combination of the following key words: COVID‐19, SARS‐CoV‐2, and pregnancy in Embase and PubMed databases. Selection criteria Papers reporting cases of women infected with SARS‐CoV‐2 who delivered. Data collection and analysis The following was extracted: author; country; number of women; study design; gestational age at delivery; selected clinical maternal data; mode of delivery; selected neonatal outcomes. Main results In the 13 studies included, vaginal delivery was reported in 6 cases (9.4%; 95% CI, 3.5–19.3). Indication for cesarean delivery was worsening of maternal conditions in 31 cases (48.4%; 95% CI, 35.8–61.3). Two newborns testing positive for SARS‐CoV‐2 by real‐time RT‐PCR assay were reported. In three neonates, SARS‐CoV‐2 IgG and IgM levels were elevated but the RT‐PCR test was negative. Conclusions The rate of vertical or peripartum transmission of SARS‐CoV‐2 is low, if any, for cesarean delivery; no data are available for vaginal delivery. Low frequency of spontaneous preterm birth and general favorable immediate neonatal outcome are reassuring. The rate of vertical or peripartum transmission of SARS‐CoV‐2 is low, if any, for cesarean delivery; no data are available for vaginal delivery.
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Affiliation(s)
- Fabio Parazzini
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Paola Agnese Mauri
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Sandro Gerli
- Department of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Enrico Ferrazzi
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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33
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Favilli A, Tiburzi C, Gargaglia E, Cerotto V, Bagaphou TC, Checcaglini A, Bini V, Gori F, Torrioli D, Gerli S. Does epidural analgesia influence labor progress in women aged 35 or more? J Matern Fetal Neonatal Med 2020; 35:1219-1223. [PMID: 32233707 DOI: 10.1080/14767058.2020.1743672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: During the last decades, the age of pregnant women significantly increased. The incidence of maternal and labor complications is higher among older women, but conclusive data have not been delivered whether labor epidural analgesia (EA) may affect the duration of labor and delivery outcomes in this population of patients. The aim of this study is to evaluate the effect of EA among women aged over 35 years.Methods: We retrospectively reviewed medical records of all, singleton, at term deliveries, laboring with EA, between December 2011 and October 2017. Women aged ≥35 years (study group) were compared with women aged <35 years (control group) to evaluate EA effects on the duration of labor and neonatal outcome.Results: The study enrolled 459 women with EA: 122 women were included in the study group and 337 in the control group. The multiple regression analysis showed that parity was an independent variable for a shorter dilation period (p = .002), second stage length (p = .0001) and for the total labor duration (p = .0001); neonatal weight was significant for a shorter dilation period (p = .005) and for the total labor duration (p = .002); maternal age and cervical dilatation at the beginning of EA did not influence neither the period of the labor stages nor the total labor duration (p > .05).Conclusions: Results of this study indicate that women aged ≥35 with EA may have labor duration and neonatal short-term outcomes similar to younger women with EA.
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Affiliation(s)
- Alessandro Favilli
- Section of Gynecology and Obstetrics, Maternal and Infant Department, Città di Castello Hospital, Città di Castello, Perugia, Italy
| | - Cinzia Tiburzi
- Section of Anesthesia, Intensive Care and Pain Medicine, Department of Emergency and Urgency, Città di Castello Hospital, Città di Castello, Perugia, Italy
| | - Eleonora Gargaglia
- Section of Anesthesia, Analgesia and Intensive Care, Department of Surgical and Biomedical Sciences, University Hospital of Perugia, Perugia, Italy
| | - Vittorio Cerotto
- Section of Anesthesia, Intensive Care and Pain Medicine, Department of Emergency and Urgency, Città di Castello Hospital, Città di Castello, Perugia, Italy
| | - Thierry C Bagaphou
- Section of Anesthesia, Intensive Care and Pain Medicine, Department of Emergency and Urgency, Città di Castello Hospital, Città di Castello, Perugia, Italy
| | - Angela Checcaglini
- Section of Gynecology and Obstetrics, Department of Surgical and Biochemical Sciences, University of Perugia, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrine and Metabolic Science Section, University of Perugia, Perugia, Italy
| | - Fabio Gori
- Section of Anesthesia, Intensive Care and Pain Medicine, University Hospital of Perugia, Perugia, Italy
| | - Donatello Torrioli
- Section of Gynecology and Obstetrics, Maternal and Infant Department, Città di Castello Hospital, Città di Castello, Perugia, Italy
| | - Sandro Gerli
- Section of Gynecology and Obstetrics, Department of Surgical and Biochemical Sciences, University of Perugia, Perugia, Italy
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Aisa MC, Barbati A, Gerli S, Clerici G, Nikolova N, Giardina I, Babucci G, De Rosa F, Cappuccini B. Brain 3D-echographic early predictors of neuro-behavioral disorders in infants: a prospective observational study. J Matern Fetal Neonatal Med 2020; 35:642-650. [PMID: 32138566 DOI: 10.1080/14767058.2020.1730323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: Prematurity, low birth weight (LBW), very low birth weight (VLBW), and intrauterine growth restriction (IUGR) are risk factors of long-term poor neuro-development outcomes and associate with reduction of regional brain volumes.Objective: To evaluate the possible role of 3D ultrasound sonography (3DUS) regional brain volumes, measured at 30-40 days of postnatal period, as early predictors of long-term risk of neuro-behavioral disorders.Methods: A highly selected population, which included: full-term, preterm, IUGR, and preterm-IUGR born individuals, was followed longitudinally from 30 to 40 days of postnatal period to the second year of life. The population was mostly composed of bichorionic twins to ensure a, theoretically, major intracategory homogeneity. Preterm and IUGR subjects were characterized by a gestational age (GA) and birth weight (BW)>32 weeks and >1500 g, respectively, whereas the full-term neonates were of 37 weeks GA. At enrollment, the assessment of the volumetric measurements was performed using the 3DUS. The evaluation of neuro-development was performed at 2 years using the Griffiths Mental Development Scales.Results: The 3DUS measurements of whole brain, thalamus, frontal cortex, and cerebellum volumes, assessed at 30-40 days of postnatal period, were significantly reduced in infants characterized by negative outcome. In addition, the respective areas of the ROC curves, made by comparing values of normal and abnormal neuro-development groups, were indicative of a strong diagnostic accuracy.Conclusion: Data found suggest that the 3DUS regional brain volumes may assume a significant role as early indicators of neonates at major risk of neuro-behavioral disorders in later life. Further and larger studies in this direction are needed to validate this significant perspective.
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Affiliation(s)
- Maria Cristina Aisa
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.,GeBiSa, Research Foundation, Perugia, Italy.,Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy
| | - Antonella Barbati
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.,GeBiSa, Research Foundation, Perugia, Italy.,Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Graziano Clerici
- Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy.,Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Second Department of Obstetrics and Gynecology, First Moscow State Sechenov Medical University, Moscow, Russia
| | - Natasha Nikolova
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.,Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.,Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Giulia Babucci
- Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
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Mazzon I, Gerli S, Di Angelo Antonio S, Assorgi C, Villani V, Favilli A. The Technique of Vaginal Septum as Uterine Septum: A New Approach for the Hysteroscopic Treatment of Vaginal Septum. J Minim Invasive Gynecol 2020; 27:60-64. [DOI: 10.1016/j.jmig.2019.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 11/28/2022]
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Tinelli A, Favilli A, Lasmar RB, Mazzon I, Gerli S, Xue X, Malvasi A. The importance of pseudocapsule preservation during hysteroscopic myomectomy. Eur J Obstet Gynecol Reprod Biol 2019; 243:179-184. [DOI: 10.1016/j.ejogrb.2019.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/08/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022]
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Guerri G, Maniscalchi T, Barati S, Gerli S, Di Renzo GC, Della Morte C, Marceddu G, Casadei A, Laganà AS, Sturla D, Ghezzi F, Garzon S, Unfer V, Bertelli M. Non-syndromic monogenic female infertility. Acta Biomed 2019; 90:68-74. [PMID: 31577258 PMCID: PMC7233646 DOI: 10.23750/abm.v90i10-s.8763] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 12/15/2022]
Abstract
Infertility is a significant clinical problem. It affects 8-12% of couples worldwide, about 30% of whom are diagnosed with idiopathic infertility (infertility lacking any obvious cause). In 2010, the World Health Organization calculated that 1.9% of child-seeking women aged 20-44 years were unable to have a first live birth (primary infertility), and 10.5% of child-seeking women with a prior live birth were unable to have an additional live birth (secondary infertility). About 50% of all infertility cases are due to female reproductive defects. Several chromosome aberrations, diagnosed by karyotype analysis, have long been known to be associated with female infertility and monogenic mutations have also recently been found. Female infertility primarily involves oogenesis. The following phenotypes are associated with monogenic female infertility: premature ovarian failure, ovarian dysgenesis, oocyte maturation defects, early embryo arrest, polycystic ovary syndrome and recurrent pregnancy loss. Here we summarize the genetic causes of non-syndromic monogenic female infertility and the genes analyzed by our genetic test.
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38
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Gerli S, Fraternale F, Lucarini E, Chiaraluce S, Tortorella A, Bini V, Giardina I, Moretti P, Favilli A. Obstetric and psychosocial risk factors associated with maternity blues. J Matern Fetal Neonatal Med 2019; 34:1227-1232. [PMID: 31185763 DOI: 10.1080/14767058.2019.1630818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM To identify risk factors for maternity blues (MB) and to evaluate the impact of obstetric factors on MB prevalence. MATERIALS AND METHODS 194 mothers have completed the Edinburgh Postnatal Depression Scale (EPDS) 2 days after delivery. Bivariate and multivariate logistic regression models were used to identify the predictors of MB. RESULTS 57 women (29.4%) were positive at screening. Comparing the two groups, no statistically significant difference was found in age (p = .536), nationality (p = .065) and BMI before pregnancy (p = .224). Interestingly, no significant differences were highlighted in terms of assisted reproduction technology or spontaneous pregnancies and the presence of labor analgesia, while MB was significantly more frequent in case of cesarean section (CS) (p = .035). Statistical differences have been found in previous CS (p = .022), previous voluntary interruption of pregnancy (p = .021), number of previous pregnancies (p = .007), Apgar 5' (p = .026), lower level of education (p = .009), and previous postpartum depression (PPD) (p = .026). A logistic regression analysis was realized according to a multivariate model incorporating all the variables with a p-value ≤.25 in bivariate analysis. In the final model vaginal delivery (OR 0.451, 95% CI [0.224-0.911], p = .026) resulted to be MB protective factor, while a lower level of education (OR 3.657, 95% CI [1.482-9.023], p = .005) as well as previous PPD (OR 4.714, 95% CI [1.273-17.458], p = .020) were identified as independent risk factors. CONCLUSION This study showed that a lower education level and a previous PPD resulted to be important risk factors for MB development, while natural delivery was revealed as a protective factor. These results could be used to develop a better and more accurate prevention program after delivery.
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Affiliation(s)
- Sandro Gerli
- Department of Obstetrics and Gynecology, Univerisity of Perugia, Perugia, Italy
| | - Federica Fraternale
- Department of Obstetrics and Gynecology, Univerisity of Perugia, Perugia, Italy
| | | | - Sofia Chiaraluce
- Department of Pediatrics, S Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | | | - Vittorio Bini
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Obstetrics and Gynecology, Univerisity of Perugia, Perugia, Italy
| | | | - Alessandro Favilli
- Department of Obstetrics and Gynecology, Univerisity of Perugia, Perugia, Italy
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Favilli A, Mazzon I, Gerli S. Regarding "Multidisciplinary Approach in Large-sized Submucosal Myoma: Hysteroscopic Myomectomy after Uterine Artery Embolization". J Minim Invasive Gynecol 2018; 26:774-776. [PMID: 30580101 DOI: 10.1016/j.jmig.2018.09.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/26/2018] [Indexed: 10/27/2022]
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Favilli A, Laurenti E, Stagni G, Tassi L, Ricci G, Gerli S. Effects of Sodium Hyaluronate on Symptoms and Quality of Life in Women Affected by Pregnancy Rhinitis: A Pilot Study. Gynecol Obstet Invest 2018; 84:159-165. [DOI: 10.1159/000493137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/20/2018] [Indexed: 11/19/2022]
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Favilli A, Tosto V, Ceccobelli M, Bini V, Gerli S. Risk factors analysis and a scoring system proposal for the prediction of retained placenta after vaginal delivery. Eur J Obstet Gynecol Reprod Biol 2018; 228:180-185. [DOI: 10.1016/j.ejogrb.2018.06.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
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Favilli A, Laganà AS, Indraccolo U, Righi A, Triolo O, Apolito MD, Gerli S. What women want? Results from a prospective multicenter study on women's preference about pain management during labour. Eur J Obstet Gynecol Reprod Biol 2018; 228:197-202. [PMID: 29990827 DOI: 10.1016/j.ejogrb.2018.06.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to assess women preference about pain and duration of labour applying a standardized questionnaire. STUDY DESIGN A prospective multicentre large cohort study was carried out in two different University Hospitals. A standardized questionnaire was proposed before active labour and the day after delivery in order to investigate whether women preferred low pain intensity for a longer labour duration or greater pain intensity for a shorter labour duration. The studied population was divided and analysed in two groups according to Epidural Analgesia (EA) administration. A multivariable linear regression analysis was performed to assess which variables were able to influence the opinion about the pain perception after birth. RESULTS EA group showed an increased risk of episiotomy (p = 0.004), of longer duration of labour (Stage I, p < 0.001; Stage II, p = 0.002) and of oxytocin augmentation (P = 0.030). No statistical differences were found about the route of delivery between the two groups. Rates of pre-labour scores significantly differed from rates of post labour scores (p < 0.001). In the multivariable linear regression analysis, pre-labour score was directly related to post-labour score (p = 0.013). The EA was indirectly related to higher pain levels for a longer duration preference (p = 0.001), whereas oxytocic infusion in labour was directly related with preference for higher pain for a shorter duration (p = 0.011). CONCLUSIONS Patients' preferences about labour are focused on both pain relief and labour duration. The standardized questionnaire could be a useful tool to screen patients eligible for EA.
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Affiliation(s)
- Alessandro Favilli
- Department of Obstetrics and Gynecology, USL Umbria 1, Alta Valle del Tevere Hospital, Città di Castello (PG), Umbria, Italy.
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Ugo Indraccolo
- Department of Obstetrics and Gynecology, USL Umbria 1, Alta Valle del Tevere Hospital, Città di Castello (PG), Umbria, Italy
| | - Alessandra Righi
- Department of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Onofrio Triolo
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Maria D' Apolito
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
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Favilli A, Mazzon I, Grasso M, Horvath S, Bini V, Di Renzo GC, Gerli S. Intraoperative Effect of Preoperative Gonadotropin-Releasing Hormone Analogue Administration in Women Undergoing Cold Loop Hysteroscopic Myomectomy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2018; 25:706-714. [DOI: 10.1016/j.jmig.2017.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/08/2017] [Accepted: 11/17/2017] [Indexed: 11/17/2022]
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Rebonato A, Maiettini D, Gerli S, Rossi M. Interventional radiology in the management of post-partum hemorrhage. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4315.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Tinelli A, Malvasi A, Favilli A, Gerli S, Stark M. What are the real advantages of trans endometrial myomectomy during cesarean delivery? J Matern Fetal Neonatal Med 2018; 32:3133-3134. [PMID: 29562791 DOI: 10.1080/14767058.2018.1456524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Andrea Tinelli
- a Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Department of Obstetrics and Gynecology , Vito Fazzi Hospital , Lecce , Italy.,b Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics , Moscow Institute of Physics and Technology (State University) , Dolgoprudny , Moscow Region , Russia
| | - Antonio Malvasi
- b Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics , Moscow Institute of Physics and Technology (State University) , Dolgoprudny , Moscow Region , Russia.,c Department of Obstetric and Gynecology , Santa Maria Hospital, GVM Care and Research , Bari , Italy
| | - Alessandro Favilli
- d Department of Obstetrics and Gynecology , University of Perugia , Perugia , Italy
| | - Sandro Gerli
- d Department of Obstetrics and Gynecology , University of Perugia , Perugia , Italy
| | - Michael Stark
- e New European Surgical Academy (NESA) , Berlin , Germany
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Biondi R, Brancorsini S, Poli G, Egidi MG, Capodicasa E, Bottiglieri L, Gerli S, Brillo E, Renzo GCD, Cretoiu D, Micu R, Suciu N. Detection and scavenging of hydroxyl radical via D-phenylalanine hydroxylation in human fluids. Talanta 2017; 181:172-181. [PMID: 29426497 DOI: 10.1016/j.talanta.2017.12.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 01/25/2023]
Abstract
Hydroxyl radical (.OH) is highly reactive, and therefore very short-lived. Finding new means to accurately detect .OH, and testing the ability of known .OH scavengers to neutralize them in human biological fluids would leverage our ability to more effectively counter oxidative (.OH) stress-mediated damage in human diseases. To achieve this, we pursued the evaluation of secondary products resulting from .OH attack, using a detection system based on Fenton reaction-mediated D-phenylalanine (D-Phe) hydroxylation. This reaction in turn generates o-tyrosine (o-tyr), m-tyrosine (m-tyr) and p-tyrosine (p-tyr). Here, these isomers were separated by HPLC, equipped with fluorescence detectors due to the natural fluorescence of these hydrotyrosines. By extension, we found that, adding radical scavengers competed with D-Phe on .OH attack, thus allowing to determine the .OH quenching capacity of a given compound expressed as inhibition ratio percent (IR%). Using a kinetic approach, we then tested the .OH scavenging capacity (OHSC) of well-known antioxidant molecules. In a test tube, N,N'-dimethylthiourea (DMTU) was the most efficient scavenger as compared to Trolox and N-Acethyl-L-cysteine, with NAC being the less effective. OHSC assay was then applied to biological fluid samples as seminal plasma, human serum from normal subjects and patients undergoing hemodialysis (HD), colostrum and human breast milk from mothers that received daily doses of 30g of chocolate (70% cocoa) during pregnancy. We found that a daily administration of dark chocolate during pregnancy almost doubled OHSC levels in breast milk (1.88 ± 0.12 times, p < 0.01). Furthermore, HD treatment determined a significant reduction of serum OHSC concentration (54.63 ± 2.82%, p < 0.001). Our results provide evidence that Fenton reaction-mediated D-Phe hydroxylation is a suitable method for routine and non-invasive evaluation of .OH detection and its scavenging in human biological fluids.
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Affiliation(s)
| | | | - Giulia Poli
- Department of Experimental Medicine, University of Perugia, Italy.
| | - Maria Giulia Egidi
- Department of Surgical and Biomedical Sciences, Institut of Urological, Andrological Surgery and Minimally Invasive Techniques, University of Perugia, Italy
| | | | | | - Sandro Gerli
- Department of Obstetrics/Gynecology, University Hospital, Perugia, Italy
| | - Eleonora Brillo
- Department of Obstetrics/Gynecology, University Hospital, Perugia, Italy
| | | | - Dragos Cretoiu
- INSMC "Alessandrescu Rusescu", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Romeo Micu
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Nicolae Suciu
- INSMC "Alessandrescu Rusescu", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Ricci E, Al-Beitawi S, Cipriani S, Alteri A, Chiaffarino F, Candiani M, Gerli S, Viganó P, Parazzini F. Dietary habits and semen parameters: a systematic narrative review. Andrology 2017; 6:104-116. [PMID: 29266782 DOI: 10.1111/andr.12452] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/03/2017] [Accepted: 11/07/2017] [Indexed: 01/10/2023]
Abstract
Semen quality and male fertility are declining worldwide. As it was observed that physiologic and pathologic processes of spermatogenesis can be influenced by diet, the relation between dietary habits and semen parameters has been the focus of much interest. To review the human observational studies on this issue, we performed a systematic literature search, up to November 2016 (MEDLINE and EMBASE). We included all observational full-text papers reporting the relation between dietary habits and semen parameters. Article selection was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Twenty-three observational studies were included. Overall, 8477 healthy men and 1204 men presenting at Fertility Clinics were included in the selected studies. Even if some inconsistencies are present, possibly due to the different effect of nutrients in fertile and infertile men, results support the hypothesis that diets including fruit and vegetables, for their contents in vitamins, and fish or low-fat dairy products as the main source of proteins, are associated with better semen quality. Recommendations may be confidently provided because of the many beneficial effects of a healthy diet, although further studies are needed to clarify the currently inconsistent findings and to shed light on the underlying mechanisms.
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Affiliation(s)
- E Ricci
- Dipartimento della donna, del bambino e del neonato, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - S Al-Beitawi
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - S Cipriani
- Dipartimento della donna, del bambino e del neonato, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Alteri
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - F Chiaffarino
- Dipartimento della donna, del bambino e del neonato, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M Candiani
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute and Vita-Salute University, Milano, Italy
| | - S Gerli
- Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - P Viganó
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - F Parazzini
- Dipartimento della donna, del bambino e del neonato, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milano, Italy
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Laganà AS, Vergara D, Favilli A, La Rosa VL, Tinelli A, Gerli S, Noventa M, Vitagliano A, Triolo O, Rapisarda AMC, Vitale SG. Epigenetic and genetic landscape of uterine leiomyomas: a current view over a common gynecological disease. Arch Gynecol Obstet 2017; 296:855-867. [DOI: 10.1007/s00404-017-4515-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/31/2017] [Indexed: 01/10/2023]
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Mazzon I, Favilli A, Grasso M, Moretti V, Soda G, Gerli S. Intramural uterine hemangioma: an insidious trap of a rare pathology. A case report. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3910.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Manganaro L, Vinci V, Giancotti A, Gerli S, Cozzi DA, Pusiol T, Scialpi M, Roncati L. Bi-parametric magnetic resonance imaging applied to obstetrics. J OBSTET GYNAECOL 2017; 37:670-672. [PMID: 28303733 DOI: 10.1080/01443615.2017.1281237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Foetal magnetic resonance imaging (MRI) plays an increasingly important role in the diagnosis of foetal abnormalities. Over the years, we have successfully applied bi-parametric MRI (bp-MRI) to the following obstetric conditions: (1) neurologic vascular diseases; (2) assessment of lung parenchyma maturation; (3) renal pathologies, such as polycystic kidney, suspected renal infarction, unilateral or bilateral renal agenesis; (4) placental pathologies, as twin-twin transfusion syndrome or placenta accreta; (5) benignant and malignant congenital tumours or cysts of the liver, such as haemangioendothelioma, hepatoblastoma or metastatic neuroblastoma, of the kidney (e.g. mesoblastic nephroma) and of the retroperitoneum, such as teratoma. The information derived from bp-MRI, and concerned with water motions in different tissues, improved the morphologic details provided by conventional foetal MRI. It has the potential to increase the value of MRI in the assessment of a wide range of foetal pathologies, particularly in renal diseases, allowing an adequate management decision and therapy.
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Affiliation(s)
- Lucia Manganaro
- a Department of Radiological Sciences, Division of Radiology , La Sapienza University , Rome , Italy
| | - Valeria Vinci
- a Department of Radiological Sciences, Division of Radiology , La Sapienza University , Rome , Italy
| | - Antonella Giancotti
- a Department of Radiological Sciences, Division of Radiology , La Sapienza University , Rome , Italy
| | - Sandro Gerli
- b Department of Surgical and Biomedical Sciences, Division of Gynecology , University of Perugia , Perugia , Italy
| | - Denis A Cozzi
- c Department of Surgical Sciences, First Division of Pediatric Surgery , La Sapienza University , Rome , Italy
| | - Teresa Pusiol
- d Santa Maria del Carmine Hospital , Provincial Health Care Services, Institute of Pathology , Rovereto , Italy
| | - Michele Scialpi
- e Department of Surgical and Biomedical Sciences, Second Division of Radiology , University of Perugia , Perugia , Italy
| | - Luca Roncati
- d Santa Maria del Carmine Hospital , Provincial Health Care Services, Institute of Pathology , Rovereto , Italy.,f Department of Diagnostic and Clinical Medicine and of Public Health, Division of Pathology , University of Modena and Reggio Emilia , Modena , Italy
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