36 results on '"Cariello L"'
Search Results
2. The effect of fetal sex on customized fetal growth charts
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Rizzo, Giuseppe, Prefumo, Federico, Ferrazzi, Enrico, Zanardini, Cristina, Di Martino, Daniela, Boito, Simona, Aiello, Elisa, Ghi, Tullio, Altobelli, G., Arduini, M., Canzone, G., Capece, A., Carboni, E., Cariello, L., Cariati, E., Cetin, I., Chianchiano, N., Clerici, G., D’Addario, V., Di Martino, D., Cosmi, E., Giacchello, R., Giancotti, A., Giorgina, M., Maiandi, A., Mandia, L., Maruotti, G., Mazzocco, A., Nicoletti, L., Periti, E., Persico, N., Rossi, A., Stampalija, T., Tenore, A., Todros, T., Visentin, S., Verrotti, C., Viora, E., Volpe, P., Rizzo, Giuseppe, Prefumo, Federico, Ferrazzi, Enrico, Zanardini, Cristina, Di Martino, Daniela, Boito, Simona, Aiello, Elisa, Ghi, Tullio, Altobelli, G., Arduini, LAURA MARIA ANGELA, Canzone, G., Capece, A., Carboni, E., Cariello, L., Cariati, E., Cetin, I., Chianchiano, N., Clerici, Giuditta, D’Addario, V., Di Martino, D., Cosmi, E., Giacchello, R., Giancotti, A., Giorgina, M., Maiandi, A., Mandia, L., Maruotti, G., Mazzocco, A., Nicoletti, L., Periti, E., Persico, N., Rossi, A., Stampalija, T., Tenore, A., Todros, T., Visentin, S., Verrotti, C., Viora, E., and Volpe, P.
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Male ,Percentile ,quantile regression ,Cross-sectional study ,customised growth chart ,fetal biometry ,Sex Factor ,Pediatrics ,Fetal Development ,0302 clinical medicine ,Pregnancy ,Reference Values ,Prenatal ,Reference Value ,030212 general & internal medicine ,Growth Charts ,Ultrasonography ,Pediatric ,030219 obstetrics & reproductive medicine ,Singleton ,Obstetrics ,Obstetrics and Gynecology ,Gestational age ,Perinatology and Child Health ,Italy ,Customized growth chart ,gender difference ,Pediatrics, Perinatology and Child Health ,embryonic structures ,Regression Analysis ,Gestation ,Female ,Human ,medicine.medical_specialty ,Biometry ,Gestational Age ,Regression Analysi ,Ultrasonography, Prenatal ,Cross-Sectional Studies ,Humans ,Sex Factors ,03 medical and health sciences ,medicine ,Cross-Sectional Studie ,Fetus ,business.industry ,medicine.disease ,Growth Chart ,Surgery ,Settore MED/40 - Ginecologia e Ostetricia ,Parity (mathematics) ,business - Abstract
OBJECTIVE: To evaluate the effect of fetal sex on singleton pregnancy growth charts customized for parental characteristics, race, and parity Methods: In a multicentric cross-sectional study, 8070 ultrasonographic examinations from low-risk singleton pregnancies between 16 and 40 weeks of gestation were considered. The fetal measurements obtained were biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Quantile regression was used to examine the impact of fetal sex across the biometric percentiles of the fetal measurements considered together with parents' height, weight, parity, and race. RESULTS: Fetal gender resulted to be a significant covariate for BDP, HC, and AC with higher values for male fetuses (p ≤ 0.0009). Minimal differences were found among sexes for FL. Parity, maternal race, paternal height and maternal height, and weight resulted significantly related to the fetal biometric parameters considered independently from fetal gender. CONCLUSION: In this study, we constructed customized biometric growth charts for fetal sex, parental, and obstetrical characteristics using quantile regression. The use of gender-specific charts offers the advantage to define individualized normal ranges of fetal biometric parameters at each specific centile. This approach may improve the antenatal identification of abnormal fetal growth.
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- 2016
3. EP23.02: Can the fetal head‐perineum distance be measured in the mid‐sagittal view?
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Youssef, A., primary, Bianchini, L., additional, Cavalera, M., additional, Montaguti, E., additional, Cariello, L., additional, Brunelli, E., additional, Salsi, G., additional, Bellussi, F., additional, and Pilu, G., additional
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- 2019
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4. OC05.07: Prediction of mode of delivery using intrapartum ultrasound in the assessment of fetal head deflexion
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Bellussi, F., primary, Livi, A., additional, Cataneo, I., additional, Salsi, G., additional, Della Gatta, A., additional, Cariello, L., additional, Youssef, A., additional, and Pilu, G., additional
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- 2019
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5. OC05.04: Dynamic two‐dimensional transperineal ultrasound prior to perineal suturing as a screening tool for anal sphincter injury and fecal incontinence
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Salsi, G., primary, Bellussi, F., additional, Montaguti, E., additional, Dodaro, M., additional, Margarito, E., additional, Di Donna, G., additional, Cariello, L., additional, and Pilu, G., additional
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- 2019
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6. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion
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Youssef, A., primary, Salsi, G., additional, Cataneo, I., additional, Pacella, G., additional, Azzarone, C., additional, Paganotto, M. C., additional, Krsmanovic, J., additional, Montaguti, E., additional, Cariello, L., additional, Bellussi, F., additional, Rizzo, N., additional, and Pilu, G., additional
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- 2018
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7. Randomised Italian Sonography for occiput POSition Trial Ante vacuum (R.I.S.POS.T.A.)
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Ghi, T., primary, Dall'Asta, A., additional, Masturzo, B., additional, Tassis, B., additional, Martinelli, M., additional, Volpe, N., additional, Prefumo, F., additional, Rizzo, G., additional, Pilu, G., additional, Cariello, L., additional, Sabbioni, L., additional, Morselli‐Labate, A. M., additional, Todros, T., additional, and Frusca, T., additional
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- 2018
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8. OP28.09: The levator-urethral gap measurement: tomographic ultrasound imaging (TUI) versus Omniview-volume contrast imaging (VCI)
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Cariello, L., primary, Montaguti, E., additional, Cataneo, I., additional, Dodaro, G., additional, Margarito, E., additional, Rizzo, N., additional, and Youssef, A., additional
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- 2017
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9. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion.
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Youssef, A., Salsi, G., Cataneo, I., Pacella, G., Azzarone, C., Paganotto, M. C., Krsmanovic, J., Montaguti, E., Cariello, L., Bellussi, F., Rizzo, N., and Pilu, G.
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ANUS ,DELIVERY (Obstetrics) ,LABOR (Obstetrics) ,LABOR complications (Obstetrics) ,LONGITUDINAL method ,EVALUATION of medical care ,MUSCLES ,PELVIC floor ,PREGNANCY ,PRESSURE ,CASE-control method ,WOUNDS & injuries - Abstract
Objective: To investigate the association between application of fundal pressure during the second stage of labor (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury.Methods: This was a prospective case-control study of women recruited immediately after their first vaginal delivery in our university hospital between March 2014 and September 2016. Women who underwent the Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched for body mass index, use of epidural analgesia, duration of second stage of labor and birth weight. All women were invited to undergo four-dimensional (4D) transperineal ultrasound (TPU) 3-6 months postpartum. The main outcome measure was the presence of LAM avulsion on 4D-TPU. TPU results were compared between cases and controls. Multivariate logistic regression analysis was performed to identify independent risk factors for LAM avulsion.Results: During the study period, 134 women in the Kristeller maneuver group and 128 women in the control group underwent TPU assessment. Women who underwent the Kristeller maneuver had a higher prevalence of LAM avulsion than did controls (38/134 (28.4%) vs 18/128 (14.1%); P = 0.005). In addition, women in the Kristeller-maneuver group had a larger hiatal area on maximum Valsalva maneuver and a greater increase in hiatal area from rest to maximum Valsalva. On multivariate logistic regression analysis, use of the Kristeller maneuver was the only independent factor associated with LAM avulsion (odds ratio, 2.5 (95% CI, 1.29-4.51)).Conclusion: The Kristeller maneuver is associated with an increased risk of LAM avulsion when applied in women during their first vaginal delivery. This should be taken into account when deciding to use fundal pressure to accelerate the second stage of labor and when counseling women following childbirth. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2019
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10. OC04.01: Does fundal pressure in the second stage (Kristeller manoeuvre) increase the risk of pelvic floor damage? A prospective case–control study
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Youssef, A., primary, Salsi, G., additional, Paganotto, M., additional, Bellussi, F., additional, Cataneo, I., additional, Pacella, G., additional, Azzarone, C., additional, Morganelli, G., additional, Krsmanovic, J., additional, Cariello, L., additional, Montaguti, E., additional, Rizzo, N., additional, and Pilu, G., additional
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- 2016
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11. P08.03: Customised fetal growth charts by quantile regression analysis: a cross-sectional multicentric Italian study
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Volpe, N., primary, Rizzo, G., additional, Cariello, L., additional, Ludovica, R., additional, Dall'Asta A, A., additional, Pedrazzi, G., additional, Ferrazzi, E., additional, Periti, E., additional, Prefumo, F., additional, Stampalija, T., additional, Viora, E., additional, Verrotti, C., additional, and Ghi, T., additional
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- 2015
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12. OC22.04: Gestational diabetes: a possible protective role in placental insufficiency
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Contro, E., primary, Cariello, L., additional, Salsi, G., additional, Pilu, G., additional, Rizzo, N., additional, and Farina, A., additional
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- 2015
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13. P04.06: The effect of fundal pressure (Kristeller manoeuvre) on pelvic floor in primiparous women
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Youssef, A., primary, Pacella, G., additional, Salsi, G., additional, Krsmanovic, J., additional, Montaguti, E., additional, Morganelli, G., additional, Azzarone, C., additional, Paganotto, M., additional, Cataneo, I., additional, Cariello, L., additional, Pilu, G., additional, and Rizzo, N., additional
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- 2015
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14. EP07.05: Customised fetal growth curves in uncomplicated twin pregnancies
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Ghi, T., primary, Franchi, L., additional, Piastra, A., additional, Cariello, L., additional, Volpe, N., additional, Bellussi, F., additional, Pedrazzi, G., additional, Nardi, E., additional, Rizzo, N., additional, Pilu, G., additional, and Frusca, T., additional
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- 2015
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15. Sonographic assessment of fetal occiput position during the second stage of labor: how reliable is the transperineal approach?
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Ghi, T., primary, Bellussi, F., additional, Eggebø, T., additional, Tondi, F., additional, Pacella, G., additional, Salsi, G., additional, Cariello, L., additional, Piastra, A., additional, Youssef, A., additional, Pilu, G., additional, and Rizzo, N., additional
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- 2014
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16. OC09.07: Pelvic hiatal area measured by a novel 3D ultrasound technique in women with and without symptoms of pelvic floor dysfunction
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Youssef, A., primary, Cariello, L., additional, Montaguti, E., additional, Ghi, T., additional, Sanlorenzo, O., additional, Rizzo, N., additional, and Pilu, G., additional
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- 2014
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17. P01.08: Risk factors associated to fetal loss after chorionic villus sampling
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Ghi, T., primary, Bellussi, F., additional, Piastra, A., additional, Pini, R., additional, Contro, E., additional, Cariello, L., additional, Pacella, G., additional, Montaguti, E., additional, Salsi, G., additional, Di Giovanni, M., additional, Cataneo, I., additional, Gabrielli, S., additional, Rizzo, N., additional, and Pilu, G., additional
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- 2014
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18. OC09.08: Reliability of a novel 3D ultrasound technique for pelvic hiatal area in women with symptoms of pelvic floor dysfunction
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Youssef, A., primary, Montaguti, E., additional, Cariello, L., additional, Ghi, T., additional, Piastra, A., additional, Sanlorenzo, O., additional, Pilu, G., additional, and Rizzo, N., additional
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- 2014
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19. Sonographic assessment of fetal occiput position during the second stage of labor: how reliable is the transperineal approach?
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Ghi, T., Bellussi, F., Eggebø, T., Tondi, F., Pacella, G., Salsi, G., Cariello, L., Piastra, A., Youssef, A., Pilu, G., and Rizzo, N.
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ABDOMEN ,CLINICAL trials ,COMPARATIVE studies ,FETAL presentation ,FETAL ultrasonic imaging ,HEAD ,LABOR (Obstetrics) ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,PERINEUM ,RESEARCH ,EVALUATION research - Abstract
Objective: To compare the accuracy of transperineal (TP) ultrasound with transabdominal (TA) approach in the sonographic assessment of fetal occiput position during the second stage of labour.Methods: A series of low-risk women at term attending the labour ward of three university hospitals were prospectively recruited for the purpose of this study. During the second stage of labor patients were evaluated first by TP and than by TA ultrasound to determine the fetal position. The occiput position was labelled as DOA (direct occiput anterior), ROA (right occiput anterior), LOA (left occiput anterior), DOP (direct occiput posterior), ROP (right occiput posterior), LOP (left occiput posterior), ROT (right occuput transverse) and LOT (left occiput transverse). The agreement between the two techniques was assessed.Results: Overall 80 patients were recruited in the study group. Ultrasound examination was performed at 21(± 8) minutes from the beginning of the active pushing. The ultrasound findings of the fetal occiput position were recorded. In all cases TA ultrasound confirmed the fetal occiput position as determined at TP approach except in one case of ROA that had been recorded as ROT using TP ultrasound.Conclusions: Ultrasound TP examination is accurate in the diagnosis of fetal occiput position during the second stage of labor. [ABSTRACT FROM AUTHOR]- Published
- 2015
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20. Comparison of two 'a priori' risk assessment algorithms for preeclampsia in Italy: a prospective multicenter study
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Nicola Rizzo, Chiara Germano, Federico Prefumo, Tullia Todros, Paolo Cavoretto, Massimo Candiani, Veronica Giorgione, F. Fuse, Antonio Farina, Danila Morano, Benedetta Bracco, L. Cariello, Giulia Parpinel, Sara Paracchini, Flavia Girlando, Daniela Di Martino, Bianca Masturzo, Di Martino, D., Masturzo, B., Paracchini, S., Bracco, B., Cavoretto, P., Prefumo, F., Germano, C., Morano, D., Girlando, F., Giorgione, V., Parpinel, G., Cariello, L., Fuse, F., Candiani, M., Todros, T., Rizzo, N., Farina, A., Di Martino D., Masturzo B., Paracchini S., Bracco B., Cavoretto P., Prefumo F., Germano C., Morano D., Girlando F., Giorgione V., Parpinel G., Cariello L., Fuse F., Candiani M., Todros T., Rizzo N., and Farina A.
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Adult ,ROC curves ,Risk Assessment ,Preeclampsia ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Risk Factors ,A priori risk ,Detection rate ,Screening for preeclampsia ,Algorithms ,Biomarkers ,Female ,Humans ,Italy ,Prospective Studies ,medicine ,Prospective cohort study ,030219 obstetrics & reproductive medicine ,Receiver operating characteristic ,business.industry ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,ROC curve ,030220 oncology & carcinogenesis ,Gestation ,Population study ,False positive rate ,business ,Risk assessment ,Algorithm - Abstract
Purpose: To compare the performance of the algorithms proposed by the Fetal Medicine Foundation in 2012 and BCNatal in 2013 in an Italian population. Methods: A multicentric prospective study was carried out which included pregnancies at 11–13weeks’ gestation from Jan 2014 through May 2017. Two previously published algorithms were used for the calculation of the “a priori” risk of preeclampsia (based on risk factors from medical history) in each individual. Results: In a study population of 11,632 cases, 67 (0.6%) developed early preeclampsia and 211 (1.8%) developed late preeclampsia. The detection rates (95% CI) for early and late preeclampsia were 58.2% (45.5–70.2) vs. 41.8% (29.6–54.5) (p value < 0.05) and 44.1% (37.3–51.1) vs. 38% (31.3–44.8) (p value < 0.05) for the Fetal Medicine Foundation and BCNatal, respectively (at a 10% false positive rate). The associated risk was 1:226 and 1:198 (p value ns) for early PE, and 1:17 and 1:24 (p value ns) for late PE for the Fetal Medicine Foundation and BCNatal, respectively. Conclusions: The Fetal Medicine Foundation screening for preeclampsia at 11–13weeks’ gestation scored the highest detection rate for both early and late PE. At a fixed 10% false positive rate, the estimated “a priori” risks of both the Fetal Medicine Foundation and the BCNatal algorithms in an Italian population were quite similar, and both were reliable and consistent.
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- 2019
21. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion
- Author
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Federica Bellussi, Nicola Rizzo, L. Cariello, Ginevra Salsi, J. Krsmanovic, G. Pacella, Gianluigi Pilu, Aly Youssef, Elisa Montaguti, C. Azzarone, M. Paganotto, I. Cataneo, Youssef, A., Salsi, G., Cataneo, I., Pacella, G., Azzarone, C., Paganotto, M.C., Krsmanovic, J., Montaguti, E., Cariello, L., Bellussi, F., Rizzo, N., and Pilu, G.
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Radiology, Nuclear Medicine and Imaging ,medicine.medical_treatment ,Anal Canal ,Avulsion ,0302 clinical medicine ,Risk Factors ,Pregnancy ,pelvic floor ,Valsalva maneuver ,Medicine ,Childbirth ,030212 general & internal medicine ,Prospective Studies ,Obstetric Labor Complication ,030219 obstetrics & reproductive medicine ,Pelvic floor ,Radiological and Ultrasound Technology ,Obstetrics ,Vaginal delivery ,4D transperineal ultrasound ,Pregnancy Outcome ,Obstetrics and Gynecology ,General Medicine ,Pelvic Floor Disorder ,medicine.anatomical_structure ,Italy ,Female ,Case-Control Studie ,Human ,Adult ,medicine.medical_specialty ,Birth weight ,fundal pressure ,Kristeller maneuver ,Pelvic Floor Disorders ,03 medical and health sciences ,Labor Stage, Second ,Pressure ,Humans ,business.industry ,Risk Factor ,Odds ratio ,Delivery, Obstetric ,Obstetric Labor Complications ,Prospective Studie ,Reproductive Medicine ,Case-Control Studies ,levator ani muscle ,business ,Body mass index - Abstract
Objective: To investigate the association between application of fundal pressure during the second stage of labor (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury. Methods: This was a prospective case–control study of women recruited immediately after their first vaginal delivery in our university hospital between March 2014 and September 2016. Women who underwent the Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched for body mass index, use of epidural analgesia, duration of second stage of labor and birth weight. All women were invited to undergo four-dimensional (4D) transperineal ultrasound (TPU) 3–6 months postpartum. The main outcome measure was the presence of LAM avulsion on 4D-TPU. TPU results were compared between cases and controls. Multivariate logistic regression analysis was performed to identify independent risk factors for LAM avulsion. Results: During the study period, 134 women in the Kristeller maneuver group and 128 women in the control group underwent TPU assessment. Women who underwent the Kristeller maneuver had a higher prevalence of LAM avulsion than did controls (38/134 (28.4%) vs 18/128 (14.1%); P = 0.005). In addition, women in the Kristeller-maneuver group had a larger hiatal area on maximum Valsalva maneuver and a greater increase in hiatal area from rest to maximum Valsalva. On multivariate logistic regression analysis, use of the Kristeller maneuver was the only independent factor associated with LAM avulsion (odds ratio, 2.5 (95% CI, 1.29–4.51)). Conclusion: The Kristeller maneuver is associated with an increased risk of LAM avulsion when applied in women during their first vaginal delivery. This should be taken into account when deciding to use fundal pressure to accelerate the second stage of labor and when counseling women following childbirth. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2019
22. Randomised Italian Sonography for occiput POSition Trial Ante vacuum (R.I.S.POS.T.A.)
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Giuseppe Rizzo, Gianluigi Pilu, Beatrice Tassis, Tullio Ghi, Tullia Todros, Bianca Masturzo, L. Cariello, Antonio Maria Morselli-Labate, M. Martinelli, Tiziana Frusca, Nicola Volpe, Federico Prefumo, L. Sabbioni, Andrea Dall'Asta, Ghi, T., Dall'Asta, A., Masturzo, B., Tassis, B., Martinelli, M., Volpe, N., Prefumo, F., Rizzo, G., Pilu, G., Cariello, L., Sabbioni, L., Morselli-Labate, A.M., Todros, T., and Frusca, T.
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Adult ,Episiotomy ,medicine.medical_specialty ,Radiology, Nuclear Medicine and Imaging ,Vacuum Extraction, Obstetrical ,fetal head position ,Pregnancy Trimester, Third ,medicine.medical_treatment ,failed instrumental delivery ,Fetal position ,Ultrasonography, Prenatal ,Labor Presentation ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Pregnancy ,law ,intrapartum ultrasound ,Humans ,Medicine ,emergency Cesarean section ,Fetal head ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,Radiological and Ultrasound Technology ,Cesarean Section ,business.industry ,Vaginal delivery ,Obstetrics ,Cephalic presentation ,emergency caesarean section ,Obstetrics and Gynecology ,Occiput ,General Medicine ,Interim analysis ,vacuum delivery ,occiput posterior ,medicine.anatomical_structure ,Reproductive Medicine ,Sample Size ,Female ,Settore MED/40 - Ginecologia e Ostetricia ,Gynecological Examination ,business ,Head - Abstract
Objective To assess whether sonographic diagnosis of fetal head position before instrumental vaginal delivery can reduce the risk of failed vacuum extraction and improve delivery outcome. Methods Randomised Italian Sonography for occiput POSition Trial Ante vacuum (R.I.S.POS.T.A.) is a randomized controlled trial of term (37 + 0 to 41 + 6 weeks' gestation) singleton pregnancies with cephalic presentation requiring instrumental delivery by vacuum extraction, which was conducted between April 2014 and June 2017 and involved 13 Italian maternity hospitals. Patients were randomized to assessment of fetal head position before attempted instrumental delivery by either vaginal examination (VE) alone or VE plus transabdominal sonography (TAS). Primary outcome was incidence of emergency Cesarean section due to failed vacuum extraction. A sample size of 653 women per group was planned to compare the primary outcome between the two groups. The sample size estimation was based on the hypothesis that the risk of failed vacuum delivery in the VE group would be 5% and that ultrasound assessment of fetal position prior to vacuum extraction would decrease this risk to 2%. Results On interim analysis, the trial was stopped for futility. During this period, 222 women were randomized and 221 were included in the final data analysis, of whom 132 (59.7%) were randomized to evaluation of fetal head position by VE only and 89 (40.3%) to assessment by VE plus TAS prior to vacuum extraction. No significant differences were observed between the two groups with respect to incidence of emergency Cesarean section due to failed instrumental delivery and other maternal and fetal outcomes. Women randomized to assessment by VE plus TAS showed higher incidence of non-occiput anterior position of the fetal head at randomization and lower incidence of incorrect diagnosis of occiput position compared with women undergoing assessment by VE alone. A higher rate of episiotomy was noted in the women undergoing both VE and TAS compared with those in the VE-only group. Conclusions Our prematurely discontinued randomized controlled trial did not demonstrate any benefit in terms of reduced risk of failed instrumental delivery or maternal and fetal morbidity in women undergoing sonographic assessment of fetal head position prior to vacuum extraction. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2018
23. Reliability of new three-dimensional ultrasound technique for pelvic hiatal area measurement
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A, Youssef, E, Montaguti, O, Sanlorenzo, L, Cariello, G, Salsi, G, Morganelli, C, Azzarone, G, Pilu, N, Rizzo, Youssef, A, Montaguti, E., Sanlorenzo, O., Cariello, L., Salsi, G., Morganelli, G., Azzarone, C., Pilu, G., and Rizzo, N.
- Subjects
Observer Variation ,Radiology, Nuclear Medicine and Imaging ,Radiological and Ultrasound Technology ,3D ultrasound ,4D ultrasound ,Reproducibility of Results ,Obstetrics and Gynecology ,Imaging, Three-Dimensional ,Reproductive Medicine ,Pregnancy ,pelvic floor ,Humans ,Female ,levator ani muscle ,OmniView ,Ultrasonography ,volume contrast imaging - Abstract
To assess the reproducibility of a new technique for three-/four-dimensional (3D/4D) ultrasound imaging of the pelvic floor: OmniView™ volume contrast imaging (VCI) for measurement of the pelvic hiatal area on maximum contraction and Valsalva maneuver. In addition, we aimed to study the intermethod agreement between the new technique and the 3D/4D render method.We acquired one static 3D and two dynamic 4D transperineal volumes (one obtained during contraction and one during Valsalva maneuver) from 35 nulliparous asymptomatic healthy volunteers and 35 women with symptoms of pelvic floor dysfunction. Each 3D dataset was analyzed using the OmniView-VCI technique to measure the pelvic hiatal area at rest, on maximum contraction and on maximum Valsalva. Analysis was performed twice by the same operator and once by another operator in order to assess intra- and interobserver reproducibility. All measurements were repeated by one operator using the 3D/4D render method to evaluate the intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficients (ICC) and the Bland-Altman method.Measurement of hiatal area using the OmniView-VCI technique showed excellent intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women at rest, on contraction and on Valsalva maneuver. In addition, excellent agreement was demonstrated between OmniView-VCI and 3D/4D render in both groups (ICCs on Valsalva in asymptomatic and symptomatic women were 0.894 and 0.975, respectively). No systematic difference was noted in any of the reliability studies performed.OmniView-VCI is a reliable method for pelvic hiatal area measurement. Both rendering mode and OmniView-VCI can be used interchangeably for assessing pelvic hiatal area. Copyright © 2015 ISUOG. Published by John WileySons Ltd.
- Published
- 2016
24. EP07.05: Customised fetal growth curves in uncomplicated twin pregnancies
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GHI, TULLIO, CARIELLO, LUISA, BELLUSSI, FEDERICA, NARDI, ELENA, RIZZO, NICOLA, PILU, GIANLUIGI, Franchi, L., Piastra, A., Volpe, N., Pedrazzi, G., Frusca, T., Ghi, T., Franchi, L., Piastra, A., Cariello, L., Volpe, N., Bellussi, F., Pedrazzi, G., Nardi, E., Rizzo, N., Pilu, G., and Frusca, T.
- Subjects
Customised fetal growth curves, twin - Published
- 2015
25. Sonographic assessment of fetal occiput position during the second stage of labor: how reliable is the transperineal approach?
- Author
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Ginevra Salsi, G. Pacella, Federica Bellussi, F. Tondi, Aly Youssef, A. Piastra, Nicola Rizzo, Gianluigi Pilu, Tullio Ghi, L. Cariello, Torbjørn Moe Eggebø, Ghi, T., Bellussi, F., Eggebø, T., Tondi, F., Pacella, G., Salsi Ginevra., Cariello, L., Piastra, A., Youssef, A., Pilu, G., and Rizzo, N.
- Subjects
Adult ,medicine.medical_specialty ,Fetal position ,Perineum ,Ultrasonography, Prenatal ,Labor Presentation ,Labor Stage, Second ,Pregnancy ,Abdomen ,Medicine ,Humans ,Prospective Studies ,Stage (cooking) ,Fetal occiput position, labor, transabdominal ultrasound, transperineal ultrasound ,business.industry ,Transperineal approach ,Ultrasound ,Obstetrics and Gynecology ,Occiput ,University hospital ,Position (obstetrics) ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Female ,Radiology ,Occiput posterior position ,business ,Head - Abstract
Objective: To compare the accuracy of transperineal (TP) ultrasound with transabdominal (TA) approach in the sonographic assessment of fetal occiput position during the second stage of labour. Methods: A series of low-risk women at term attending the labour ward of three university hospitals were prospectively recruited for the purpose of this study. During the second stage of labor patients were evaluated first by TP and than by TA ultrasound to determine the fetal position. The occiput position was labelled as DOA (direct occiput anterior), ROA (right occiput anterior), LOA (left occiput anterior), DOP (direct occiput posterior), ROP (right occiput posterior), LOP (left occiput posterior), ROT (right occuput transverse) and LOT (left occiput transverse). The agreement between the two techniques was assessed. Results: Overall 80 patients were recruited in the study group. Ultrasound examination was performed at 21(±8) minutes from the beginning of the active pushing. The ultrasound findings of the fetal occiput position were recorded. In all cases TA ultrasound confirmed the fetal occiput position as determined at TP approach except in one case of ROA that had been recorded as ROT using TP ultrasound. Conclusions: Ultrasound TP examination is accurate in the diagnosis of fetal occiput position during the second stage of labor.
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- 2015
26. A new simple technique for 3-dimensional sonographic assessment of the pelvic floor muscles
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Olimpia Sanlorenzo, L. Cariello, Elisa Montaguti, El-sayed El-badawy Awad, G. Pacella, Gianluigi Pilu, Nicola Rizzo, Tullio Ghi, Aly Youssef, Youssef, A, Montaguti, E, Sanlorenzo, O, Cariello, L, Awad, Ee, Pacella, G, Ghi, T, Pilu, G, and Rizzo, N
- Subjects
Adult ,gynecologic ultrasound ,Intraclass correlation ,Volume Contrast Imaging ,medicine.medical_treatment ,Asymptomatic ,Pelvic Floor Disorders ,3-dimensional sonography ,Imaging, Three-Dimensional ,Pelvic floor dysfunction ,medicine ,Valsalva maneuver ,Humans ,Radiology, Nuclear Medicine and imaging ,Muscle, Skeletal ,OmniView ,Ultrasonography ,Observer Variation ,Reproducibility ,Pelvic floor ,Radiological and Ultrasound Technology ,business.industry ,Ultrasound ,Reproducibility of Results ,Pelvic Floor ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Levator ani ,Female ,levator ani muscle ,medicine.symptom ,Nuclear medicine ,business - Abstract
The purpose of this study was to assess the reproducibility of a new technique for 3-dimensional (3D) pelvic floor sonography: OmniView combined with Volume Contrast Imaging (VCI; GE Healthcare, Kretz Ultrasound, Zipf, Austria) for pelvic hiatal area measurement. In addition, we aimed to study the intermethod agreement between the new technique and the standard 3D rendering method.We acquired a static 3D sonographic transperineal volume from 124 nulliparous asymptomatic women and 118 women with symptoms of pelvic floor dysfunction. Each 3D data set was analyzed by the OmniView-VCI technique to measure the pelvic hiatal area twice by one operator and once by another to assess intraobserver and interobserver reproducibility. The first operator later measured the hiatal area using the 3D rendering method to evaluate intermethod agreement. Reproducibility and intermethod agreement were studied by the intraclass correlation coefficient and Bland-Altman method.Hiatal area measurements by the OmniView-VCI technique showed high intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women. In addition, high agreement was shown between the new technique and 3D rendering in both groups. No systematic differences were noted in any of the reliability studies performed. The new technique took slightly less time to calculate the hiatal area than the standard rendering method in both asymptomatic and symptomatic women.OmniView-VCI is a reliable method for pelvic hiatal area measurement. Further studies are needed to assess its reliability under contraction and the Valsalva maneuver and to evaluate its usefulness and reproducibility for diagnosis of levator ani lesions. Objectives-The purpose of this study was to assess the reproducibility of a new technique for 3-dimensional (3D) pelvic floor sonography: OmniView combined with Volume Contrast Imaging (VCI; GE Healthcare, Kretz Ultrasound, Zipf, Austria) for pelvic hiatal area measurement. In addition, we aimed to study the intermethod agreement between the new technique and the standard 3D rendering method.Methods-We acquired a static 3D sonographic transperineal volume from 124 nulliparous asymptomatic women and 118 women with symptoms of pelvic floor dysfunction. Each 3D data set was analyzed by the OmniView-VCI technique to measure the pelvic hiatal area twice by one operator and once by another to assess intraobserver and interobserver reproducibility. The first operator later measured the hiatal area using the 3D rendering method to evaluate intermethod agreement. Reproducibility and intermethod agreement were studied by the intraclass correlation coefficient and Bland-Altman method.Results-Hiatal area measurements by the OmniView-VCI technique showed high intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women. In addition, high agreement was shown between the new technique and 3D rendering in both groups. No systematic differences were noted in any of the reliability studies performed. The new technique took slightly less time to calculate the hiatal area than the standard rendering method in both asymptomatic and symptomatic women.Conclusions-OmniView-VCI is a reliable method for pelvic hiatal area measurement. Further studies are needed to assess its reliability under contraction and the Valsalva maneuver and to evaluate its usefulness and reproducibility for diagnosis of levator ani lesions.
- Published
- 2014
27. Sonography of fetal holoprosencephaly: a guide to recognize the lesser varieties.
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Montaguti E, Cariello L, Brunelli E, Youssef A, Livi A, Salsi G, and Pilu G
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- Female, Humans, Pregnancy, Ultrasonography, Prenatal methods, Pregnancy Trimester, Second, Septum Pellucidum abnormalities, Fetus, Holoprosencephaly diagnostic imaging
- Abstract
Background: Alobar holoprosencephaly (HPE) is easily detected during a first-trimester screening examination, conversely, recognizing the lesser varieties may be difficult even in the second trimester., Objectives: To describe the imaging findings of a cohort of fetuses with holoprosencephaly (HPE) and to elucidate the appearances of the different anatomical varieties., Materials and Methods: We reviewed medical records and stored images of pregnant women referred to our clinic because of a diagnosis or the suspicion of various forms of HPE. We reported the imaging characteristics, the presence of other associated anomalies, magnetic resonance findings, karyotype and autoptic examinations when available., Results: Alobar forms show great distortion of normal brain anatomy, with a single ventricle detectable during the first trimester of pregnancy. Extracerebral, face and karyotype abnormalities are often associated. In semilobar and lobar forms the septum pellucidum is typically absent in axial planes, with fused frontal horns, while posterior fossa is often normal. At multiplanar neurosonogram, anomalies involving corpus callosum and cortex development can be detected. Face abnormalities are mild in lobar forms: receding forehead, various degrees of hypotelorism and the presence of a single central maxillary incisor are reported., Conclusions: The alobar forms are detectable since the first trimester, with a peculiar single ventricle and extremely frequent extracerebral and karyotype abnormalities. The semilobar and lobar forms are more challenging and the diagnosis is easily missed in a mid-trimester screening exam unless a careful evaluation of both cavum septi pellucidi and frontal horns as well is conducted.
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- 2022
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28. A case of prenatal strangulated inguinal hernia.
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Cariello L, Montaguti E, and Pilu G
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- Hernia, Humans, Retrospective Studies, Hernia, Inguinal complications, Hernia, Inguinal diagnostic imaging, Hernia, Inguinal surgery, Vascular Diseases
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- 2022
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29. The role of a new three-dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion.
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Montaguti E, Cariello L, Dodaro MG, Rizzo N, Pilu G, and Youssef A
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- Adult, Female, Humans, Imaging, Three-Dimensional, Pelvic Floor injuries, Pregnancy, Prospective Studies, Reproducibility of Results, Urethra diagnostic imaging, Obstetric Labor Complications diagnostic imaging, Pelvic Floor diagnostic imaging, Pelvic Floor Disorders diagnostic imaging, Ultrasonography methods
- Abstract
Aims: To evaluate the intermethod agreement between the tomographic ultrasound imaging (TUI), considered as the gold standard, and the OmniView-VCI in the diagnosis of levator ani muscle (LAM) avulsion and in the measurement of levator-urethral gap (LUG)., Methods: We acquired dynamic 4D transperineal ultrasound volumes from 114 women. Each data set was analyzed on maximal pelvic floor contraction by TUI and OmniView-VCI techniques to check for LAM avulsion. Moreover, we measured LUG using both TUI and OmniView-VCI, twice by an operator and once by another to assess intraobserver and interobserver reproducibility. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Cohen's kappa coefficient., Results: In the diagnosis of ani levator avulsion, the two techniques showed a good agreement (Cohen's κ = 0.691, 95% confidence interval [CI], 0.522-0.860; P < .001); we also reported a good intraobserver and interobserver agreement (Cohen's κ = 0.738, 95% CI, 0.597-0.879; P < .001, and Cohen's κ = 0.864, 95% CI, 0.750-0.978; P < .001, respectively). LUG measurements by OmniView-VCI technique showed high intraobserver (ICC 0.895; 95% CI, 0.866-0.918) and interobserver (ICC 0.821; 95% CI, 0.774-0.858) reproducibility. High intermethod agreement was demonstrated between the two methods (ICC 0.813; 95% CI, 0.764-0.853). The area under the receiver-operating characteristic curve of LUG in predicting avulsion was 0.931 (0.868-0.994, 95% CI; P < .001) with 24 mm showing the best sensitivity (82%) and specificity (97%)., Conclusions: OmniView-VCI is a reliable method for LUG measurement and for levator avulsion diagnosis., (© 2019 Wiley Periodicals, Inc.)
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- 2020
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30. Comparison of two "a priori" risk assessment algorithms for preeclampsia in Italy: a prospective multicenter study.
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Di Martino D, Masturzo B, Paracchini S, Bracco B, Cavoretto P, Prefumo F, Germano C, Morano D, Girlando F, Giorgione V, Parpinel G, Cariello L, Fusè F, Candiani M, Todros T, Rizzo N, and Farina A
- Subjects
- Adult, Algorithms, Female, Humans, Italy, Pregnancy, Prospective Studies, Risk Assessment, Risk Factors, Biomarkers metabolism, Pre-Eclampsia diagnosis
- Abstract
Purpose: To compare the performance of the algorithms proposed by the Fetal Medicine Foundation in 2012 and BCNatal in 2013 in an Italian population., Methods: A multicentric prospective study was carried out which included pregnancies at 11-13 weeks' gestation from Jan 2014 through May 2017. Two previously published algorithms were used for the calculation of the "a priori" risk of preeclampsia (based on risk factors from medical history) in each individual., Results: In a study population of 11,632 cases, 67 (0.6%) developed early preeclampsia and 211 (1.8%) developed late preeclampsia. The detection rates (95% CI) for early and late preeclampsia were 58.2% (45.5-70.2) vs. 41.8% (29.6-54.5) (p value < 0.05) and 44.1% (37.3-51.1) vs. 38% (31.3-44.8) (p value < 0.05) for the Fetal Medicine Foundation and BCNatal, respectively (at a 10% false positive rate). The associated risk was 1:226 and 1:198 (p value ns) for early PE, and 1:17 and 1:24 (p value ns) for late PE for the Fetal Medicine Foundation and BCNatal, respectively., Conclusions: The Fetal Medicine Foundation screening for preeclampsia at 11-13 weeks' gestation scored the highest detection rate for both early and late PE. At a fixed 10% false positive rate, the estimated "a priori" risks of both the Fetal Medicine Foundation and the BCNatal algorithms in an Italian population were quite similar, and both were reliable and consistent.
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- 2019
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31. A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign.
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Bellussi F, Salsi G, Simonazzi G, Youssef A, Cataneo I, Cariello L, Ghi T, and Pilu G
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- Adult, Female, Humans, Labor Presentation, Obstetric Labor Complications diagnostic imaging, Pregnancy, Prospective Studies, Retrospective Studies, Delivery, Obstetric methods, Forehead diagnostic imaging, Head diagnostic imaging, Ultrasonography, Prenatal methods, Vacuum Extraction, Obstetrical statistics & numerical data
- Abstract
Background: Intrapartum ultrasound scanning has been proposed as an ancillary tool in the decision-making process of instrumental vaginal delivery., Objective: The purpose of this study was to evaluate the correlation between the sonographic visualization with a transperineal scan of the fetal occiput or forehead distal to the pubic symphysis with anterior or posterior presentation, respectively (fetal occiput or forehead sign), and the outcome of a vacuum delivery., Study Design: We conducted a retrospective cohort study of patients who underwent a vacuum application in our hospital from 2011-2017, excluding outlet applications. In each case, a preliminary transperineal scan was performed to confirm fetal presentation and position and to demonstrate the presence or absence of the fetal occiput or forehead sign. The head direction, angle of progression, and the head perineum distance were also noted. The primary outcome measure was the success of the vacuum. The secondary outcome measures included fetal complications and perineal lacerations., Results: A total of 196 consecutive patients were enrolled in the study. The occiput or forehead sign was present in 150 and was associated with a successful vaginal extraction in all cases. Of the 46 cases without the sign, 5 babies (10.8%) were delivered by cesarean section after a failed vacuum (P=.0006). The occiput or forehead sign was also associated with fewer grade 3-4 perineal lacerations (10.7% vs 35.7%; P=.0005) and cephalohematomas, although the difference was not statistically significant (1.4% vs 4.3%). There was a good correlation between the occiput or forehead sign and the other sonographic methods that previously had been proposed to predict a successful vacuum extraction, such as head direction, angle of progression, and head perineum distance., Conclusion: In our hands, the fetal occiput or forehead sign was associated strongly with successful vacuum application and with a very low rate of maternal and fetal complications., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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32. Prenatal sonographic diagnosis of meconium peritonitis from duodenal atresia.
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Chandrasekaran N, Benardete D, Cariello L, and Meraz D
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- Adult, Female, Fetal Diseases diagnostic imaging, Humans, Intestinal Atresia, Peritonitis diagnosis, Pregnancy, Premature Birth, Duodenal Obstruction complications, Meconium diagnostic imaging, Peritonitis diagnostic imaging, Ultrasonography, Prenatal
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2017
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33. Infant born with Robert's syndrome without prenatal care in a developing nation.
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Benardete D, Chandrasekaran N, Cariello L, and Meraz D
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- Adult, Developing Countries, Female, Humans, Infant, Newborn, Male, Mexico, Pregnancy, Prenatal Care, Craniofacial Abnormalities diagnosis, Ectromelia diagnosis, Hypertelorism diagnosis
- Abstract
Maternal and child well-being during pregnancy can be attributed to receiving optimal prenatal care. However, in developing nations, there are many barriers to receiving this. We present a primigravid female aged 29 years with severe abdominal pain. She was in active labour at 40 weeks and completely unaware of her pregnancy; hence, she did not receive any prenatal care. The baby was born with significant birth deformities that were consistent with Robert's syndrome. Although early detection could not preclude the development of this disorder, proper care would have facilitated in receiving genetic counselling and proper understanding of the prognosis. In this case, we discuss the various barriers to receiving prenatal care and measures taken for improvement in developing nations., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
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- 2016
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34. Customized Fetal Growth Charts for Parents' Characteristics, Race, and Parity by Quantile Regression Analysis: A Cross-sectional Multicenter Italian Study.
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Ghi T, Cariello L, Rizzo L, Ferrazzi E, Periti E, Prefumo F, Stampalija T, Viora E, Verrotti C, and Rizzo G
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- Algorithms, Computer Simulation, Cross-Sectional Studies, Female, Humans, Image Interpretation, Computer-Assisted methods, Italy epidemiology, Male, Models, Statistical, Regression Analysis, Reproducibility of Results, Sensitivity and Specificity, Body Height physiology, Fetal Development physiology, Growth Charts, Parents, Racial Groups statistics & numerical data, Ultrasonography, Prenatal statistics & numerical data
- Abstract
Objectives: The purpose of this study was to construct fetal biometric charts between 16 and 40 weeks' gestation that were customized for parental characteristics, race, and parity, using quantile regression analysis., Methods: In a multicenter cross-sectional study, 8070 sonographic examinations from low-risk pregnancies between 16 and 40 weeks' gestation were analyzed. The fetal measurements obtained were biparietal diameter, head circumference, abdominal circumference, and femur diaphysis length. Quantile regression was used to examine the impact of parental height and weight, parity, and race across biometric percentiles for the fetal measurements considered., Results: Paternal and maternal height were significant covariates for all of the measurements considered (P < .05). Maternal weight significantly influenced head circumference, abdominal circumference, and femur diaphysis length. Parity was significantly associated with biparietal diameter and head circumference. Central African race was associated with head circumference and femur diaphysis length, whereas North African race was only associated with femur diaphysis length., Conclusions: In this study we constructed customized biometric growth charts using quantile regression in a large cohort of low-risk pregnancies. These charts offer the advantage of defining individualized normal ranges of fetal biometric parameters at each specific percentile corrected for parental height and weight, parity, and race. This study supports the importance of including these variables in routine sonographic screening for fetal growth abnormalities.
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- 2016
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35. A new simple technique for 3-dimensional sonographic assessment of the pelvic floor muscles.
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Youssef A, Montaguti E, Sanlorenzo O, Cariello L, Awad EE, Pacella G, Ghi T, Pilu G, and Rizzo N
- Subjects
- Adult, Female, Humans, Middle Aged, Observer Variation, Pelvic Floor diagnostic imaging, Reproducibility of Results, Ultrasonography, Imaging, Three-Dimensional methods, Muscle, Skeletal diagnostic imaging, Pelvic Floor Disorders diagnostic imaging
- Abstract
Objectives: The purpose of this study was to assess the reproducibility of a new technique for 3-dimensional (3D) pelvic floor sonography: OmniView combined with Volume Contrast Imaging (VCI; GE Healthcare, Kretz Ultrasound, Zipf, Austria) for pelvic hiatal area measurement. In addition, we aimed to study the intermethod agreement between the new technique and the standard 3D rendering method., Methods: We acquired a static 3D sonographic transperineal volume from 124 nulliparous asymptomatic women and 118 women with symptoms of pelvic floor dysfunction. Each 3D data set was analyzed by the OmniView-VCI technique to measure the pelvic hiatal area twice by one operator and once by another to assess intraobserver and interobserver reproducibility. The first operator later measured the hiatal area using the 3D rendering method to evaluate intermethod agreement. Reproducibility and intermethod agreement were studied by the intraclass correlation coefficient and Bland-Altman method., Results: Hiatal area measurements by the OmniView-VCI technique showed high intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women. In addition, high agreement was shown between the new technique and 3D rendering in both groups. No systematic differences were noted in any of the reliability studies performed. The new technique took slightly less time to calculate the hiatal area than the standard rendering method in both asymptomatic and symptomatic women., Conclusions: OmniView-VCI is a reliable method for pelvic hiatal area measurement. Further studies are needed to assess its reliability under contraction and the Valsalva maneuver and to evaluate its usefulness and reproducibility for diagnosis of levator ani lesions., (© 2015 by the American Institute of Ultrasound in Medicine.)
- Published
- 2015
- Full Text
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36. Fetal head-symphysis distance and mode of delivery in the second stage of labor.
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Youssef A, Maroni E, Cariello L, Bellussi F, Montaguti E, Salsi G, Morselli-Labate AM, Paccapelo A, Rizzo N, Pilu G, and Ghi T
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- Adult, Female, Fetal Monitoring methods, Fetal Monitoring statistics & numerical data, Humans, Imaging, Three-Dimensional methods, Italy epidemiology, Predictive Value of Tests, Pregnancy, Pregnancy Outcome epidemiology, Prospective Studies, Risk Assessment, Ultrasonography, Prenatal methods, Ultrasonography, Prenatal statistics & numerical data, Cesarean Section statistics & numerical data, Labor Presentation, Labor Stage, Second physiology, Natural Childbirth statistics & numerical data, Vacuum Extraction, Obstetrical statistics & numerical data
- Abstract
Objective: To evaluate whether the fetal head-symphysis distance measured by three-dimensional transperineal ultrasound during the active second stage predicts operative delivery., Design: Prospective observational study., Setting: University hospital, Bologna, Italy., Population: Seventy-one nulliparous women at term in active second stage of labor., Methods: We acquired a series of sonographic volumes at the beginning of the active second stage (T1) and every 20 min thereafter (T2, T3, T4, T5, T6) until delivery. All volumes were retrospectively analyzed and head-symphysis distance was measured for each acquisition. We compared head-symphysis distance between women with spontaneous vaginal delivery and those with operative delivery. Receiver operator characteristic curves were constructed to estimate the accuracy of head-symphysis distance in the prediction of operative delivery. Logistic regression was used to identify independent variables associated with operative delivery., Main Outcome Measures: Operative delivery (vacuum or cesarean)., Results: Of the women included, 81.7% had a spontaneous vaginal delivery and 18.3% underwent operative delivery. Women with spontaneous vaginal delivery had shorter head-symphysis distance than women in the operative delivery group at T1 (p < 0.001), T2 (p < 0.001) and T3 (p = 0.025), whereas no significant differences were recorded thereafter. Receiver operator characteristic curves revealed accuracy values of 81.0%, 87.9% and 77.6% in the prediction of operative delivery at T1, T2 and T3, respectively. At multivariate logistic regression head-symphysis distance and epidural analgesia were the only independent predictors of operative delivery among ultrasonographic, maternal and intrapartum variables., Conclusions: Ultrasonographic measurement of head-symphysis distance in the second stage of labor can be used to predict operative delivery., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Published
- 2014
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