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The article focuses on a research study which aims to analyze the evolution of breast interventions from the radical mastectomy, to quadrantectomy, and to breast conservative surgery (BCS). Materials and methods are presented which used collected data from breast surgery interventions between 2002 and 2010. Results are discussed indicating absolute increase in yearly breast operation count characterized by decreased mastectomies, increased BCS, and more satisfying breast reconstruction.

The article discusses a study aimed at determining the prevalence of chronic pelvic pain (CPP) in a cohort of young adult women following at least a year from delivery and investigating the possible influence of both delivery and concomitant pathologic conditions on painful pelvi-perineal symptoms. It focuses on autoimmune diseases such as rheumatic, allergic and gastrointestinal inflammatory ones as well as on previous painful pelvi-perineal symptoms and any kind of abdomino-pelvic surgical intervention. Participants were asked about pelvi-perineal painful symptoms particularly about painful bladder, painful intercourse and generalysed pelvic pain. It hypothesizes that there are two different kinds of CPP based on their etiology.

The article presents a study on the prevalence of pelviperineal rehabilitation and urinary incontinence in postpartum patients. The said urinary incontinence is the childbirth-related perineal trauma classical sign, wherein the estimated prevalence ranges from 10%-50%. It notes that the pelviperineal rehabilitation within the observed patients has a quite low occurrence versus the high disturbances prevalence related to pelvic floor dysfunctions during postnatal pregnancies.

SARS-CoV-2 disease mechanisms are not yet fully understood, especially in cases affecting pregnant women. In fact, although they suffer from the same symptoms as non-pregnant women, they are more susceptible to-adverse outcomes of COVID-19 as well as pregnancy complications leading to stillbirth, premature rupture of membrane, or intrauterine fetal demise (IUFD). The consequences on pregnancy are not clearly correlated with the severity of the infection. We present a case of fetal death in a 30-year-old woman with a confirmed SARS-CoV-2 infection without any other significant clinical or obstetric disorders. A histopathological examination of the placenta indicated massive and diffuse intervillar fibrinoid deposits associated with chronic histiocytic intervillositis that can be associated with SARS-CoV-2 placentitis. Given the high rates of SARS-CoV-2 infections in pregnancy, it is important to understand the factors that determine negative pregnancy outcomes, regardless of the severity of the patient's symptoms.

Uterine leiomyosarcoma is a rare malignant gynecologic tumor that arises from the myometrial or endometrial stromal precursor cells. This tumor has the highest prevalence in the pre- and post-is more frequent between 40 and 60 years old. It has a very unfavorable prognosis: only early-stage tumors have an acceptable prognosis; unfortunately, it is often diagnosed accidentally, typically on an advanced stage, when hematological metastases have already spread. Surgery is the main treatment strategy, while systemic treatment and radiotherapy are not recommended due to the lack of results. Since metastatization is mainly hematological, lymphadenectomy is not recommended. Recent progresses have been achieved in advanced and recurrent disease, often inoperable, thanks to new chemotherapies, target therapies and immunotherapies. We reported the case of a 51-year-old woman evaluated for lumbar pain in the right region compatible with renal colic. The ultrasound evaluation revealed right hydronephrosis and the presence of a paraovarian or intraligamentary mass compatible with fibroma. The abdominal CT confirmed the presence of a mass with heterogeneous vascularization. Therefore, the patient underwent laparoscopic surgery to remove the lesion which resulted to be a leiomyosarcoma G2. During the following week the patient underwent a laparoscopic hysterectomy. The first step for differential diagnosis consists in the evaluation of clinicopathological features, followed by the analysis of preoperative imaging. Pelvic MRI represents the gold standard, while CT is used to detect metastases. The main issue is that imaging shows limited ability in differential diagnosis between benign and malign smooth muscle tumor. The definitive diagnosis is confirmed by histological analysis; this implies the necessity of improved attentions on the surgical procedure, which is often performed by steps with prolongation of the treatment pathway. To distinguish which fibroids presents a major risk to be misdiagnosed, some risk scores were developed (rPRESS in 2014 and pLMS in 2019), though actually they are not applied in clinical practice. Uterine leiomyosarcoma (uLMS) is rare but causes several deaths in perimenopausal women due to lack of effective treatments, although target therapies represent a future hope. Furthermore, clinical practice needs support through the development and improvement of diagnostic risk scores and their integration into guidelines.

Glutaric aciduria type II (GA II) is a genetic disorder that interferes with the body's ability to break down proteins and fats to produce energy. Signs and symptoms vary greatly depending on the age of onset and severity of the condition. Pregnancy may be a high-risk period in women affected by metabolic disorders, because the mother must guarantee wellness for both her and fetus. A 37-year-old primigravida woman affected by a mild form of GA II presented to our high-risk department. During pregnancy a dietician strictly controlled her diet and nutritional intake. The fetal growth was regular but around the 38 th week a polyhydramnios was diagnosed. A modification in carbohydrate intake led to a normal amniotic fluid. Considering the high risk of metabolic decompensation during labor, an elective cesarean section was programmed. The rare disease geneticist gave some indications to follow before, during and after delivery to reduce the risk for the mother. No complications occurred and the patient with her baby was discharged on the third postoperative day. We present a case report and a review of literature. In pregnant women affected by GA II periodical nutritional and obstetrical evaluations are important to monitor maternal condition and fetal growth. Adequate nutrient intake is fundamental to preserve mother and fetus from complications. Elective caesarean section is preferred to reduce metabolic distress during delivery and to avoid the risk of metabolic crisis. Pregnant women with metabolic diseases are increasing, consequently guidelines may be necessary for a better management.

Background: Group B Streptococcus (GBS) is the leading cause of neonatal morbidity and mortality in developed countries. This study aims primarily to estimate the prevalence of maternal GBS positivity and secondarily to evaluate the compliance and the effectiveness of the current GBS prevention protocol., Methods: This retrospective study has considered 27382 single pregnancies carried to delivery between 2001 and 2014 at our Obstetrics and Gynecology clinic. All women carrying a singleton pregnancy in the considered period were eligible to be included in this study., Results: The GBS swab was positive in 17.66% of cases, negative in 51.93%, and unknown in 30.41%. Data collected revealed that out of the total of GBS-positive women, 3362 were treated with antibiotic prophylaxis, and 1331 were not. There were no differences between cases admitted to Neonatal Intensive Care Unit and perinatal deaths between treated and non-treated GBS-positive pregnancies. Moreover, the data showed that 74.62% of patients between 34 and 37 weeks of gestation at the time of delivery were treated with antibiotic prophylaxis unnecessarily, and 25.38% of patients >37 weeks of gestation whose GBS status at delivery was unknown would have required intrapartum antibiotic prophylaxis. The only risk factor for chorioamnionitis among GBS-positive women in multivariate logistic regression analysis was an early gestational age (OR 0.61; 95% CI: 0.56-0.66; P<0.05)., Conclusions: GBS prevalence was found to be 17.66%, and prophylaxis in colonized patients was carried out correctly according to our internal procedure allowing a low incidence of adverse outcomes. Finally, the only risk factor associated with chorioamnionitis in GBS patients was early gestational age at delivery.

Background: Hormonal pills are among the most widely contraceptive methods used by women, despite the possible onset of different adverse events. To minimize the risk of thrombosis-related adverse events, different formulations and doses have been investigated. Micronized estradiol (E2)/nomegestrol acetate (NOMAC) 24+4 is the first monophasic combined oral contraceptive pill containing natural E2, the same steroid produced by the granulosa cells of women ovaries. This combination presents an improved effect on hemostasis and metabolism compared to ethinyl-estradiol (EE)-based products and may be considered a good option to meet women's needs in a more physiological way. Despite the benefits of E2, its use is still not so common among combined oral contraceptives (COC)., Methods: Seventy-seven Italian gynecologists were involved and asked to answer a survey to investigate some aspects related to contraception. The results of the survey were discussed within the same gynecologists and a panel of experts during eight macro-regional meetings., Results: The survey demonstrated that clinicians dedicate 40-60% of their time to contraception and confirmed the importance of the choice of the contraceptive pill, which is mostly prescribed for contraceptive purposes. Moreover, COC containing E2 is considered as the first choice in oral contraception and meets the features of an ideal pill., Conclusions: Italian gynecologists reported that E2-based pill presents benefits related to safety, good tolerability, and low adverse events, in particular, related to a reduced thromboembolic risk. Research market data highlight that the use of these types of COC should expand with respect to traditional compounds containing EE.