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52. Valacyclovir for cytomegalovirus infection in pregnancy: additional evidences, additional questions

Author

Zammarchi, Lorenzo, primary, Lazzarotto, Tiziana, additional, Andreoni, Massimo, additional, Giaché, Susanna, additional, Campolmi, Irene, additional, Pasquini, Lucia, additional, Di Tommaso, Mariarosaria, additional, Simonazzi, Giuliana, additional, Tomasoni, Lina Rachele, additional, Castelli, Francesco, additional, Galli, Luisa, additional, Borchi, Beatrice, additional, Clerici, Pierangelo, additional, Bartoloni, Alessandro, additional, Tavio, Marcello, additional, and Trotta, Michele, additional

Published
2021
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53. Clinical Validation of the INTERGROWTH-21st Standards of Fetal Abdominal Circumference for the Prediction of Small-for-Gestational-Age Neonates in Italy

Author

Bellussi, Federica, Cataneo, Ilaria, Visentin, Silvia, Simonazzi, Giuliana, Lenzi, Jacopo, Fantini, Maria Pia, Mimmi, Stefano, Cosmi, Erich, Pilu, Gianluigi, Bellussi, Federica, Cataneo, Ilaria, Visentin, Silvia, Simonazzi, Giuliana, Lenzi, Jacopo, Fantini, MARIA PIA, Mimmi, Stefano, Cosmi, Erich, and Pilu, Gianluigi

Subjects
Abdominal circumference, Fetal growth restriction, INTERGROWTH-21st, Small for gestational age, Pediatrics, Perinatology and Child Health, Embryology, Radiology, Nuclear Medicine and Imaging, Obstetrics and Gynecology, medicine.medical_specialty, Gestational Age, Pediatrics, Ultrasonography, Prenatal, Fetal Development, 03 medical and health sciences, 0302 clinical medicine, Obstetrics and gynaecology, Nuclear Medicine and Imaging, Abdomen, medicine, Humans, Intergrowth 21st, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Gynecology, Fetus, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Ultrasound, General Medicine, Perinatology and Child Health, medicine.disease, Italy, Infant, Small for Gestational Age, Radiology, business
Abstract

Objectives: To compare the accuracy of the INTERGROWTH-21st (IG-21) with the Italian Society of Ultrasound in Obstetrics and Gynecology (SIEOG) abdominal circumference (AC) standards in the detection of small-for-gestational-age (SGA) fetuses in a high-risk population. Material and Methods: Our study included all pregnant patients with an increased risk of placental insufficiency that were seen in two Italian university hospitals between 2014 and 2015. The accuracy of IG-21 and SIEOG AC standards in the detection of SGA neonates was analyzed by means of the area under the receiver operating characteristic curve (ROC-AUC) at 4 gestational age intervals (24-27, 28-31, 32-35, >35 weeks). Results: We enrolled 428 patients (278 Italians). There was no significant difference between the ROC-AUC of AC according to IG-21 and SIEOG standards for all birthweight thresholds and gestational intervals that were considered. The diagnostic performance was similar in Italian and non-Italian patients. The accuracy was, however, limited, with values of ROC-AUC ranging between 0.80 and 0.89. Conclusions: The IG-21 and SIEOG AC standards are interchangeable for the diagnosis of SGA fetuses. The diagnostic accuracy is, however, limited. We provide figures that can be used to stratify the probability that an infant will be SGA in an obstetric population at increased risk of growth restriction.

Published
2017
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59. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Author

Di Mascio, Daniele, primary, Sen, Cihat, additional, Saccone, Gabriele, additional, Galindo, Alberto, additional, Grünebaum, Amos, additional, Yoshimatsu, Jun, additional, Stanojevic, Milan, additional, Kurjak, Asım, additional, Chervenak, Frank, additional, Rodríguez Suárez, María José, additional, Gambacorti-Passerini, Zita Maria, additional, Baz, María de los Angeles Anaya, additional, Aguilar Galán, Esther Vanessa, additional, López, Yolanda Cuñarro, additional, De León Luis, Juan Antonio, additional, Hernández, Ignacio Cueto, additional, Herraiz, Ignacio, additional, Villalain, Cecilia, additional, Venturella, Roberta, additional, Rizzo, Giuseppe, additional, Mappa, Ilenia, additional, Gerosolima, Giovanni, additional, Hellmeyer, Lars, additional, Königbauer, Josefine, additional, Ameli, Giada, additional, Frusca, Tiziana, additional, Volpe, Nicola, additional, Luca Schera, Giovanni Battista, additional, Fieni, Stefania, additional, Esposito, Eutalia, additional, Simonazzi, Giuliana, additional, Di Donna, Gaetana, additional, Youssef, Aly, additional, Della Gatta, Anna Nunzia, additional, Di Donna, Mariano Catello, additional, Chiantera, Vito, additional, Buono, Natalina, additional, Sozzi, Giulio, additional, Greco, Pantaleo, additional, Morano, Danila, additional, Bianchi, Beatrice, additional, Lombana Marino, Maria Giulia, additional, Laraud, Federica, additional, Ramone, Arianna, additional, Cagnacci, Angelo, additional, Barra, Fabio, additional, Gustavino, Claudio, additional, Ferrero, Simone, additional, Ghezzi, Fabio, additional, Cromi, Antonella, additional, Laganà, Antonio Simone, additional, Laurita Longo, Valentina, additional, Stollagli, Francesca, additional, Sirico, Angelo, additional, Lanzone, Antonio, additional, Driul, Lorenza, additional, Cecchini D, Fabiana, additional, Xodo, Serena, additional, Rodriguez, Brian, additional, Mercado-Olivares, Felipe, additional, Elkafrawi, Deena, additional, Sisti, Giovanni, additional, Esposito, Rosanna, additional, Coviello, Antonio, additional, Cerbone, Marco, additional, Morlando, Maddalena, additional, Schiattarella, Antonio, additional, Colacurci, Nicola, additional, De Franciscis, Pasquale, additional, Cataneo, Ilaria, additional, Lenzi, Marinella, additional, Sandri, Fabrizio, additional, Buscemi, Riccardo, additional, Gattei, Giorgia, additional, Sala, Francesca della, additional, Valori, Eleonora, additional, Rovellotti, Maria Cristina, additional, Done, Elisa, additional, Faron, Gilles, additional, Gucciardo, Leonardo, additional, Esposito, Valentina, additional, Vena, Flaminia, additional, Giancotti, Antonella, additional, Brunelli, Roberto, additional, Muzii, Ludovico, additional, Nappi, Luigi, additional, Sorrentino, Felice, additional, Vasciaveo, Lorenzo, additional, Liberati, Marco, additional, Buca, Danilo, additional, Leombroni, Martina, additional, Di Sebastiano, Francesca, additional, Di Tizio, Luciano, additional, Gazzolo, Diego, additional, Franchi, Massimo, additional, Ianniciello, Quintino Cesare, additional, Garzon, Simone, additional, Petriglia, Giuliano, additional, Borrello, Leonardo, additional, Nieto-Calvache, Albaro Josè, additional, Burgos-Luna, Juan Manuel, additional, Kadji, Caroline, additional, Carlin, Andrew, additional, Bevilacqua, Elisa, additional, Moucho, Marina, additional, Pinto, Pedro Viana, additional, Figueiredo, Rita, additional, Morales Roselló, José, additional, Loscalzo, Gabriela, additional, Martinez-Varea, Alicia, additional, Diago, Vincente, additional, Jimenez Lopez, Jesús S, additional, Aykanat, Alicia Yeliz, additional, Cosma, Stefano, additional, Carosso, Andrea, additional, Benedetto, Chiara, additional, Bermejo, Amanda, additional, May Feuerschuette, Otto Henrique, additional, Uyaniklar, Ozlem, additional, Ocakouglu, Sakine Rahimli, additional, Atak, Zeliha, additional, Gündüz, Reyhan, additional, Haberal, Esra Tustas, additional, Froessler, Bernd, additional, Parange, Anupam, additional, Palm, Peter, additional, Samardjiski, Igor, additional, Taccaliti, Chiara, additional, Okuyan, Erhan, additional, Daskalakis, George, additional, Moreira de Sa, Renato Augusto, additional, Pittaro, Alejandro, additional, Gonzalez-Duran, Maria Luisa, additional, Guisan, Ana Concheiro, additional, Genç, Şerife Özlem, additional, Zlatohlávková, Blanka, additional, Piqueras, Anna Luengo, additional, Oliva, Dolores Esteban, additional, Cil, Aylin Pelin, additional, Api, Olus, additional, Antsaklis, Panos, additional, Ples, Liana, additional, Kyvernitakis, Ioannis, additional, Maul, Holger, additional, Malan, Marcel, additional, Lila, Albert, additional, Granese, Roberta, additional, Ercoli, Alfredo, additional, Zoccali, Giuseppe, additional, Villasco, Andrea, additional, Biglia, Nicoletta, additional, Madalina, Ciuhodaru, additional, Costa, Elena, additional, Daelemans, Caroline, additional, Pintiaux, Axelle, additional, Cueto, Elisa, additional, Hadar, Eran, additional, Dollinger, Sarah, additional, Brzezinski Sinai, Noa A., additional, Huertas, Erasmo, additional, Arango, Pedro, additional, Sanchez, Amadeo, additional, Schvartzman, Javier Alfonso, additional, Cojocaru, Liviu, additional, Turan, Sifa, additional, Turan, Ozhan, additional, Di Dedda, Maria Carmela, additional, Molpeceres, Rebeca Garrote, additional, Zdjelar, Snezana, additional, Premru-Srsen, Tanja, additional, Cerar, Lilijana Kornhauser, additional, Druškovič, Mirjam, additional, De Robertis, Valentina, additional, Stefanovic, Vedran, additional, Nupponen, Irmeli, additional, Nelskylä, Kaisa, additional, Khodjaeva, Zulfiya, additional, Gorina, Ksenia A., additional, Sukhikh, Gennady T., additional, Maruotti, Giuseppe Maria, additional, Visentin, Silvia, additional, Cosmi, Erich, additional, Ferrari, Jacopo, additional, Gatti, Alessandra, additional, Luvero, Daniela, additional, Angioli, Roberto, additional, Puri, Ludovica, additional, Palumbo, Marco, additional, D’Urso, Giusella, additional, Colaleo, Francesco, additional, Chiara Rapisarda, Agnese Maria, additional, Carbone, Ilma Floriana, additional, Mollo, Antonio, additional, Nazzaro, Giovanni, additional, Locci, Mariavittoria, additional, Guida, Maurizio, additional, Di Spiezio Sardo, Attilio, additional, Panici, Pierluigi Benedetti, additional, Berghella, Vincenzo, additional, Flacco, Maria Elena, additional, Manzoli, Lamberto, additional, Bifulco, Giuseppe, additional, Scambia, Giovanni, additional, Zullo, Fulvio, additional, and D’Antonio, Francesco, additional

Published
2020
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67. Emilia-Romagna Study on Pregnancy and Exposure to Antiepileptic drugs (ESPEA): a population-based study on prescription patterns, pregnancy outcomes and fetal health

Author

Mostacci, Barbara, Bisulli, Francesca, Poluzzi, Elisabetta, Cocchi, Guido, Piccinni, Carlo, Curti, Alessandra, Simonazzi, Giuliana, Astolfi, Gianni, Rizzo, Nicola, Zenesini, Corrado, D'Alessandro, Roberto, Tinuper, Paolo, Licchetta, Laura, Mostacci, Barbara, Bisulli, Francesca, Poluzzi, Elisabetta, Cocchi, Guido, Piccinni, Carlo, Curti, Alessandra, Simonazzi, Giuliana, Astolfi, Gianni, Rizzo, Nicola, Zenesini, Corrado, D'Alessandro, Roberto, Tinuper, Paolo, and Licchetta, Laura

Subjects
Male, medicine.medical_specialty, neuropharmacology, Infant, Newborn, Diseases, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Hospital discharge, Humans, clinical neurology, 030212 general & internal medicine, Medical prescription, Pregnancy outcomes, reproductive and urinary physiology, Retrospective Studies, Epilepsy, Obstetrics, business.industry, Infant, Newborn, Pregnancy Outcome, epilepsy,anticonvulsant, Fetal health, medicine.disease, Population based study, Pregnancy Complications, Psychiatry and Mental health, Distress, Italy, anticonvulsants, Small for gestational age, Surgery, Female, Neurology (clinical), pharmacology, business, 030217 neurology & neurosurgery
Abstract

ObjectivesTo assess the prevalence of antiepileptic drug (AED) exposure in pregnant women and the comparative risk of terminations of pregnancy (TOPs), spontaneous abortions, stillbirths, major birth defects (MBDs), neonatal distress and small for gestational age (SGA) infants following intrauterine AED exposure in the Emilia Romagna region, Italy (4 459 246 inhabitants on 31 December 2011).MethodsWe identified all deliveries and hospitalised abortions in Emilia Romagna in the period 2009–2011 from the certificate of delivery assistance registry (Certificato di Assistenza al Parto— CedAP) and the hospital discharge card registry, exposure to AEDs from the reimbursed drug prescription registries, MBDs from the regional registry of congenital malformations, and Apgar scores and cases of SGA from the CedAP. Records from different registries were linked.ResultsWe identified 145 243 pregnancies: 111 284 deliveries, 16 408 spontaneous abortions and 17 551 TOPs. Six hundred and eleven pregnancies (0.42%; 95% Cl 0.39 to 0.46) were exposed to AEDs. In the AED-exposed group 21% of pregnancies ended in TOPs vs 12% in the non-exposed women (OR: 2.24; 95% CI 1.41 to 3.56). Rates of spontaneous abortions, stillbirths, neonatal distress and SGA were comparable. Three hundred and fifty-three babies (0.31%; 95% CI 0.28 to 0.35) were exposed to AEDs during the first trimester. MBD rates were 2.3% in the exposed vs 2.0% in the non-exposed pregnancies (OR: 1.12, 95% CI 0.55 to 2.55).ConclusionThe Emilia Romagna prevalence of AED exposure in pregnancy was 0.42%, comparable with previous European studies. Rates of spontaneous abortions, stillbirths, neonatal distress, SGA and MBDs following AED exposure were not significantly increased. The rate of TOPs was significantly higher in the AED-exposed women.

Published
2018

68. Prevalence, Correlates and Outcomes of Smoking in Pregnant Women with HIV: A National Observational Study in Italy

Author

Floridia, Marco, primary, Ravizza, Marina, additional, Masuelli, Giulia, additional, Tassis, Beatrice, additional, Savasi, Valeria Maria, additional, Liuzzi, Giuseppina, additional, Sansone, Matilde, additional, Simonazzi, Giuliana, additional, Franceschetti, Laura, additional, Meloni, Alessandra, additional, Vimercati, Antonella, additional, Guaraldi, Giovanni, additional, Pinnetti, Carmela, additional, Dalzero, Serena, additional, and Tamburrini, Enrica, additional

Published
2020
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69. PREGNANCY LOSS IN WOMEN WITH HIV IS NOT ASSOCIATED WITH HIV MARKERS: DATA FROM A NATIONAL STUDY IN ITALY, 2001-2018

Author

Floridia, Marco, primary, Masuelli, Giulia, primary, Tassis, Beatrice, primary, Tamburrini, Enrica, primary, Savasi, Valeria, primary, Sansone, Matilde, primary, Spinillo, Arsenio, primary, Liuzzi, Giuseppina, primary, Degli Antoni, Anna, primary, Dalzero, Serena, primary, Franceschetti, Laura, primary, Simonazzi, Giuliana, primary, Maso, Gianpaolo, primary, Francisci, Daniela, primary, Pinnetti, Carmela, primary, and Ravizza, Marina, primary

Published
2019
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70. Valacyclovir for prevention and treatment of fetal CMV infection: inclusion in the Law 648/96 list and launch of the Italian multicentre observational prospective study "MEGAL-ITALI".

Author

Zammarchi, Lorenzo, Lazzarotto, Tiziana, Di Tommaso, Mariarosaria, Tomasoni, Lina, Pasquini, Lucia, Galli, Luisa, Simonazzi, Giuliana, Castelli, Francesco, Borchi, Beatrice, Campolmi, Irene, Ornaghi, Sara, Bartoloni, Alessandro, Andreoni, Massimo, Pagano, Immacolata, Petraglia, Sandra, Ramenghi, Luca, Clerici, Pierangelo, Tavio, Marcello, and Trotta, Michele

Published
2021

71. Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection

Author

Gabrielli, Liliana, primary, Bonasoni, Maria Paola, additional, Foschini, Maria Pia, additional, Silini, Enrico Maria, additional, Spinillo, Arsenio, additional, Revello, Maria Grazia, additional, Chiereghin, Angela, additional, Piccirilli, Giulia, additional, Petrisli, Evangelia, additional, Turello, Gabriele, additional, Simonazzi, Giuliana, additional, Gibertoni, Dino, additional, and Lazzarotto, Tiziana, additional

Published
2018
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72. Emilia-Romagna Study on Pregnancy and Exposure to Antiepileptic drugs (ESPEA): a population-based study on prescription patterns, pregnancy outcomes and fetal health

Author

Mostacci, Barbara, primary, Bisulli, Francesca, additional, Poluzzi, Elisabetta, additional, Cocchi, Guido, additional, Piccinni, Carlo, additional, Curti, Alessandra, additional, Simonazzi, Giuliana, additional, Astolfi, Gianni, additional, Rizzo, Nicola, additional, Zenesini, Corrado, additional, D’Alessandro, Roberto, additional, and Tinuper, Paolo, additional

Published
2018
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73. Infezione primaria da Citomegalovirus in gravidanza: fattori prognostici di malattia sintomatica determinabili entro la ventiduesima settimana di gestazione

Author

Simonazzi, Giuliana, Cervi, Francesca <1983>, Simonazzi, Giuliana, and Cervi, Francesca <1983>

Abstract

Background. L’infezione primaria da Citomegalovirus (CMV) in gravidanza può portare a infezione congenita in circa il 30% dei casi, di cui 15-20% possono sviluppare sintomi a lungo termine inclusi deficit uditivi e sequele neurologiche. Gravi anomalie cerebrali nello studio ecografico prenatale sono associate a peggiore prognosi, ma è più difficile stabilire gli esiti post-natali nei feti con anomalie ecografiche non gravi. Obiettivi. Valutazione del potere predittivo di malattia sintomatica delle anomalie ecografiche non gravi, in associazione all’amniocentesi, determinabili entro la ventiduesima settimana di gestazione. Metodi. Studio prospettico osservazionale di donne con infezione primaria in gravidanza tra il 2007 e 2015: le pazienti sono state sottoposte a studio ecografico e neurosografico della morfologia fetale ed isolamento virale su liquido amniotico tra 20 e 21 settimane di gestazione, ad almeno 6 settimane dal presunto contagio materno. I segni e i sintomi di malattia congenita sono stati valutati alla nascita e al follow up nei nati vivi e attraverso l’esame autoptico nei casi di interruzione di gravidanza. Risultati. Lo studio ecografico prenatale di 306 gravidanze complicate da infezione primaria da CMV ha rilevato la presenza di anomalie cerebrali lievi e/o extracerebrali in 15 casi (4.9%). Tali reperti si sono dimostrati significativamente associati alla presenza di malattia sintomatica post-natale (OR= 18.5; 95% CI: 5.43-62.8, P<0.001), con alta specificità (97.6%) e valore predittivo negativo (95.6%) La contemporanea presenza di anomalie ecografiche e isolamento di DNA virale su liquido amniotico ha mostrato specificità e valore predittivo negativo pari a 99.7% e 95.7%, mentre la presenza di uno solo dei due reperti ha raggiunto una sensibilità di 94.7% e valore predittivo negativo di 99.6%. Conclusioni. La valutazione del rischio di malattia sintomatica può essere realizzata prima della ventiduesima settimana con buona sensibilità e specificità, Background. Primary maternal Cytomegalovirus (CMV) infection during pregnancy can lead to congenital infection in around 30% of newborns, with 15-20% of infected children developing long-term symptoms including hearing loss and neurological sequelae. Severe brain ultrasound anomalies are associated with poor prognosis, but post-natal outcomes of fetuses with mild ultrasound anomalies are difficult to establish. Objective. The aim of the study was to evaluate the predictive value of mild ultrasound anomalies and viral load in amniotic fluid, performed before twenty-second week of gestation, in relation to the presence of symptomatic congenital disease. Methods. This is a prospective observational study of pregnant women with primary CMV infection enrolled between 2007 and 2015: fetal ultrasound scan with detailed neurosonogram and viral isolation in amniotic fluid were performed in all pregnancies between 20 and 21 weeks of gestation, at least 6 weeks after maternal infection. Sign and symptoms of congenital infection were evaluated at birth and at neonatal follow up in live-borns, post-mortem examinations were carried out in second trimester aborted fetuses. Results. Ultrasound fetal scan of 306 pregnant women with primary CMV infection detected the presence of mild cerebral and extracerebral anomalies in 15 cases (4.9%). These features was significantly associated with symptomatic congenital disease (OR= 18.5; 95%CI: 5.43-62.8, P<0.001) with high specificity (97.6%) and high negative predictive value (95.6%). The combined specificity and negative predictive value of ultrasound and viral isolation in amniotic fluid were 99.7% and 95.7%, respectively. The presence of one of this features alone reached sensibility of 94.7% and negative predictive value of 99.6%. Conclusion. The evaluation of neonatal risk of symptomatic CMV congenital disease can be realized with a good sensibility and specificity through the combination of detailed ultrasound fetal scan and viral iso

Published
2018

74. 122: Timing of delivery of uncomplicated monochorionic monoamniotic twins

Author

Saccone, Gabriele, primary, Martinelli, Pasquale, additional, Maruotti, Giuseppe, additional, Schoen, Corina, additional, Berghella, Vincenzo, additional, Lanna, Mariano, additional, Fiola, Stefano, additional, Fichera, Anna, additional, Prefumo, Federico, additional, Rizzo, Giuseppe, additional, Simonazzi, Giuliana, additional, Seravalli, Viola, additional, Miller, Jena, additional, Bashat, Ahmet, additional, Magro-Malosso, Elena Rita, additional, Di Tommaso, Mariarosaria, additional, Visentin, Silvia, additional, Di Mascio, Daniele, additional, Suhag, Anju, additional, Gambacorti-Passerini, Zita Maria, additional, Napolitano, Raffaele, additional, Dall'Asta, Andrea, additional, Frusca, Tiziana, additional, and Ghi, Tullio, additional

Published
2018
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75. Restoring In Vivo-Like Membrane Lipidomics Promotes Exosome Trophic Behavior from Human Placental Mesenchymal Stromal/Stem Cells

Author

Cavallini, Claudia, primary, Zannini, Chiara, additional, Olivi, Elena, additional, Tassinari, Riccardo, additional, Taglioli, Valentina, additional, Rossi, Martina, additional, Poggi, Paola, additional, Chatgilialoglu, Alexandros, additional, Simonazzi, Giuliana, additional, Alviano, Francesco, additional, Bonsi, Laura, additional, and Ventura, Carlo, additional

Published
2018
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76. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

M. Floridia, M. F. Pirillo, A. Degli Antoni, A. Molinari, E. Tamburrini, C. Pinnetti, G. Guaraldi, G. Nardini, G. Masuelli, S. Dalzero, I. Cetin, M. Sansone, R. Amici, M. Ravizza, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy: [. . ., F. Mori, P. Ortolani, E. R. dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, B. Del Pin, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V. S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, M. Zaramella, B. Mariani, G. Natalini Raponi, C. Stentarelli, B. Beghetto, A. M. Degli Antoni, M. P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, S. Coletto, F. Di Nello, C. Madia, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, L. Bernini, P. Grossi, L. Rizzi, S. Alberico, G. Maso, M. Airoud, G. Soppelsa, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Bordoni Vicini, K. Luzi, A. Spinillo, M. Roccio, A. Vimercati, A. Miccolis, A. De Gennaro, GUERRA, BRUNELLA, F. Cervi, SIMONAZZI, GIULIANA, E. Margarito, M. G. Capretti, C. Marsico, FALDELLA, GIACOMO, P. Martinelli, A. Agangi, A. Capone, G. M. Maruotti, C. Tibaldi, L. Trentini, T. Todros, V. Frisina, T. Brambilla, V. Savasi, C. Personeni, C. Giaquinto, M. Fiscon, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, O. Genovese, C. Cafforio, G. Liuzzi, V. Tozzi, P. Massetti, A. M. Casadei, A. F. Cavaliere, M. Cellini, G. Castelli Gattinara, A. M. Marconi, V. Sacchi, M. Ierardi, C. Polizzi, A. Mattei, C. M. Galluzzo, S. Donnini, S. Baroncelli, P. Villani, M. Cusato, A. Cerioli, M. De Martino, P. Mastroiacovo, F. Parazzini, S. Vella, M. Floridia, M.F. Pirillo, A. Degli Antoni, A. Molinari, E. Tamburrini, C. Pinnetti, G. Guaraldi, G.Nardini, G.Masuelli, S. Dalzero, I. Cetin, M. Sansone, R. Amici, M. Ravizza, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy: [.., F. Mori, P. Ortolani, E. R. dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, B. Del Pin, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V. S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, M. Zaramella, B. Mariani, G. Natalini Raponi, G. Nardini, C. Stentarelli, B. Beghetto, A. M. Degli Antoni, M. P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, S. Coletto, F. Di Nello, C. Madia, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, L. Bernini, P. Grossi, L. Rizzi, S. Alberico, G. Maso, M. Airoud, G. Soppelsa, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Bordoni Vicini, K. Luzi, A. Spinillo, M. Roccio, A. Vimercati, A. Miccoli, A. De Gennaro, B. Guerra, F. Cervi, G. Simonazzi, E. Margarito, M. G. Capretti, C. Marsico, G. Faldella, P. Martinelli, A. Agangi, A. Capone, G. M. Maruotti, C. Tibaldi, L. Trentini, T. Todro, G. Masuelli, V. Frisina, T. Brambilla, V. Savasi, C. Personeni, C. Giaquinto, M. Fiscon, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, O. Genovese, C. Cafforio, G. Liuzzi, V. Tozzi, P. Massetti, A. M. Casadei, A. F. Cavaliere, M. Cellini, G. Castelli Gattinara, A. M. Marconi, V. Sacchi, M. Ierardi, C. Polizzi, A. Mattei, M. F. Pirillo, C. M. Galluzzo, S. Donnini, S. Baroncelli, P. Villani, M. Cusato, A. Cerioli, M. De Martino, P. Mastroiacovo, F. Parazzini, S. Vella, and ]

Subjects
0301 basic medicine, Cytomegalovirus Infection, pregnancy outcomes, Cytomegalovirus, HIV Infections, Cytomegalovirus Infections, Female, Humans, Italy, Population Surveillance, Pregnancy, Pregnancy Outcome, Prevalence, Coinfection, Pregnancy Complications, Infectious, Viremia, Microbiology (medical), Infectious Diseases, 0302 clinical medicine, Hiv infected, HIV Infection, 030212 general & internal medicine, CMV, CMV-DNA, Infectious, General Medicine, pregnancy, Cytomegalovirus infections, preterm delivery, Human, 030106 microbiology, Congenital cytomegalovirus infection, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, medicine, Pregnancy outcomes, Preterm delivery, business.industry, HIV, Cytomegaloviru, medicine.disease, Virology, Pregnancy Complications, Pregnancy Complications, Infectiou, business
Published
2016

79. Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol.

Author

Tibaldi, Cecilia, Masuelli, Giulia, Sansone, Matilde, Tassis, Beatrice, Cetin, Irene, Franceschetti, Laura, Spinillo, Arsenio, Simonazzi, Giuliana, Vimercati, Antonella, Dalzero, Serena, Meloni, Alessandra, Bernardon, Maria, Frisina, Valentina, Polizzi, Cosimo, Todros, Tullia, Martinelli, Pasquale, Floridia, Marco, Ravizza, Marina, for SIGO-HIV Study Group, and Tibaldi, C.

Subjects
DIAGNOSIS of HIV infections, HIV infection transmission, ANTIRETROVIRAL agents, BIRTH weight, CESAREAN section, CHILD health services, INFECTIOUS disease transmission, DELIVERY (Obstetrics), HIV infections, HIV-positive persons, EVALUATION of medical care, MEDICAL protocols, PARENT-infant relationships, PATIENT safety, PUBLIC health surveillance, VAGINA, WOMEN'S health, VIRAL load, PREGNANCY
Abstract

Purpose: To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. Methods: Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). Results: Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p < 0.001). Women who delivered vaginally were younger, more commonly nulliparous, diagnosed with HIV during current pregnancy, and antiretroviral-naïve, but had a slightly longer duration of pregnancy, with significantly higher birthweight of newborns. NECS was associated with adverse pregnancy outcomes. The rate of HIV transmission was minimal (0.4%). There were no differences between vaginal and ECS about delivery complications, while NECS was more commonly associated with complications compared to ECS. Conclusions: Vaginal delivery in HIV-infected women with suppressed viral load appears to be safe for mother and children. No cases of HIV transmission were observed. Despite an ongoing significant increase, the rate of vaginal delivery remains relatively low compared to other countries, and further progress is needed to promote this mode of delivery in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2019
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80. Antiphospholipid antibody profile based obstetric outcomes of primary antiphospholipid syndrome: The PREGNANTS study

Author

Epi Methoden Team 4, Saccone, Gabriele, Berghella, Vincenzo, Maruotti, Giuseppe Maria, Ghi, Tullio, Rizzo, Giuseppe, Simonazzi, Giuliana, Rizzo, Nicola, Facchinetti, Fabio, Dall'Asta, Andrea, Visentin, Silvia, Sarno, Laura, Xodo, Serena, Bernabini, Dalila, Monari, Francesca, Roman, Amanda, Eke, Ahizechukwu Chigoziem, Hoxha, Ariela, Ruffatti, Amelia, Schuit, Ewoud, Martinelli, Pasquale, PREGNANTS (PREGNancy in women with ANTiphospholipid Syndrome) working group, Epi Methoden Team 4, Saccone, Gabriele, Berghella, Vincenzo, Maruotti, Giuseppe Maria, Ghi, Tullio, Rizzo, Giuseppe, Simonazzi, Giuliana, Rizzo, Nicola, Facchinetti, Fabio, Dall'Asta, Andrea, Visentin, Silvia, Sarno, Laura, Xodo, Serena, Bernabini, Dalila, Monari, Francesca, Roman, Amanda, Eke, Ahizechukwu Chigoziem, Hoxha, Ariela, Ruffatti, Amelia, Schuit, Ewoud, Martinelli, Pasquale, and PREGNANTS (PREGNancy in women with ANTiphospholipid Syndrome) working group

Published
2017

81. HBV coinfection is associated with reduced CD4 response to antiretroviral treatment in pregnancy

Author

Floridia, Marco, Masuelli, Giulia, Tamburrini, Enrica, Spinillo, Arsenio, Simonazzi, Giuliana, Guaraldi, Giovanni, Degli Antoni, Anna Maria, Martinelli, Pasquale, Portelli, Vincenzo, Dalzero, Serena, Ravizza, Marina, Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Floridia, Marco, Masuelli, Giulia, Tamburrini, Enrica, Spinillo, Arsenio, Simonazzi, Giuliana, Guaraldi, Giovanni, Degli Antoni, Anna Maria, Martinelli, Pasquale, Portelli, Vincenzo, Dalzero, Serena, Ravizza, Marina, and Tamburrini, Enrica (ORCID:0000-0003-4930-426X)

Abstract

Objective: To evaluate the impact of Hepatitis B virus (HBV) coinfection on response to antiretroviral treatment in pregnant women with HIV. Methods: Retrospective analysis of a large case series of pregnant women with HIV in Italy; outcome measures were CD4 changes, HIV viral load, and main pregnancy outcomes (preterm delivery, low birthweight, intrauterine growth restriction, mode of delivery, and major birth defects). Results: Rate of HBV coinfection among 1462 pregnancies was 12.0%. Compared to the HBV-uninfected, HBV-coinfected women had a significantly lower median CD4 cell gain between first and third trimester (26.5 vs. 60 cells/mm3, p = 0.034), with similar rate of undetectable (<50 copies/ml) HIV-RNA at third trimester (70.5% vs. 65.2%, p = 0.229), and no differences in all the main maternal and infant outcomes. A multivariable linear regression analysis identified four variables significantly and independently associated with a lower CD4 response in pregnancy: HBV coinfection (–35 cells/mm3), being on antiretroviral treatment at conception (–59.7 cells/mm3), AIDS status (–59.8 cells/mm3) and higher first CD4 levels in pregnancy (–0.24 cells per unitary CD4 increase). Conclusions: HBV coinfection had no adverse influence on the main pregnancy outcomes or on HIV viral load suppression in late pregnancy but was associated with a significantly reduced CD4 response in pregnancy. This effect might have clinical relevance, particularly in women with advanced immune deterioration.

Published
2017

82. HBV coinfection is associated with reduced CD4 response to antiretroviral treatment in pregnancy

Author

Floridia, Marco, primary, Masuelli, Giulia, additional, Tamburrini, Enrica, additional, Spinillo, Arsenio, additional, Simonazzi, Giuliana, additional, Guaraldi, Giovanni, additional, Degli Antoni, Anna Maria, additional, Martinelli, Pasquale, additional, Portelli, Vincenzo, additional, Dalzero, Serena, additional, and Ravizza, Marina, additional

Published
2017
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88. Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection.

Author

Gabrielli, Liliana, Bonasoni, Maria Paola, Foschini, Maria Pia, Silini, Enrico Maria, Spinillo, Arsenio, Revello, Maria Grazia, Chiereghin, Angela, Piccirilli, Giulia, Petrisli, Evangelia, Turello, Gabriele, Simonazzi, Giuliana, Gibertoni, Dino, Lazzarotto, Tiziana, Bonasoni, Maria Paola, Foschini, Maria Pia, Silini, Enrico Maria, and Revello, Maria Grazia

Subjects
CYTOMEGALOVIRUS disease prevention, GLOBULINS, PLACENTA, HISTOLOGY, IMMUNOHISTOCHEMISTRY
Abstract

Background: The Congenital Human Cytomegalovirus Infection Prevention (CHIP) study, a randomized, blinded, placebo-controlled trial, demonstrated that the efficacy of hyperimmune globulin (HIG) was not different from that of placebo regarding transmission of cytomegalovirus (CMV) from mothers to newborns. Our aim was to analyze histologically HIG effects on placentas collected for the CHIP study.Materials and Methods: Virological and histological analyses were performed on 40 placentas from transmitter and nontransmitter HIG-treated and untreated mothers by assessing the number of CMV-positive cells, tissue viral load, tissue damage, and compensatory mechanisms.Results: The HIG and placebo groups showed no significant differences in the number of CMV-positive cells (median number in 10 fields at 10 high-power fields: 2.5 vs. 2, p = 0.969) and viral load (median load: 5 copies/5 ng vs. 10.5 copies/5 ng, p = 0.874). Regarding histological examination, the scores of parameters related to tissue damage and hypoxic parenchymal compensation were higher in transmitters except for chorangiosis, with statistically significant differences observed for chronic villitis (p = 0.007), calcification (p = 0.011), and the total score of tissue damage (p < 0.001). The HIG and placebo groups showed no significant differences for all tissue damage and compensation parameters and overall scores.Discussion: HIGs are not able to reduce placental viral load and histological damage, which was significantly associated only with infection. [ABSTRACT FROM AUTHOR]

Published
2019
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89. Real-Time Volume Contrast Imaging in the A Plane with a Four-Dimensional Electronic Probe Facilitates the Evaluation of Fetal Extremities in Midtrimester Sonograms.

Author

Bellussi, Federica, Simonazzi, Giuliana, Salsi, Ginevra, Guasina, Francesca, and Pilu, Gianluigi

Subjects
*RANDOMIZED controlled trials, *SPECTROGRAMS, *ELECTRONIC probes, *DIAGNOSTIC ultrasonic imaging, *RADIOLOGISTS
Abstract

Objective: To evaluate the efficiency of real-time volume contrast imaging in the A plane (VCI-A) of fetal extremities, compared with conventional two-dimensional ultrasound (2D).Methods: This was a randomized controlled trial of 100 patients undergoing midtrimester sonography. The fetal limbs were imaged with either 2D or VCI-A with a four-dimensional (4D) electronic probe. Time required for the examination, number of images stored, and quality of the documentation were compared. During the study, 6 fetuses with abnormal extremities were scanned with both 2D and VCI-A, and the diagnostic accuracy and quality of the images were also compared.Results: In the VCI-A group, the fetal extremities were imaged more rapidly (2.3 ± 1.1 vs. 3.3 ± 0.9 min, p < 0.0001), less images were required to document the examination (5.6 ± 1.4 vs. 7.3 ± 1.6), and an optimal documentation was more frequently obtained (84 vs. 54%, p < 0.0001) compared with the 2D group. In malformed fetuses, a precise diagnosis was achieved with both techniques, although images obtained with VCI-A were found to be of superior quality.Conclusions: Real-time VCI-A with a 4D electronic probe is an effective tool for imaging the fetal extremities in midtrimester examinations and carries some advantages over conventional 2D sonography. [ABSTRACT FROM AUTHOR]

Published
2018
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90. Congenital Human Cytomegalovirus Infection: Identification Of New Prognostic Markers Of Brain Damage In Infected Fetuses

Author

L. Gabrielli, M. P. Bonasoni, G. Tani, T. D’atena, F. Carfagnini, G. Piccirilli, F. Bellini, M. G. Capretti, GUERRA, BRUNELLA, SANTINI, DONATELLA, PUCCETTI, CHIARA, SIMONAZZI, GIULIANA, MURANO, PAOLA, CHIEREGHIN, ANGELA, PETRISLI, EVANGELIA, LAZZAROTTO, TIZIANA, L.Gabrielli, B.Guerra, M.P.Bonasoni, G.Tani, T.D’atena, F.Carfagnini, D.Santini, C.Puccetti, G.Simonazzi, P.Murano, A.Chiereghin, G.Piccirilli, E.Petrisli, F.Bellini, M.G.Capretti, and T.Lazzarotto.

Subjects
PRENATAL DIAGNOSIS, fetal cerebral magnetic resonance, histological examination, HCMV
Abstract

Background. Human cytomegalovirus (HCMV) is a major cause of congenital infection as well as sensorineural hearing loss and neurodevelopmental delay. Prenatal diagnosis is based mainly on the detection of HCMV infection in amniotic fluid and on ultrasound (US) examination. The major limitation of these techniques is that US identifies prenatally only up to 15-20% of infected babies and positive results of amniotic fluids tests do not discriminate between the infants who will have symptoms at birth and those who will not. Objectives. The aims of this study are to evaluate the usefulness of fetal cerebral magnetic resonance (MR) and biological parameters in fetal blood when a high HCMV load is detected in amniotic fluid. The results of MR and fetal blood testing were correlated with the fetal histological examination or neonatal outcome. Methods. We enrolled 17 women at 20-21 weeks gestation with documented intrauterine transmission of HCMV (amniotic fluid with a viral load more than 10^5 copies/ml) with or without abnormal ultrasound findings. All pregnant women performed cerebral MR at 21 weeks gestation. Twelve women elected to terminate the pregnancy and fetal blood was collected from the umbilical cord. Immunological, haematological, biochemical and virological examinations were performed in fetal blood. HCMV antigen expression and inflammatory response were studied in all fetal tissues including inner ears using immunohistochemical staining procedures. Five pregnancies continued up to term and fetal MR was repeated at 32 weeks of gestation. Results. We found no evidence of brain HCMV infection by immunohistochemistry in 4 out of 12 foetuses and US and MR brain imaging were both normal in these cases. Eight fetal brains were HCMV positive and a brain histological damage was observed. Among these, 4 HCMV positive inner ears were observed. Viral infection always involved the stria vascularis, the most vascularised area of the cochlea, and less the Reissner's membrane, the Organ of Corti and the vestibular apparatus. Considering the 8 fetuses with histological brain damage, US was pathological in 4 cases (50%) and MR imaging only in 3 (38%). The most prevalent finding were periventricular hyperechogenicity (US) and microcephaly (MR). In fetal blood only platelet count and the % of natural killer cells were associated significantly .

Published
2012

91. Parvovirus B19 in pregnancy: possible consequences of vertical transmission

Author

PUCCETTI, CHIARA, BONVICINI, FRANCESCA, CERVI, FRANCESCA, SIMONAZZI, GIULIANA, GALLINELLA, GIORGIO, MURANO, PAOLA, FARINA, ANTONIO, GUERRA, BRUNELLA, ZERBINI, MARIALUISA, RIZZO, NICOLA, Contoli M, Puccetti C, Contoli M, Bonvicini F, Cervi F, Simonazzi G, Gallinella G, Murano P, Farina A, Guerra B, Zerbini M, and Rizzo N.

Subjects
Adult, parvovirus B19, Infant, Newborn, Pregnancy Outcome, Gestational Age, Infant, Newborn, Diseases, Infectious Disease Transmission, Vertical, Parvoviridae Infections, Fetal Diseases, Young Adult, Pregnancy, immunoglobulin M, Parvovirus B19, Human, Humans, Female, Pregnancy Complications, Infectious, Retrospective Studies
Abstract

Objective: The aim was to determine the outcome of pregnancies complicated by maternal Parvovirus B19 (B19) infection. Method: Among 175 pregnant women referred to our clinic because of suspicion of a B19 infection, 63 with confirmed laboratory diagnosis of acute/recent B19 infection were followed up by ultrasound and Doppler measurement of the middle cerebral artery peak systolic velocity. Results: The vertical transmission rate was 31.7% (20/63). Of the 20 infected, 8 had hydrops, 1 had signs suggestive of meconium peritonitis and 1 had an isolated hydrothorax. Three fetuses presenting with hydrops were treated with intrauterine blood transfusion. Two of them died while the last showed resolution of anemia. Among the five untreated hydropic fetuses, one presented with mild signs that resolved spontaneously, two died at 16 and 17 weeks of gestation and two had also cardiomegaly and the parents opted for elective termination of pregnancy. All the anemic fetuses had middle cerebral artery peak systolic velocity values more than 1.8 multiples of the median. No stillbirth occurred. Conclusions: The outcome of uncomplicated cases with B19 infection is good. In the presence of hydrops prognosis was very poor. It seems therefore logical to attempt to pick up this ominous signs early. © 2012 John Wiley & Sons, Ltd.

Published
2011

93. Parvovirus B19-derived fetal complications following gestational infection

Author

BONVICINI, FRANCESCA, GALLINELLA, GIORGIO, GENTILOMI, GIOVANNA ANGELA, MANARESI, ELISABETTA, DI FURIO, FRANCESCA, GUERRA, BRUNELLA, SIMONAZZI, GIULIANA, PUCCETTI, CHIARA, MUSIANI, MONICA, ZERBINI, MARIALUISA, M. Contoli, F.Bonvicini, G.Gallinella, G.A.Gentilomi, E.Manaresi, F.Di Furio, B.Guerra, G.Simonazzi, C.Puccetti, M.Contoli, M.Musiani, and M.Zerbini.

Subjects
B19 fetal infection
Published
2011

94. Comparative evaluation of an automated assay for parvovirus B19 antibody detection

Author

BONVICINI, FRANCESCA, GALLINELLA, GIORGIO, GENTILOMI, GIOVANNA ANGELA, MANARESI, ELISABETTA, DI FURIO, FRANCESCA, MUSIANI, MONICA, ZERBINI, MARIALUISA, B. Guerra, SIMONAZZI, GIULIANA, C. Puccetti, M. Contoli, F.Bonvicini, G.Gallinella, G.A.Gentilomi, E.Manaresi, F.Di Furio, B.Guerra, G.Simonazzi, C.Puccetti, M.Contoli, M.Musiani, and M.Zerbini.

Subjects
B19 antibody detection
Published
2011

95. Study of Soluble HLA-G in Congenital Human Cytomegalovirus Infection

Author

Rizzo, Roberta, primary, Gabrielli, Liliana, additional, Bortolotti, Daria, additional, Gentili, Valentina, additional, Piccirilli, Giulia, additional, Chiereghin, Angela, additional, Pavia, Claudia, additional, Bolzani, Silvia, additional, Guerra, Brunella, additional, Simonazzi, Giuliana, additional, Cervi, Francesca, additional, Capretti, Maria Grazia, additional, Fainardi, Enrico, additional, Luca, Dario Di, additional, Landini, Maria Paola, additional, and Lazzarotto, Tiziana, additional

Published
2016
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97. Infezione da Parvovirus B19 nella donna in gravidanza, nel feto e nel neonato

Author

BONVICINI, FRANCESCA, GALLINELLA, GIORGIO, MANARESI, ELISABETTA, DI FURIO, FRANCESCA, GUERRA, BRUNELLA, SIMONAZZI, GIULIANA, PUCCETTI, CHIARA, MUSIANI, MONICA, ZERBINI, MARIALUISA, GENTILOMI, GIOVANNA ANGELA, Bonvicini F., Gallinella G., Gentilomi G.A., Manaresi E, Di Furio F., Guerra B., Simonazzi G., Puccetti C., Musiani M., and Zerbini M.

Published
2010

98. Parvovirus B19 infection during pregnancy and evaluation of fetal outcomes

Author

BONVICINI, FRANCESCA, GALLINELLA, GIORGIO, GUERRA, BRUNELLA, SIMONAZZI, GIULIANA, PUCCETTI, CHIARA, MUSIANI, MONICA, ZERBINI, MARIALUISA, GENTILOMI, GIOVANNA ANGELA, Bonvicini F., Gallinella G., Gentilomi G.A., Guerra B., Simonazzi G., Puccetti C., Musiani M., and Zerbini M.

Published
2010

99. Preeclampsia

Author

A. Curti, SIMONAZZI, GIULIANA, RIZZO, NICOLA, A. Curti, G. Simonazzi, and N. Rizzo

Subjects
LABORATORY TESTS, PREECLAMPSIA, PREGNANCY, HELLP SYNDROME
Abstract

Hypertensive disorders complicate approximately 10- 20% of pregnancies and cover a spectrum of diffe- rent clinical pictures with varying impact on the health of mother and fetus. Among these pre-eclampsia (PE) represents the most severe form, being alone respon- sible for 15-20% of cases of maternal mortality and a major cause of perinatal mortality and morbi- dity. The clinical significance of hypertensive disorders in pregnancy is also linked to the possibility of serious maternal complications represented by HELLP syn- drome (characterized by hemolysis, elevated liver fun- ction and low platelet count), eclampsia and dissemi- nated intravascular coagulation (DIC). Laboratory monitoring of indices (blood count, pla- telet count, liver function, renal function, uric acid, LDH, proteinuria, etc.), associated with the evaluation of the patient’s clinical condition, is the only tool available to the clinical diagnosis and subsequent management of various conditions, with particular reference to the ti- ming of childbirth, the only real treatment of PE. Key-words: pregnancy, gestosis, preeclamsia, laboratory findings, HELLP syndrome.

Published
2010

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