25 results on '"Bracalente G."'
Search Results
2. EP09.04: Obliterated cavum septi pellucidi: clinical significance and role of fetal magnetic resonance
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Fantasia, I., primary, Bracalente, G., additional, Ciardo, C., additional, Filippi, E., additional, Murru, F., additional, Quintero, O. Mendez, additional, Montaguti, E., additional, Lees, C., additional, Papanikolaou, K., additional, Pilu, G., additional, Prefumo, F., additional, Thilaganathan, B., additional, and Stampalija, T., additional
- Published
- 2022
- Full Text
- View/download PDF
3. Role of prenatal magnetic resonance imaging in fetuses with isolated anomalies of corpus callosum: multinational study
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Sileo F. G., Pilu G., Prayer D., Rizzo G., Khalil A., Managanaro L., Volpe P., Van Mieghem T., Bertucci E., Morales Rosello J., Facchinetti F., Di Mascio D., Stampalija T., Buca D., Tinari S., Oronzi L., Ercolani G., D'Amico A., Matarrelli B., Cerra C., Fantasia I., Pasquini L., Masini G., Olivieri C., Ghi T., Frusca T., Dall'Asta A., Visentin S., Cosmi E., D'Errico I., Villalain C., Quintero O. M., Giancotti A., D'Ambrosio V., Antonelli A., Caulo M., Panar V., De Santis M., Mappa I., Prefumo F., Pinelli L., Loscalzo G., Bracalente G., Liberati M., Filippi E., Trincia E., Pateisky P., Kiss H., Curado J., Almeida M., Santos A., Galindo A., D'Antonio F., Sileo F.G., Pilu G., Prayer D., Rizzo G., Khalil A., Managanaro L., Volpe P., Van Mieghem T., Bertucci E., Morales Rosello J., Facchinetti F., Di Mascio D., Stampalija T., Buca D., Tinari S., Oronzi L., Ercolani G., D'Amico A., Matarrelli B., Cerra C., Fantasia I., Pasquini L., Masini G., Olivieri C., Ghi T., Frusca T., Dall'Asta A., Visentin S., Cosmi E., D'Errico I., Villalain C., Quintero O.M., Giancotti A., D'Ambrosio V., Antonelli A., Caulo M., Panar V., De Santis M., Mappa I., Prefumo F., Pinelli L., Loscalzo G., Bracalente G., Liberati M., Filippi E., Trincia E., Pateisky P., Kiss H., Curado J., Almeida M., Santos A., Galindo A., D'Antonio F., Sileo, Fg, Pilu, G, Prayer, D, Rizzo, G, Khalil, A, Managanaro, L, Volpe, P, Van Mieghem, T, Bertucci, E, Rosello, Jm, Facchinetti, F, Di Mascio, D, Stampalija, T, Buca, D, Tinari, S, Oronzi, L, Ercolani, G, D'Amico, A, Matarrelli, B, Cerra, C, Fantasia, I, Pasquini, L, Masini, G, Olivieri, C, Ghi, T, Frusca, T, Dall'Asta, A, Visentin, S, Cosmi, E, D'Errico, I, Villalain, C, Quintero, Om, Giancotti, A, D'Ambrosio, V, Antonelli, A, Caulo, M, Panara, V, De Santis, M, Mappa, I, Prefumo, F, Pinelli, L, Loscalzo, G, Bracalente, G, Liberati, M, Filippi, E, Trincia, E, Pateisky, P, Kiss, H, Curado, J, Almeida, M, Santos, A, Galindo, A, and D'Antonio, F
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Fetal magnetic resonance imaging ,Adult ,Prenatal Diagnosi ,medicine.medical_specialty ,Logistic Model ,Prenatal diagnosis ,Gestational Age ,Nervous System Malformations ,Corpus callosum ,Ultrasonography, Prenatal ,Corpus Callosum ,corpus callosum ,Nervous System Malformation ,Fetus ,Pregnancy ,Retrospective Studie ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Fetu ,fetal magnetic resonance imaging ,Agenesis of the corpus callosum ,Retrospective Studies ,prenatal diagnosis ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,MRI ,central nervous system ,fetal ultrasound ,neurosonography ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Logistic Models ,Reproductive Medicine ,Settore MED/40 ,Female ,Radiology ,Agenesis of Corpus Callosum ,business ,Fetal medicine ,Human - Abstract
Objective To assess the performance of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses diagnosed with isolated corpus callosal (CC) anomaly on multiplanar ultrasound evaluation of the fetal brain (neurosonography). Methods This was a multicenter, retrospective cohort study involving 14 fetal medicine centers in Italy, UK, Portugal, Canada, Austria and Spain. Inclusion criteria were fetuses with an apparently isolated CC anomaly, defined as an anomaly of the CC and no other additional central nervous system (CNS) or extra-CNS abnormality detected on expert ultrasound, including multiplanar neurosonography; normal karyotype; maternal age >= 18 years; and gestational age at diagnosis >= 18 weeks. The primary outcome was the rate of additional CNS abnormalities detected exclusively on fetal MRI within 2 weeks following neurosonography. The secondary outcomes were the rate of additional abnormalities according to the type of CC abnormality (complete (cACC) or partial (pACC) agenesis of the CC) and the rate of additional anomalies detected only on postnatal imaging or at postmortem examination. Results A total of 269 fetuses with a sonographic prenatal diagnosis of apparently isolated CC anomalies (207 with cACC and 62 with pACC) were included in the analysis. Additional structural anomalies of the CNS were detected exclusively on prenatal MRI in 11.2% (30/269) of cases, with malformations of cortical development representing the most common type of anomaly. When stratifying the analysis according to the type of CC anomaly, the rate of associated anomalies detected exclusively on MRI was 11.6% (24/207) in cACC cases and 9.7% (6/62) in pACC cases. On multivariate logistic regression analysis, only maternal body mass index was associated independently with the likelihood of detecting associated anomalies on MRI (odds ratio, 1.07 (95% CI, 1.01-1.14); P = 0.03). Associated anomalies were detected exclusively after delivery and were missed on both types of prenatal imaging in 3.9% (8/205) of fetuses with prenatal diagnosis of isolated anomaly of the CC. Conclusion In fetuses with isolated anomaly of the CC diagnosed on antenatal neurosonography, MRI can identify a small proportion of additional anomalies, mainly malformations of cortical development, which are not detected on ultrasound. (c) 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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- 2021
4. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: international multicenter study
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Di Mascio, D, Khalil, A, Thilaganathan, B, Rizzo, G, Buca, D, Liberati, M, Celentano, C, Melchiorre, K, Caulo, M, Pilu, G, Salsi, G, Toni, F, Stampalija, T, Fantasia, I, Luise, G, Gregori, M, Volpe, P, Olivieri, C, Giancotti, A, D'Ambrosio, V, Brunelli, R, Panici, PB, Manganaro, L, Antonelli, A, Ercolani, G, Pasquini, L, Masini, G, Di Maurizio, M, Lees, C, Bracalente, G, Morales-Rosello, J, Loscalzo, G, Saccone, G, Carbone, L, Sarno, L, Maruotti, GM, Zullo, F, Ghi, T, Frusca, T, Dall'Asta, A, Volpe, N, Ormitti, F, Buongiorno, S, De Santis, M, D'Oria, L, Lanzone, A, Prefumo, F, Pinelli, L, Bertucci, E, Sileo, FG, Flacco, ME, Manzoli, L, Giangiordano, I, Mastricci, L, Meccariello, G, Vasciaveo, L, Nappi, L, Familiari, A, Scambia, G, Berghella, V, D'Antonio, F, and ENSO Working Grp
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prenatal diagnosis ,fetal ultrasound ,fetal magnetic resonance imaging ,central nervous system ,ventriculomegaly ,MRI ,neurosonography - Abstract
Objectives To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain. Methods This was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0-11.9 mm) or moderate (ventricular atrial diameter, 12.0-14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra-CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anomalies detected exclusively on prenatal MRI and missed on ultrasound, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed on prenatal imaging (ultrasound and MRI). Subgroup analysis according to gestational age at MRI (< 24 vs >= 24 weeks), laterality of VM (unilateral vs bilateral) and severity of dilatation (mild vs moderate VM) were also performed. Results Five hundred and fifty-six fetuses with a prenatal diagnosis of isolated mild or moderate VM on ultrasound were included in the analysis. Additional structural anomalies were detected on prenatal MRI and missed on ultrasound in 5.4% (95% CI, 3.8-7.6%) of cases. When considering the type of anomaly, supratentorial intracranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly were detected in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected on MRI in 6.7% of cases, while dysgenesis was detected in 3.3%. Fetuses with an associated anomaly detected only on MRI were more likely to have moderate than mild VM (60.0% vs 17.7%; P
- Published
- 2020
5. Chromosome 11 segmental paternal isodisomy in amniocytes from two fetuses with omphalocoele: new highlights on phenotype–genotype correlations in Beckwith–Wiedemann syndrome
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Grati, F R, Turolla, L, D’Ajello, P, Ruggeri, A, Miozzo, M, Bracalente, G, Baldo, D, Laurino, L, Boldorini, R, Frate, E, Surico, N, Larizza, L, Maggi, F, and Simoni, G
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- 2007
6. Prediction of successful induction of labor at term: Role of clinical history, digital examination, ultrasound assessment of the cervix, and fetal fibronectin assay
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Reis, F. M., Gervasi, M. T., Florio, P., Bracalente, G., Fadalti, M., Severi, F. M., and Petraglia, F.
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- 2003
7. EXIT (ex Utero Intrapartum Treatment) technique – management of a giant fetal lymphagioma
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Pascoli, I, Gritti, A, Cutrone, C, Presotto, S, Bendini, M, Bordignon, L, Stampalija, T, Bracalente, G, Pascoli, I, Gritti, A, Cutrone, C, Presotto, S, Bendini, M, Bordignon, L, Stampalija, T, and Bracalente, G
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- 2010
8. An unexpected adverse outcome of a fetal mild pyelectasis
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Bracalente, G., Pitter, M., Pascoli, I., tamara stampalija, Gritti, A., Grimaldi, M. R., Agostini, S., Dal Pozzo, G., Bracalente, G, Pitter, M, Pascoli, I, Stampalija, T, Gritti, A, Grimaldi, Mr, Agostini, S, and Dal Pozzo, G
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- 2008
9. Relationship between stage, site and morphological characteristics of pelvic endometriosis and pain
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Parazzini, F., Cipriani, S., Moroni, S., Crosignani, P. G., Ciavattini, A., Garzetti, G., Dolcetta, G., Scollo, M., Vicino, M., Loverro, G., Sabatelli, S., Decca, L., Falsetti, L., Giacomucci, E., Flamigni, C., Mais, V., Guerriero, S., Boscia, F., Sangiorgio, G., Scollo, P., Muriana, A., La Greca, M., Distefano, C., Belloni, C., Spolaor, L., Bianchi, A., Aretini, M., Franchini, M., Bracco, G. L., Coccia, M. E., Scarselli, G. F., Ciuffreda, F., Fiscella, C., Tinelli, F., Demarzi, C. A., Bianco, B., Iannelli, A., Radaelli, U., Meroni, N., Federici, D., Calia, C., Vercellini, P., Bertulessi, C., Hanozet, F., Busacca, M., Dal Pozzo, G., Pieroni, A., Lita, P., Bracciante, R., Baiocchi, G., Congiu, M. A., Fanfani, R., Sesti, F., Bonifacio, S., Porpora, M. G., Pittino, M., Del Frate, G., Dessole, S., Capobianco, G., Montanino Oliva, M., Primilerio, M., Micalef, S., Ansaldi, E., Massobrio, M., Guidetti, D., Rosati, M., Di Dionisio, A., Bracalente, G., Guaschino, S., Troiano, L., Francesco De Seta, Santuz, M., Petraglia, F., Canducci, E., Beretta, P., and Santo, D.
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Stage ,Endometriosis ,Pain ,Site ,Settore MED/40 - Ginecologia e Ostetricia - Published
- 2001
10. ATTIVAZIONE IN SITU DELLE METALLOPROTEINASI DA PARTE DEL SISTEMA FIBRINOLITICO COME MECCANISMO PATOGENETICO DELLA ROTTURA DELLA PLACCA ATEROSCLEROTICA
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Costantini, V., Stabile, Anna Maria, De Monte, P., Lenti, M., Bracalente, G., Bellezza, Guido, Parliani, T., and Sidoni, Angelo
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coagulazione - Published
- 1999
11. Chromosome 11 segmental paternal isodisomy in amniocytes from Iwo fetuses with omphalocoele: new highlights on phenotype—genotype correlations in Beckwith—Wiedemann syndrome.
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Grati, F. R., Turolla, I., D'Ajello, P., Ruggeri, A., Miozzo, M., Bracalente, G., Baldo, D., Laurino, I., Boldorini, R., Frate, E., Surico, N., Larizza, I., Maggi, F., and Simoni, G.
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CHROMOSOMES ,PROTEUS syndrome ,CELL lines ,MEDICAL imaging systems ,GENETIC polymorphisms - Abstract
Background: The phenotypic variability in Beckwith-Wiedemann syndrome (BWS) reflects the genetic heterogeneity of the mechanism which by default leads to the deregulation of genes located at 11p15.5. Genotype-phenotype correlation studies have demonstrated an association between omphalocoele and CDKN1C/p57 mutations or hypermethylation. Paternal uniparental disomy 11 (pUPD11) has been described only in the mosaic condition with both uniparental and biparental cell lines, and no association with ompholocoele has been pointed out. Methods: Two cases are presented here, in which a paternal segmental UPD11 was detected by molecular investigation of amniotic fluid cell cultures after the presence of apparently isolated omphalocoele was revealed in the fetuses by ultrasound scan. Further studies were performed on additional autoptic feto-placental tissues to characterise the distribution of the uniparental cell line and to unmask any biparental lineage in order to document in more detail the as yet unreported association between omphalocoele and pUPD11. Results: Results on the UPD distribution profile showed that the abdominal organs have a predominant uniparental constitution. This condition could mimic the effect of CDKN1C/p57 inactivation, causing the omphalocoele. Conclusion: New genotype-phenotype correlations emerge from the investigated cases, suggesting that molecular analysis be extended to all cases with fetal omphalocoele in order to establish the incidence of pUPD11 in complete BWS and in monosymptomatic/mild forms. [ABSTRACT FROM AUTHOR]
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- 2007
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12. EXIT (Ex Utero Intrapartum Treatment) technique - Management of a giant fetal lymphangioma.
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Pascoli I, Gritti A, Cutrone C, Presotto S, Bendini M, Bordignon L, Stampalija T, and Bracalente G
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- 2010
- Full Text
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13. Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: A multicenter study
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Paolo Volpe, Sara Tinari, Vincenzo Berghella, Francesca Ormitti, Francesco Toni, Olav Bennike Bjørn Petersen, Erich Cosmi, Ludovica Oronzi, Alberto Galindo, Marco De Santis, José Morales-Roselló, Lucia Manganaro, Marcella Pellegrino, Gabriela Loscalzo, Giada Ercolani, Lorenzo Pinelli, Giovanni Scambia, Asma Khalil, Flora Murru, Federico Prefumo, Puk Sandager, Daniele Di Mascio, Tamara Stampalija, F. Forlani, Giuseppe Rizzo, Ignacio Herraiz, Cecilia Parazzini, A. Lanzone, Giulia Masini, Gabriele Saccone, Luigi Carbone, Ilaria Giangiordano, Danilo Buca, Marco Liberati, Gianluigi Pilu, Ilenia Mappa, Elena Trincia, Tiziana Frusca, Silvia Visentin, Tullio Ghi, Luigi Nappi, Mariano Lanna, Francesco D'Antonio, Claudiana Olivieri, Christoph Lees, Sandra Ciulla, Ilaria Fantasia, Cecilia Acuti Martellucci, Maria Elena Flacco, Valentina D'Ambrosio, Giuseppe Maria Maruotti, Andrea Dall'Asta, Marco Di Maurizio, Massimo Caulo, Fulvio Zullo, Lamberto Manzoli, Cecilia Villalain, Olivia Mendez Quintero, Ludovico Muzii, Filomena Giulia Sileo, Raquel Garcia, Antonella Giancotti, Lucia Pasquini, Gabriella Bracalente, Roberto Brunelli, Amanda Antonelli, Alice D'Amico, Lisa Neerup, Ginevra Salsi, Di Mascio, D., Khalil, A., Pilu, G., Rizzo, G., Caulo, M., Liberati, M., Giancotti, A., Lees, C., Volpe, P., Buca, D., Oronzi, L., D'Amico, A., Tinari, S., Stampalija, T., Fantasia, I., Pasquini, L., Masini, G., Brunelli, R., D'Ambrosio, V., Muzii, L., Manganaro, L., Antonelli, A., Ercolani, G., Ciulla, S., Saccone, G., Maruotti, G. M., Carbone, L., Zullo, F., Olivieri, C., Ghi, T., Frusca, T., Dall'Asta, A., Visentin, S., Cosmi, E., Forlani, F., Galindo, A., Villalain, C., Herraiz, I., Sileo, F. G., Mendez Quintero, O., Salsi, G., Bracalente, G., Morales-Rosello, J., Loscalzo, G., Pellegrino, M., De Santis, M., Lanzone, A., Parazzini, C., Lanna, M., Ormitti, F., Toni, F., Murru, F., Di Maurizio, M., Trincia, E., Garcia, R., Bennike Bjorn Petersen, O., Neerup, L., Sandager, P., Prefumo, F., Pinelli, L., Mappa, I., Acuti Martellucci, C., Flacco, M. E., Manzoli, L., Giangiordano, I., Nappi, L., Scambia, G., Berghella, V., D'Antonio, F., Di Mascio, Daniele, Khalil, Asma, Pilu, Gianluigi, Rizzo, Giuseppe, Caulo, Massimo, Liberati, Marco, Giancotti, Antonella, Lees, Christoph, Volpe, Paolo, Buca, Danilo, Oronzi, Ludovica, D'Amico, Alice, Tinari, Sara, Stampalija, Tamara, Fantasia, Ilaria, Pasquini, Lucia, Masini, Giulia, Brunelli, Roberto, D'Ambrosio, Valentina, Muzii, Ludovico, Manganaro, Lucia, Antonelli, Amanda, Ercolani, Giada, Ciulla, Sandra, Saccone, Gabriele, Maruotti, Giuseppe Maria, Carbone, Luigi, Zullo, Fulvio, Olivieri, Claudiana, Ghi, Tullio, Frusca, Tiziana, Dall'Asta, Andrea, Visentin, Silvia, Cosmi, Erich, Forlani, Francesco, Galindo, Alberto, Villalain, Cecilia, Herraiz, Ignacio, Sileo, Filomena Giulia, Quintero, Olivia Mendez, Salsi, Ginevra, Bracalente, Gabriella, Morales-Roselló, José, Loscalzo, Gabriela, Pellegrino, Marcella, De Santis, Marco, Lanzone, Antonio, Parazzini, Cecilia, Lanna, Mariano, Ormitti, Francesca, Toni, Francesco, Murru, Flora, Di Maurizio, Marco, Trincia, Elena, Garcia, Raquel, Petersen, Olav Bennike Bjørn, Neerup, Lisa, Sandager, Puk, Prefumo, Federico, Pinelli, Lorenzo, Mappa, Ilenia, Martellucci, Cecilia Acuti, Flacco, Maria Elena, Manzoli, Lamberto, Giangiordano, Ilaria, Nappi, Luigi, Scambia, Giovanni, Berghella, Vincenzo, and D'Antonio, Francesco
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medicine.medical_specialty ,Central nervous system ,Fetal magnetic resonance imaging ,Fetal ultrasound ,MRI ,Neurosonography ,Prenatal diagnosis ,Ventriculomegaly ,Prenatal diagnosi ,central nervous system ,fetal magnetic resonance imaging ,fetal ultrasound ,neurosonography ,prenatal diagnosis ,ventriculomegaly ,Ultrasonography, Prenatal ,NO ,Cohort Studies ,Lesion ,Central nervous system, Fetal magnetic resonance imaging, Fetal ultrasound, MRI, Neurosonography, Prenatal diagnosis, Ventriculomegaly ,Fetus ,Pregnancy ,Humans ,Medicine ,ventriculomegaly, central nervous system, fetal magnetic resonance imaging, MRI, fetal ultrasound, neurosonography, prenatal diagnosis ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,Gestational age ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,Reproductive Medicine ,Settore MED/40 ,Gestation ,Female ,Radiology ,medicine.symptom ,business ,Hydrocephalus - Abstract
Objective: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography. Method: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (≥15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (
- Published
- 2021
14. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: international multicenter study
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Vincenzo Berghella, Giuseppe Maria Maruotti, Francesco Toni, Gabriella Bracalente, José Morales-Roselló, Ilaria Fantasia, Karen Melchiorre, Ginevra Salsi, Giovanni Scambia, Gabriella Meccariello, Lucia Manganaro, Marco Di Maurizio, Federico Prefumo, Pierluigi Benedetti Panici, Tamara Stampalija, Christoph Lees, Giuseppe Rizzo, Giada Ercolani, Gianluigi Pilu, Paolo Volpe, Francesco D'Antonio, Basky Thilaganathan, Asma Khalil, Tullio Ghi, Alessandra Familiari, Luisa D'Oria, Luigi Nappi, Roberto Brunelli, Claudio Celentano, Marco De Santis, Ilaria Giangiordano, Danilo Buca, S. Buongiorno, Francesca Ormitti, Tiziana Frusca, Giulia Masini, Fulvio Zullo, Nicola Volpe, Luciana Mastricci, Laura Sarno, Lorenzo Vasciaveo, Massimo Caulo, Lucia Pasquini, Valentina D'Ambrosio, Maria Elena Flacco, Giulia Luise, Lamberto Manzoli, Gabriele Saccone, Antonio Lanzone, Filomena Giulia Sileo, Emma Bertucci, Antonella Giancotti, Amanda Antonelli, Gabriela Loscalzo, Luigi Carbone, Massimo Gregori, Daniele Di Mascio, Claudiana Olivieri, Marco Liberati, Andrea Dall'Asta, Lorenzo Pinelli, Di Mascio D., Khalil A., Thilaganathan B., Rizzo G., Buca D., Liberati M., Celentano C., Melchiorre K., Caulo M., Pilu G., Salsi G., Toni F., Stampalija T., Fantasia I., Luise G., Gregori M., Volpe P., Olivieri C., Giancotti A., D'Ambrosio V., Brunelli R., Panici P.B., Manganaro L., Antonelli A., Ercolani G., Pasquini L., Masini G., Di Maurizio M., Lees C., Bracalente G., Morales-Rosello J., Loscalzo G., Saccone G., Carbone L., Sarno L., Maruotti G.M., Zullo F., Ghi T., Frusca T., Dall'Asta A., Volpe N., Ormitti F., Buongiorno S., De Santis M., D'Oria L., Lanzone A., Prefumo F., Pinelli L., Bertucci E., Sileo F.G., Flacco M.E., Manzoli L., Giangiordano I., Mastricci L., Meccariello G., Vasciaveo L., Nappi L., Familiari A., Scambia G., Berghella V., D'Antonio F., Di Mascio, Daniele, Khalil, Asma, Thilaganathan, Basky, Rizzo, Giuseppe, Buca, Danilo, Liberati, Marco, Celentano, Claudio, Melchiorre, Karen, Caulo, Massimo, Pilu, Gianluigi, Salsi, Ginevra, Toni, Francesco, Stampalija, Tamara, Fantasia, Ilaria, Luise, Giulia, Gregori, Massimo, Volpe, Paolo, Olivieri, Claudiana, Giancotti, Antonella, D'Ambrosio, Valentina, Brunelli, Roberto, Benedetti Panici, Pierluigi, Manganaro, Lucia, Antonelli, Amanda, Ercolani, Giada, Pasquini, Lucia, Masini, Giulia, Di Maurizio, Marco, Lees, Christoph, Bracalente, Gabriella, Morales‐roselló, José, Loscalzo, Gabriela, Saccone, Gabriele, Carbone, Luigi, Sarno, Laura, Maruotti, GIUSEPPE MARIA, Zullo, Fulvio, Ghi, Tullio, Frusca, Tiziana, Dall'Asta, Andrea, Volpe, Nicola, Ormitti, Francesca, Buongiorno, Silvia, De Santis, Marco, D'Oria, Luisa, Lanzone, Antonio, Prefumo, Federico, Pinelli, Lorenzo, Bertucci, Emma, Giulia Sileo, Filomena, Elena Flacco, Maria, Manzoli, Lamberto, Giangiordano, Ilaria, Mastricci, Luciana, Meccariello, Gabriella, Vasciaveo, Lorenzo, Nappi, Luigi, Familiari, Alessandra, Scambia, Giovanni, Berghella, Vincenzo, D'Antonio, Francesco, Mascio, Daniele Di, Panici, Pierluigi Benedetti, Maruotti, Giuseppe Maria, Sileo, Filomena Giulia, and Flacco, Maria Elena
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Fetal magnetic resonance imaging ,central nervous system ,fetal magnetic resonance imaging ,fetal ultrasound ,MRI ,neurosonography ,prenatal diagnosis ,ventriculomegaly ,Adult ,Cohort Studies ,Europe ,Female ,Gestational Age ,Humans ,Hydrocephalus ,Predictive Value of Tests ,Pregnancy ,Retrospective Studies ,Magnetic Resonance Imaging ,Prenatal Diagnosis ,medicine.medical_specialty ,Socio-culturale ,Fetal brain ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Fetus ,prenatal diagnosi ,030219 obstetrics & reproductive medicine ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Reproductive Medicine ,Multicenter study ,embryonic structures ,Radiology ,business ,Ventriculomegaly - Abstract
Objectives: To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain. Methods: This was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0–11.9 mm) or moderate (ventricular atrial diameter, 12.0–14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra-CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anomalies detected exclusively on prenatal MRI and missed on ultrasound, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed on prenatal imaging (ultrasound and MRI). Subgroup analysis according to gestational age at MRI (< 24 vs ≥ 24 weeks), laterality of VM (unilateral vs bilateral) and severity of dilatation (mild vs moderate VM) were also performed. Results: Five hundred and fifty-six fetuses with a prenatal diagnosis of isolated mild or moderate VM on ultrasound were included in the analysis. Additional structural anomalies were detected on prenatal MRI and missed on ultrasound in 5.4% (95% CI, 3.8–7.6%) of cases. When considering the type of anomaly, supratentorial intracranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly were detected in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected on MRI in 6.7% of cases, while dysgenesis was detected in 3.3%. Fetuses with an associated anomaly detected only on MRI were more likely to have moderate than mild VM (60.0% vs 17.7%; P < 0.001), while there was no significant difference in the proportion of cases with bilateral VM between the two groups (P = 0.2). Logistic regression analysis showed that lower maternal body mass index (adjusted odds ratio (aOR), 0.85 (95% CI, 0.7–0.99); P = 0.030), the presence of moderate VM (aOR, 5.8 (95% CI, 2.6–13.4); P < 0.001) and gestational age at MRI ≥ 24 weeks (aOR, 4.1 (95% CI, 1.1–15.3); P = 0.038) were associated independently with the probability of detecting an associated anomaly on MRI. Associated anomalies were detected exclusively at birth and missed on prenatal imaging in 3.8% of cases. Conclusions: The incidence of an associated fetal anomaly missed on ultrasound and detected only on fetal MRI in fetuses with isolated mild or moderate VM undergoing neurosonography is lower than that reported previously. The large majority of these anomalies are difficult to detect on ultrasound. The findings from this study support the practice of MRI assessment in every fetus with a prenatal diagnosis of VM, although parents can be reassured of the low risk of an associated anomaly when VM is isolated on neurosonography. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2020
15. First trimester lower abdominal cysts as early predictor of anorectal malformations.
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Erculiani M, Trovalusci E, Zanatta C, De Lorenzis MS, Filippi E, Bracalente G, and Midrio P
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- Infant, Newborn, Female, Pregnancy, Humans, Pregnancy Trimester, First, Ultrasonography, Prenatal methods, Anorectal Malformations diagnostic imaging, Fetal Diseases, Cysts diagnostic imaging
- Abstract
Introduction: Prenatal ultrasound diagnosis of anorectal malformations (ARMs) is challenging and often missed as direct visualization of the anal sphincter is not routinely performed, plus the technique is operator-dependent and inaccurate, also in expert hands. Other indirect signs, such as rectosigmoid overdistension or intraluminal calcifications, are occasionally present in late pregnancy. The detection of a cyst of the lower abdomen in the first trimester may be an early sign of ARM. Here we reported our experience and a review of the literature of such cases., Material and Methods: Isolated cases of lower abdomen cysts encountered in the first trimester at the Prenatal Diagnosis Unit during the last 5 years were retrieved and compared with those found in literature. Post-natal clinical data were analyzed to check the presence and type of malformations., Results: A total of three cases of lower abdomen cysts were found in our center and 13 in literature. In our case series all the cysts spontaneously regressed and were no longer visible since the second trimester of pregnancy, while in literature this was reported in only 4 out of 13 cases. ARM was confirmed in all patients at birth or post-mortem., Conclusions: The finding of a lower abdomen cyst during the first trimester of pregnancy could be an early predictive sign of ARM, even if it disappears during pregnancy. In these cases, we suggest mentioning to the parents the possibility of an ARM during the counseling and to refer the couple to a Colorectal Center., (© 2022. The Author(s).)
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- 2023
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16. Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance.
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Fantasia I, Ciardo C, Bracalente G, Filippi E, Murru FM, Spezzacatene A, Bin M, Mendez Quintero O, Montaguti E, Lees C, Papanikolaou K, Pilu G, Prefumo F, Thilaganathan B, and Stampalija T
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- Female, Pregnancy, Humans, Ultrasonography, Prenatal methods, Magnetic Resonance Imaging methods, Fetus abnormalities, Retrospective Studies, Magnetic Resonance Spectroscopy, Clinical Relevance, Microcephaly
- Abstract
Introduction: The objective of this study was to describe a cohort of fetuses with an ultrasound prenatal diagnosis of obliterated cavum septi pellucidi (oCSP) with the aim to explore the rate of associated malformations, the progression during pregnancy and the role of fetal magnetic resonance imaging (MRI)., Material and Methods: This was a retrospective multicenter international study of fetuses diagnosed with oCSP in the second trimester with available fetal MRI and subsequent ultrasound and/or fetal MRI follow-up in the third trimester. Where available, postnatal data were collected to obtain information on neurodevelopment., Results: We identified 45 fetuses with oCSP at 20.5 weeks (interquartile range 20.1-21.1). oCSP was apparently isolated at ultrasound in 89% (40/45) and fetal MRI found additional findings in 5% (2/40) of cases, including polymicrogyria and microencephaly. In the remaining 38 fetuses, fetal MRI found a variable amount of fluid in CSP in 74% (28/38) and no fluid in 26% (10/38). Ultrasound follow-up at or after 30 weeks confirmed the diagnosis of oCSP in 32% (12/38) while fluid was visible in 68% (26/38). At follow-up MRI, performed in eight pregnancies, there were periventricular cysts and delayed sulcation with persistent oCSP in one case. Among the remaining cases with normal follow-up ultrasound and fetal MRI findings, the postnatal outcome was normal in 89% of cases (33/37) and abnormal in 11% (4/37): two with isolated speech delay, and two with neurodevelopmental delay secondary to postnatal diagnosis of Noonan syndrome at 5 years in one case and microcephaly with delayed cortical maturation at 5 months in the other., Conclusions: Apparently isolated oCSP at mid-pregnancy is a transient finding with the visualization of the fluid later in pregnancy in up to 70% of cases. At referral, associated defects can be found in around 11% of cases at ultrasound and 8% at fetal MRI indicating the need for a detailed evaluation by expert physicians when oCSP is suspected., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)
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- 2023
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17. Corrigendum to "The Italian guidelines on ultrasound in obstetrics and gynecology: Executive summary of recommendations for practice" [Eur. J. Obstetrics Gynecol. 279 (2022) 176-182].
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Aprile A, Calì G, Chianchiano N, Chiappa V, Corbella P, D'Addario V, Dall'Asta A, De Robertis V, Exacustos C, Familiari A, Fichera A, Formigoni C, Frusca T, Ghi T, Guerriero S, Iuculano A, Labate F, Martinelli P, Monni G, Morlano M, Nonino F, Olivieri C, Paladini D, Peddes C, Prefumo F, Rizzo G, Rustico M, Sarno L, Sciacovelli I, Sciarrone A, Stampalija T, Taddei F, Todros T, Valensise H, Vergani P, Volpe N, Volpe P, Votino C, Bettoncelli G, Bracalente G, Collini Ceccatelli M, Costantini M, D'Aloia A, Ferrazzi E, Giorlandino C, Locci M, Verrotti di Pianella C, Viora E, Zoia R, Bilardo K, and Vicar M
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- 2023
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18. Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: A multicenter study.
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Di Mascio D, Khalil A, Pilu G, Rizzo G, Caulo M, Liberati M, Giancotti A, Lees C, Volpe P, Buca D, Oronzi L, D'Amico A, Tinari S, Stampalija T, Fantasia I, Pasquini L, Masini G, Brunelli R, D'Ambrosio V, Muzii L, Manganaro L, Antonelli A, Ercolani G, Ciulla S, Saccone G, Maruotti GM, Carbone L, Zullo F, Olivieri C, Ghi T, Frusca T, Dall'Asta A, Visentin S, Cosmi E, Forlani F, Galindo A, Villalain C, Herraiz I, Sileo FG, Mendez Quintero O, Salsi G, Bracalente G, Morales-Roselló J, Loscalzo G, Pellegrino M, De Santis M, Lanzone A, Parazzini C, Lanna M, Ormitti F, Toni F, Murru F, Di Maurizio M, Trincia E, Garcia R, Bennike Bjørn Petersen O, Neerup L, Sandager P, Prefumo F, Pinelli L, Mappa I, Acuti Martellucci C, Flacco ME, Manzoli L, Giangiordano I, Nappi L, Scambia G, Berghella V, and D'Antonio F
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- Cohort Studies, Female, Fetus, Humans, Magnetic Resonance Imaging, Pregnancy, Prenatal Diagnosis, Retrospective Studies, Hydrocephalus diagnostic imaging, Ultrasonography, Prenatal
- Abstract
Objective: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography., Method: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (≥15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (
- Published
- 2021
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19. Laparoscopic vs. open feeding jejunostomy insertion in oesophagogastric cancer.
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Mastoridis S, Bracalente G, Hanganu CB, Neccia M, Giuliani A, Gillies R, Marshall R, Maynard N, and Sgromo B
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- Enteral Nutrition, Humans, Jejunostomy, Retrospective Studies, Esophageal Neoplasms surgery, Laparoscopy
- Abstract
Background: Jejunal feeding is an invaluable method by which to improve the nutritional status of patients undergoing neoadjuvant and surgical treatment of oesophageal malignancies. However, the insertion of a feeding jejunostomy can cause significant postoperative morbidity. The aim of this study is to compare the outcomes of patients undergoing placement of feeding jejunostomy by conventional laparotomy with an alternative laparoscopic approach., Methods: A retrospective review of data prospectively collected at the Oxford Oesophagogastric Centre between August 2017 and July 2019 was performed including consecutive patients undergoing feeding jejunostomy insertion., Results: In the study period, 157 patients underwent jejunostomy insertion in the context of oesophageal cancer therapy, 126 (80%) by open technique and 31 (20%) laparoscopic. Pre-operative demographic and nutritional characteristics were broadly similar between groups. In the early postoperative period jejunostomy-associated complications were noted in 54 cases (34.4%) and were significantly more common among those undergoing open as compared with laparoscopic insertion (38.1% vs. 19.3%, P = 0.049). Furthermore, major complications were more common among those undergoing open insertion, whether as a stand-alone or at the time of staging laparoscopy (n = 11/71), as compared with insertion at the time of oesophagectomy (n = 3/86, P = 0.011)., Conclusions: This report represents the largest to our knowledge single-centre comparison of open vs. laparoscopic jejunostomy insertion in patients undergoing oesophagectomy in the treatment of gastroesophageal malignancy. We conclude that the laparoscopic jejunostomy insertion technique described represents a safe and effective approach to enteral access which may offer superior outcomes to conventional open procedures., (© 2021. The Author(s).)
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- 2021
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20. Risks and implications for health and the environment associated with products and waste containing nanomaterials: regulatory and management issues in the European framework.
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Zamengo L, Nasello M, Branchi B, Bracalente G, Vergari W, Bertocco C, and Costernaro A
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- Europe, Humans, Refuse Disposal legislation & jurisprudence, Refuse Disposal methods, Risk Assessment methods, Waste Management legislation & jurisprudence, Waste Products adverse effects, Environmental Pollutants toxicity, Nanostructures toxicity, Waste Management methods
- Abstract
Summary: Nanomaterials can revolutionize everyday products, but there are still many unanswered questions about the risks they may pose to human health and the environment. Inconsistent definitions and metrological issues are still of concern for manufacturers, importers and distributors who are demanded to comply with strict regulations. It is also likely that the increasing number of nanomaterial-containing products available on the market will vary the chemical and physical properties of the waste produced, which is currently treated in traditional plants without any particular differentiation. Treatment efficiency for nanomaterials-containing waste should then be addressed and the risks of uncontrolled emissions considered. Finally, the risks associated with the use of nanomaterials-containing products may not be sufficiently characterized as current exposure estimation models are not designed for estimating exposure to nanomaterials and they are likely to be affected by large uncertainties. Hence, it would be important for national and international institutions to provide, as soon as possible, harmonized regulations covering all aspects of the life cycle of products and waste containing nanomaterials. This paper is proposed as a starting point for reflection on the main regulatory and management issues associated with products and waste containing nanomaterials, focusing mainly on the European framework., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by GIMLE.)
- Published
- 2020
21. Outcomes in pregnancies with a confined placental mosaicism and implications for prenatal screening using cell-free DNA.
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Grati FR, Ferreira J, Benn P, Izzi C, Verdi F, Vercellotti E, Dalpiaz C, D'Ajello P, Filippi E, Volpe N, Malvestiti F, Maggi F, Simoni G, Frusca T, Cirelli G, Bracalente G, Re AL, Surico D, Ghi T, and Prefumo F
- Subjects
- Chromosomes, Human, Pair 16 genetics, Cohort Studies, Female, Fetal Growth Retardation diagnosis, Fetus, Gestational Age, Humans, Infant, Newborn, Infant, Small for Gestational Age physiology, Mosaicism embryology, Noninvasive Prenatal Testing methods, Placenta metabolism, Pregnancy, Pregnancy Outcome genetics, Prenatal Care, Prenatal Diagnosis methods, Retrospective Studies, Sequence Analysis, DNA methods, Trisomy genetics, Cell-Free Nucleic Acids analysis, Mosaicism classification, Placentation genetics
- Abstract
Purpose: To assess the association between confined placental mosaicism (CPM) and adverse pregnancy outcome., Methods: A retrospective cohort study was carried out evaluating the outcome of pregnancies with and without CPM involving a rare autosomal trisomy (RAT) or tetraploidy. Birthweight, gestational age at delivery, fetal growth restriction (FGR), Apgar score, neonatal intensive care admission, preterm delivery, and hypertensive disorders of pregnancy were considered., Results: Overall 181 pregnancies with CPM and 757 controls were recruited. Outcome information was available for 69% of cases (n = 124) and 62% of controls (n = 468). CPM involving trisomy 16 (T16) was associated with increased incidence of birthweight <3rd centile (P = 0.007, odds ratio [OR] = 11.2, 95% confidence interval [CI] = 2.7-47.1) and preterm delivery (P = 0.029, OR = 10.2, 95% CI = 1.9-54.7). For the other RATs, an association with prenatally diagnosed FGR was not supported by birthweight data and there were no other strong associations with adverse outcomes., Conclusion: Excluding T16, the incidence of adverse pregnancy outcomes for pregnancies carrying a CPM is low. RATs can also be identified through genome-wide cell-free DNA screening. Because most of these will be attributable to CPMs, we conclude that this screening is of minimal benefit.
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- 2020
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22. Prenatal phenotype of Williams-Beuren syndrome and of the reciprocal duplication syndrome.
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Marcato L, Turolla L, Pompilii E, Dupont C, Gruchy N, De Toffol S, Bracalente G, Bacrot S, Troilo E, Tabet AC, Rossi S, Delezoïde AL, Baldo D, Leporrier N, Maggi F, Molin A, Pilu G, Simoni G, Vialard F, and Grati FR
- Abstract
Key Clinical Message: Copy losses/gains of the Williams-Beuren syndrome (WBS) region cause neurodevelopmental disorders with variable expressivity. The WBS prenatal diagnosis cannot be easily performed by ultrasound because only few phenotypic features can be assessed. Three WBS and the first reciprocal duplication prenatal cases are described with a review of the literature.
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- 2014
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23. Viral invasion of the amniotic cavity (VIAC) in the midtrimester of pregnancy.
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Gervasi MT, Romero R, Bracalente G, Chaiworapongsa T, Erez O, Dong Z, Hassan SS, Yeo L, Yoon BH, Mor G, Barzon L, Franchin E, Militello V, and Palù G
- Subjects
- Adult, Amniocentesis, Amniotic Fluid metabolism, Asymptomatic Infections epidemiology, Biomarkers metabolism, Case-Control Studies, DNA, Viral analysis, Female, Humans, Italy epidemiology, Pregnancy, Pregnancy Complications, Infectious diagnosis, Pregnancy Complications, Infectious metabolism, Pregnancy Complications, Infectious virology, Pregnancy Outcome, Prevalence, Prospective Studies, Real-Time Polymerase Chain Reaction, Virus Diseases diagnosis, Virus Diseases metabolism, Virus Diseases virology, Amniotic Fluid virology, Pregnancy Complications, Infectious epidemiology, Pregnancy Trimester, Second, Virus Diseases epidemiology
- Abstract
Introduction: The prevalence of viral infections in the amniotic fluid (AF) has not yet been ascertained. The aim of this study was to determine the prevalence of specific viral nucleic acids in the AF and its relationship to pregnancy outcome., Study Design: From a cohort of 847 consecutive women undergoing midtrimester amniocentesis, 729 cases were included in this study after exclusion of documented fetal anomalies, chromosomal abnormalities, unavailability of AF specimens and clinical outcomes. AF specimens were tested by quantitative real-time PCR for the presence of genome sequences of the following viruses: adenoviruses, herpes simplex virus (HSV), varicella zoster virus (VZV), human herpesvirus 6 (HHV6), human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), parvovirus B19 and enteroviruses. Viral nucleic acid testing was also performed in maternal blood and cord blood in the population of women in whom AF was positive for viruses and in a control group of 29 women with AF negative for viral nucleic acids. The relationship between the presence of viruses and pregnancy and neonatal outcome was examined. The correlation between the presence of nucleic acids of viruses in the AF and the concentration of the cytokine interleukin-6 (IL-6) and the T cell chemokine CXCL-10 (or IP-10) in AF and maternal blood were analyzed., Results: Viral genome sequences were found in 16 of 729 (2.2%) AF samples. HHV6 was the most commonly detected virus (7 cases, 1.0%), followed by HCMV (6 cases, 0.8%), parvovirus B19 (2 cases, 0.3%) and EBV (1 case, 0.1%), while HSV, VZV, enteroviruses and adenoviruses were not found in this cohort. Corresponding viral DNA was also detected in maternal blood of six out of seven women with HHV6-positive AF and in the umbilical cord plasma, which was available in one case. In contrast, viral DNA was not detected in maternal blood of women with AF positive for parvovirus B19, HCMV, EBV or of women with AF negative for viruses. HHV6 genome copy number in AF and maternal blood was consistent with genomic integration of viral DNA and genetic infection in all women. There was no significant difference in the AF concentration of IL-6 and IP-10 between patients with and without VIAC. However, for HCMV, there was a significant relationship between viral copy number and IP-10 concentration in maternal blood and AF. The group of women with AF positive for viral DNA delivered at term healthy neonates without complications in 14 out of 16 cases. In one case of HHV6 infection in the AF, the patient developed gestational hypertension at term, and in another case of HHV6 infection in the AF, the patient delivered at 33 weeks after preterm premature rupture of membranes (PPROM)., Conclusion: Viral nucleic acids are detectable in 2.2% of AF samples obtained from asymptomatic women in the midtrimester. HHV6 was the most frequently detected virus in AF. Adenoviruses were not detected. Vertical transmission of HHV6 was demonstrated in one case.
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- 2012
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24. Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery.
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Gervasi MT, Romero R, Bracalente G, Erez O, Dong Z, Hassan SS, Yeo L, Yoon BH, and Chaiworapongsa T
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- Adult, Chorioamnionitis metabolism, Female, Humans, Pregnancy, Premature Birth diagnosis, Premature Birth epidemiology, Amniotic Fluid chemistry, Chemokine CXCL10 analysis, Gestational Age, Interleukin-6 analysis, Premature Birth metabolism
- Abstract
Introduction: Intra-amniotic inflammation is traditionally defined as an elevation of amniotic fluid interleukin (IL)-6. Previous case control studies have suggested an association between an elevated midtrimester amniotic fluid IL-6 and preterm delivery, although such an association has been recently challenged. Intra-amniotic inflammation can also be defined by an elevation of the T-cell chemokine, Interferon-gamma-inducible protein (IP)-10. An elevation in amniotic fluid IP-10 has been associated with chronic chorioamnionitis, a lesion frequently found in late spontaneous preterm birth and fetal death. In contrast, an elevation in amniotic fluid IL-6 is typically associated with acute chorioamnionitis and funisitis. This study was conducted to examine the relationship between an elevation in amniotic fluid IL-6 in the midtrimester and preterm delivery at or before 32 weeks of gestation, and the amniotic fluid concentration of IP-10 and preterm delivery after 32 weeks of gestation., Materials and Methods: This cohort study included 847 consecutive women undergoing genetic midtrimester amniocentesis; in 796 cases, amniotic fluid and pregnancy outcome was available for study after exclusion of abnormal karyotype and/or fetal congenital anomalies. Spontaneous preterm delivery was defined as early (≤32 weeks) or late (after 32 completed weeks of pregnancy). The amniotic fluid and maternal blood concentrations of IL-6 and IP-10 were measured by specific immunoassays., Results: 1) The prevalence of preterm delivery was 8.3% (66/796), while those of early and late spontaneous preterm delivery were 1.5% (n=12), and 4.5% (n=36), respectively; 2) patients who had a spontaneous preterm delivery after 32 weeks of gestation had a higher median amniotic fluid IP-10 concentration than those who delivered at term [median 713 pg/mL, inter-quartile range (IQR) 509-1427 pg/mL vs. median 589 pg/mL, IQR 402-953 pg/mL; P=0.006] and an elevation of amniotic fluid IP-10 concentration above 502 pg/mL (derived from an ROC curve) was associated with late spontaneous preterm delivery [odds ratio 3.9 (95% CI 1.6-9.9)]; 3) patients who had a spontaneous preterm delivery ≤32 weeks of gestation had a higher median amniotic fluid IL-6 concentration than those who delivered at term [median 2052 pg/mL, IQR 435-3015 pg/mL vs. median 414 pg/mL, IQR 209-930 pg/mL; P=0.006], and an elevated amniotic fluid IL-6 concentration above 1740 pg/mL (derived from an ROC curve) was associated with early spontaneous preterm delivery [odds ratio 9.5 (95% CI 2.9-31.1)]; 4) subclinical intra-amniotic inflammation, defined as an elevation of IL-6 (≥2.9 ng/mL) or IP-10 (≥2.2 ng/mL) concentration above the 95th percentile of patients who had uncomplicated term delivery (n=652 for IL-6 and n=633 for IP-10), was observed in 6.3% (50/796) and 5.8% (45/770) of cases, respectively. Although each type of inflammation is a risk factor for spontaneous preterm delivery, many patients had a term delivery without complication; 5) the amniotic fluid in the midtrimester did not contain microorganisms detectable with cultivation techniques., Conclusions: INTRA-amniotic inflammation is heterogeneous. Some patients have elevated amniotic fluid concentrations of IL-6, and are at risk for spontaneous preterm delivery before 32 weeks of gestation, while others have an elevated IP-10 (a chemotactic T-cell chemokine) and such patients are at risk for spontaneous preterm delivery after 32 weeks of gestation. A fraction of patients have subclinical intra-amniotic inflammation and deliver at term. The clinical significance of this condition remains to be determined.
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- 2012
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25. An unexpected adverse outcome of a fetal mild pyelectasis.
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Bracalente G, Pitter M, Pascoli I, Stampalija T, Gritti A, Grimaldi MR, Agostini S, and Dal Pozzo G
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- Adult, Dilatation, Pathologic, Female, Humans, Severity of Illness Index, Kidney Pelvis diagnostic imaging, Ultrasonography, Prenatal
- Published
- 2008
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