47 results on '"I, Cataneo"'
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2. 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
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Eran Hadar, Chiara Benedetto, Agnese Maria Chiara Rapisarda, Renato Augusto Moreira de Sá, Deena Elkafrawi, Daniela Luvero, Noa A Brzezinski Sinai, Alicia Martínez-Varea, Antonio Schiattarella, Anna Nunzia Della Gatta, Giovanni Scambia, Albert Lila, Luciano Di Tizio, Andrea Carosso, Giovanni Nazzaro, G. Schera, Giuseppe Rizzo, Giuseppe Maria Maruotti, Giusella D'Urso, Albaro José Nieto-Calvache, Ilenia Mappa, Ozlem Uyaniklar, Fabio Barra, Gilles Faron, Luigi Nappi, Jacopo Ferrari, Giulio Sozzi, Simone Ferrero, Mirjam Druškovič, Tanja Premru-Srsen, Leonardo Borrello, Fabiana Cecchini D, George Daskalakis, Giuliano Petriglia, Caroline Kadji, Felipe Mercado-Olivares, Zeliha Atak, Aylin Pelin Cil, Claudio Gustavino, Axelle Pintiaux, Pantaleo Greco, Rita Figueiredo, Stefano Cosma, Ludovica Puri, Valentina Esposito, Anupam Parange, Simone Garzon, Alessandra Gatti, Ioannis Kyvernitakis, Roberto Brunelli, Maddalena Morlando, Attilio Di Spiezio Sardo, Ignacio Cueto Hernández, Giuseppe Zoccali, Brian Rodriguez, Antonio Mollo, Flaminia Vena, Cihat Sen, Ciuhodaru Madalina, Felice Sorrentino, Francesca Di Sebastiano, Gennady T. Sukhikh, Ilma Floriana Carbone, Andrea Villasco, Blanka Zlatohlavkova, Gabriele Saccone, Erasmo Huertas, Marcel Malan, Leonardo Gucciardo, Eutalia Esposito, Otto Henrique May Feuerschuette, Sarah Dollinger, María de Los Angeles Anaya Baz, Jun Yoshimatsu, Sifa Turan, Vincente Diago, Alicia Yeliz Aykanat, Ignacio Herraiz, Javier Alfonso Schvartzman, Diego Gazzolo, Natalina Buono, Milan Stanojević, Erich Cosmi, Valentina De Robertis, Elena Costa, Angelo Cagnacci, Eleonora Valori, Nicoletta Biglia, Şerife Özlem Genç, Vincenzo Berghella, Francesco Maria Colaleo, Esther Vanessa Aguilar Galán, Gabriela Loscalzo, Marco Palumbo, Fabrizio Sandri, Irmeli Nupponen, Antonio Lanzone, Juan Antonio De León Luis, Amos Grunebaum, Giuseppe Bifulco, Marinella Lenzi, Serena Xodo, Fulvio Zullo, Ozhan Turan, Josefine Königbauer, Anna Luengo Piqueras, Nicola Volpe, Holger Maul, Chiara Taccaliti, Juan Manuel Burgos-Luna, Giovanni Sisti, Rosanna Esposito, Alfredo Ercoli, Panos Antsaklis, Dolores Esteban Oliva, Aly Youssef, Pedro Viana Pinto, Alberto Galindo, Asim Kurjak, Erhan Okuyan, Roberto Angioli, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Massimo Franchi, Maria Carmela Di Dedda, Giovanni Gerosolima, Francesco D'Antonio, Caroline Daelemans, Quintino Cesare Ianniciello, Pasquale De Franciscis, Maurizio Guida, Maria Cristina Rovellotti, Liana Ples, Frank A. Chervenak, Nicola Colacurci, Lilijana Kornhauser Cerar, Zulfiya Khodjaeva, Valentina Longo, Francesca Stollagli, Daniele Di Mascio, Mariavittoria Locci, Amadeo Sanchez, Angelo Sirico, Stefania Fieni, Rebeca Garrote Molpeceres, Pierluigi Benedetti Panici, Vito Chiantera, Esra Tustas Haberal, Liviu Cojocaru, Maria Elena Flacco, Antonella Cromi, Roberta Granese, Antonio Simone Laganà, Maria Giulia Lombana Marino, Silvia Visentin, Beatrice Bianchi, Roberta Venturella, Federica Laraud, Amanda Bermejo, Reyhan Gündüz, Marina Moucho, Zita Maria Gambacorti-Passerini, Danila Morano, Pedro Arango, Francesca Della Sala, Gaetana Di Donna, Jesús S Jimenez Lopez, Mariano Catello Di Donna, Giuliana Simonazzi, Snezana Zdjelar, Vedran Stefanovic, Cecilia Villalain, Antonio Coviello, Lars Hellmeyer, Antonella Giancotti, Elisa Bevilacqua, Igor Samardjiski, Riccardo Buscemi, Arianna Ramone, Marco Cerbone, Lorenza Driul, Danilo Buca, Tiziana Frusca, Elisa Done, Marco Liberati, José Morales Roselló, Fabio Ghezzi, Lorenzo Vasciaveo, Bernd Froessler, Alejandro Pittaro, Yolanda Cuñarro López, Andrew Carlin, Sakine Rahimli Ocakouglu, Giorgia Gattei, I. Cataneo, María José Suárez, Giada Ameli, Lamberto Manzoli, Kaisa Nelskylä, Ludovico Muzii, Peter Palm, Olus Api, Elisa Cueto, Martina Leombroni, Ksenia A. Gorina, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Children's Hospital, HUS Children and Adolescents, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, Gündüz, Reyhan, Di Mascio D., Sen C., Saccone G., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., De Los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., De Leon Luis J.A., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Della Gatta A.N., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Fabiana Cecchini D., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Della Sala F., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Vasciaveo L., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Di Tizio L., Gazzolo D., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Pinto P.V., Figueiredo R., Rosello J.M., Loscalzo G., Martinez-Varea A., Diago V., Lopez J.S.J., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., De Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Sinai N.A.B., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Cerar L.K., Druskovie M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Mollo A., Nazzaro G., Locci M., Guida M., Di Spiezio Sardo A., Panici P.B., Berghella V., Flacco M.E., Manzoli L., Bifulco G., Scambia G., Zullo F., D'Antonio F., Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MLAA, Aguilar Galán EV, López YC, De León Luis JA, Hernández IC, Herraiz I, Villalain C, Venturella R, Rizzo G, Mappa I, Gerosolima G, Hellmeyer L, Königbauer J, Ameli G, Frusca T, Volpe N, Luca Schera GB, Fieni S, Esposito E, Simonazzi G, Di Donna G, Youssef A, Della Gatta AN, Di Donna MC, Chiantera V, Buono N, Sozzi G, Greco P, Morano D, Bianchi B, Lombana Marino MG, Laraud F, Ramone A, Cagnacci A, Barra F, Gustavino C, Ferrero S, Ghezzi F, Cromi A, Laganà AS, Laurita Longo V, Stollagli F, Sirico A, Lanzone A, Driul L, Cecchini D F, Xodo S, Rodriguez B, Mercado-Olivares F, Elkafrawi D, Sisti G, Esposito R, Coviello A, Cerbone M, Morlando M, Schiattarella A, Colacurci N, De Franciscis P, Cataneo I, Lenzi M, Sandri F, Buscemi R, Gattei G, Sala FD, Valori E, Rovellotti MC, Done E, Faron G, Gucciardo L, Esposito V, Vena F, Giancotti A, Brunelli R, Muzii L, Nappi L, Sorrentino F, Vasciaveo L, Liberati M, Buca D, Leombroni M, Di Sebastiano F, Di Tizio L, Gazzolo D, Franchi M, Ianniciello QC, Garzon S, Petriglia G, Borrello L, Nieto-Calvache AJ, Burgos-Luna JM, Kadji C, Carlin A, Bevilacqua E, Moucho M, Pinto PV, Figueiredo R, Roselló JM, Loscalzo G, Martinez-Varea A, Diago V, Jimenez Lopez JS, Aykanat AY, Cosma S, Carosso A, Benedetto C, Bermejo A, May Feuerschuette OH, Uyaniklar O, Ocakouglu SR, Atak Z, Gündüz R, Haberal ET, Froessler B, Parange A, Palm P, Samardjiski I, Taccaliti C, Okuyan E, Daskalakis G, Moreira de Sa RA, Pittaro A, Gonzalez-Duran ML, Guisan AC, Genç ŞÖ, Zlatohlávková B, Piqueras AL, Oliva DE, Cil AP, Api O, Antsaklis P, Ples L, Kyvernitakis I, Maul H, Malan M, Lila A, Granese R, Ercoli A, Zoccali G, Villasco A, Biglia N, Madalina C, Costa E, Daelemans C, Pintiaux A, Cueto E, Hadar E, Dollinger S, Brzezinski Sinai NA, Huertas E, Arango P, Sanchez A, Schvartzman JA, Cojocaru L, Turan S, Turan O, Di Dedda MC, Molpeceres RG, Zdjelar S, Premru-Srsen T, Cerar LK, Druškovič M, De Robertis V, Stefanovic V, Nupponen I, Nelskylä K, Khodjaeva Z, Gorina KA, Sukhikh GT, Maruotti GM, Visentin S, Cosmi E, Ferrari J, Gatti A, Luvero D, Angioli R, Puri L, Palumbo M, D'Urso G, Colaleo F, Chiara Rapisarda AM, Carbone IF, Mollo A, Nazzaro G, Locci M, Guida M, Di Spiezio Sardo A, Panici PB, Berghella V, Flacco ME, Manzoli L, Bifulco G, Scambia G, Zullo F, D'Antonio F, Di Mascio, D., Sen, C., Saccone, G., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., De Los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., De Leon Luis, J. A., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Della Gatta, A. N., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Fabiana Cecchini, D., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Della Sala, F., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Vasciaveo, L., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Di Tizio, L., Gazzolo, D., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Pinto, P. V., Figueiredo, R., Rosello, J. M., Loscalzo, G., Martinez-Varea, A., Diago, V., Lopez, J. S. J., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., De Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Sinai, N. A. B., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Cerar, L. K., Druskovie, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Mollo, A., Nazzaro, G., Locci, M., Guida, M., Di Spiezio Sardo, A., Panici, P. B., Berghella, V., Flacco, M. E., Manzoli, L., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., Di Mascio, Daniele, Sen, Cihat, Saccone, Gabriele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Rodríguez Suárez, María José, Gambacorti-Passerini, Zita Maria, Baz, María de Los Angeles Anaya, Aguilar Galán, Esther Vanessa, López, Yolanda Cuñarro, De León Luis, Juan Antonio, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Luca Schera, Giovanni Battista, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Della Gatta, Anna Nunzia, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Lombana Marino, Maria Giulia, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini D, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado-Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Vasciaveo, Lorenzo, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Di Tizio, Luciano, Gazzolo, Diego, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto-Calvache, Albaro Josè, Burgos-Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Pinto, Pedro Viana, Figueiredo, Rita, Roselló, José Morale, Loscalzo, Gabriela, Martinez-Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, May Feuerschuette, Otto Henrique, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, Moreira de Sa, Renato Augusto, Pittaro, Alejandro, Gonzalez-Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Yapar Eyi, Elif Gül, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski Sinai, Noa A, Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru-Srsen, Tanja, Cerar, Lilijana Kornhauser, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A, Sukhikh, Gennady T, Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Chiara Rapisarda, Agnese Maria, Carbone, Ilma Floriana, Mollo, Antonio, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Di Spiezio Sardo, Attilio, Panici, Pierluigi Benedetti, Berghella, Vincenzo, Flacco, Maria Elena, Manzoli, Lamberto, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, and D'Antonio, Francesco
- Subjects
COVID-19 Vaccine ,Infectious Disease Transmission ,Perinatal Death ,Abortion ,Clinical Laboratory Technique ,Miscarriage ,Cohort Studies ,0302 clinical medicine ,COVID-19 Testing ,Pregnancy ,Risk Factors ,3123 Gynaecology and paediatrics ,Secondary analysis ,Perinatal medicine ,Abortion, Spontaneou ,Medicine ,Vertical ,030212 general & internal medicine ,Viral ,Pregnancy Complications, Infectious ,coronavirus ,perinatal morbidity ,perinatal mortality ,covid-19 ,Coronavirus ,Abortion, Spontaneous ,COVID-19 ,COVID-19 Vaccines ,Clinical Laboratory Techniques ,Coronavirus Infections ,Female ,Gestational Age ,Humans ,Infant, Newborn ,Infant, Premature ,Infectious Disease Transmission, Vertical ,Pandemics ,Pneumonia, Viral ,Pregnancy Outcome ,Reverse Transcriptase Polymerase Chain Reaction ,SARS-CoV-2 ,Betacoronavirus ,Fetal Death ,030219 obstetrics & reproductive medicine ,Obstetrics ,Infectious ,Gestational age ,Obstetrics and Gynecology ,3. Good health ,Settore MED/40 ,Gestation ,Human ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Coronaviru ,Socio-culturale ,Intrauterine device ,03 medical and health sciences ,PARVOVIRUS B19 INFECTION ,Coronavirus, perinatal morbidity, perinatal mortality ,Adverse effect ,Premature ,Fetus ,Betacoronaviru ,Pandemic ,Coronavirus Infection ,business.industry ,Risk Factor ,Spontaneous ,MORTALITY ,Infant ,Odds ratio ,Pneumonia ,medicine.disease ,Newborn ,Pregnancy Complications ,Pediatrics, Perinatology and Child Health ,Pregnancy Complications, Infectiou ,Cohort Studie ,business - Abstract
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8–0.9 per week increase; p Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.
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- 2021
3. Maternal perception of the risk of vertically transmitted infections: the impact of expert counseling
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Alessandra Livi, I. Cataneo, Giuliana Simonazzi, Liliana Gabrielli, Tiziana Lazzarotto, Maria Pia Fantini, Annalisa Carapezzi, Jacopo Lenzi, Cataneo I., Carapezzi A., Livi A., Lenzi J., Fantini M.P., Lazzarotto T., Gabrielli L., and Simonazzi G.
- Subjects
Counseling ,medicine.medical_specialty ,Visual analogue scale ,Quality of life ,risk perception ,Pregnancy ,Medicine ,Humans ,termination of pregnancy ,vertically transmitted infection ,business.industry ,Obstetrics ,General Medicine ,medicine.disease ,Confidence interval ,Maternal perception ,Risk perception ,Pregnancy Trimester, First ,Pregnancy Trimester, Second ,Quality of Life ,Gestation ,Observational study ,Female ,Perception ,business ,Human - Abstract
BACKGROUND Insufficient and imprecise information during pregnancy can lead to an overestimation of maternal and fetal risk associated to various exposures during gestation. OBJECTIVE This study aimed to assess whether expert obstetrical counseling in cases of maternal infections at risk of vertical transmission could impact maternal perception of risk and the tendency to terminate pregnancy. STUDY DESIGN This is a monocentric prospective observational study of 185 consecutive pregnant women with confirmed diagnosis of infectious diseases at risk of vertical transmission during the first or second trimester of pregnancy. Patients were divided into 2 different groups, according to the type infectious disease: infections at high risk of fetal damages and infections at low risk. Every woman included in the study underwent medical counseling with a physician with experience of vertically transmitted infections. Moreover, each woman involved in the study was offered a detailed second trimester ultrasound scan. Maternal concern for their pregnancy and the disposition to interrupt the pregnancy were investigated by 2 questionnaires submitted to patients before and after medical expert counseling; a third questionnaire was completed only by those women who decided to undergo second trimester ultrasound scan at our hospital. RESULTS Of the 185 consecutive patients meeting the inclusion criteria, 171 (92.4%) filled out the visual analog scale for concern about the baby's health both before and after medical consultation. After medical consultation, there was a significant decrease in mean visual analog scale for concern: from 67.1±26.0 to 41.3±28.8 (change score, –25.8; 95% confidence interval, –29.9 to –21.7). Higher baseline levels of concern had more room for reduction, and infections at high fetal risk of damage were associated with lower decrease in concern. However, risk perception decreased in both low-risk and high-risk pregnancies. Notably, 82 patients (53.2%) underwent ultrasonography and filled out the visual analog scale after examination. The mean score after examination was 28.3±24.4 and significantly lower than the mean score registered after consultation (change score, –16.6; 95% confidence interval, –22.9 to –10.3). A total of 162 women (87.6%) declared their tendency to interrupt pregnancy both before and after the consultation. There was a significant decrease in mean tendency from 42.1±32.6 to 22.7±27.1 (change score, –19.4; 95% confidence interval, –23.6 to –15.2). Regression analysis revealed that both low- and high-risk patients significantly reduced their tendency. A total of 73 patients (45.1%) underwent ultrasonography and filled out the visual analog scale after examination. The mean score after examination was 9.9±20.6 and significantly lower than the mean score registered after consultation (change score, –13.4; 95% confidence interval, –19.1 to –7.7). CONCLUSION Our results confirm the importance of a comprehensive and sufficient expert medical counseling that, on one hand, can reduce maternal risk perception, improving quality of life for mothers, and, on the other hand, can lead to feasible results, reducing a woman's disposition to termination of pregnancy.
- Published
- 2021
4. Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery
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Federica Bellussi, Alessandra Livi, Jacopo Lenzi, Gianluigi Pilu, I. Cataneo, Ginevra Salsi, Bellussi, Federica, Livi, Alessandra, Cataneo, Ilaria, Salsi, Ginevra, Lenzi, Jacopo, and Pilu, Gianluigi
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Thorax ,medicine.medical_specialty ,malposition ,Face Presentation ,labor ,ultrasound in labor and delivery ,Ultrasonography, Prenatal ,Labor Presentation ,Fetus ,Pregnancy ,Medicine ,Humans ,Fetal head ,reproductive and urinary physiology ,business.industry ,Obstetrics ,Cesarean Section ,Cephalic presentation ,Infant, Newborn ,Occiput ,intrapartum sonography ,General Medicine ,ultrasound in labor ,Chin ,Position (obstetrics) ,medicine.anatomical_structure ,occiput posterior position ,deflexion ,Female ,business ,Head ,malpresentation - Abstract
Background: Malpositions and deflexed cephalic malpresentations are well recognized causes of dysfunctional labor, may result in fetal and maternal complications, and are diagnosed more precisely with an ultrasound examination than with a digital examination. Objective: This study aimed to assess the incidence of malpositions and deflexed cephalic malpresentations at the beginning of the second stage of labor and to evaluate the role of the sonographic diagnosis of deflexion in the prediction of the mode of delivery. Study design: Women in labor with a singleton pregnancy at term with fetuses in a cephalic presentation at 10 cm of cervical dilatation were prospectively examined. A transabdominal ultrasound was performed to assess the fetal head position by demonstrating the fetal occiput or the eyes. Deflexion was assessed by the measurement of the occiput-spine angle when the occiput was anterior or transverse and by qualitative assessment of the relationship between chin and thorax when the occiput was posterior. Transperineal ultrasound was performed in occiput posterior fetuses to discriminate between sinciput, brow, and face presentation. Maternal, labor, and neonatal parameters including maternal age, induction of labor, use of epidural, birthweight, arterial pH, and neonatal intensive care unit admission were recorded. Patients were divided into 2 groups according to the sonographic diagnosis of head deflexion. Adjusted odds ratios were calculated using multivariate logistic regression to determine the association between cesarean delivery and the 2 groups. In addition, labor and neonatal characteristics were compared between occiput anterior and occiput posterior-occiput transverse fetuses. Results: Of the 200 women at the beginning of the second stage, the fetus was in occiput anterior position in 156 (78%), transverse in 11 (5.5%), and posterior in 33 (16.5%) cases. Deflexion was diagnosed in 33 of 156 (21.2%) occiput anterior fetuses and 19 of 44 (43.2%) occiput posterior and occiput transverse fetuses. Cesarean deliveries were significantly associated with fetal head deflexion both in occiput anterior (P=.001) and occiput posterior (P
- Published
- 2020
5. Is curved three-dimensional ultrasound reconstruction needed to assess the warped pelvic floor plane?
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M. Cavalera, Giovanni Morganelli, Nicola Rizzo, G. Pacella, Elisa Montaguti, Aly Youssef, Gianluigi Pilu, I. Cataneo, and Ginevra Salsi
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education.field_of_study ,Reproducibility ,030219 obstetrics & reproductive medicine ,Pelvic floor ,Radiological and Ultrasound Technology ,Plane (geometry) ,business.industry ,Population ,3D reconstruction ,Obstetrics and Gynecology ,General Medicine ,Anatomy ,03 medical and health sciences ,0302 clinical medicine ,Levator ani ,medicine.anatomical_structure ,Reproductive Medicine ,Coronal plane ,medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Image warping ,education ,business ,Nuclear medicine - Abstract
Objectives Caudal distension of female pelvic floor is common and results in perineal descent and a caudally curved hiatus (so called ‘warping’). All the available ultrasound techniques to date however aim to reconstruct the pelvic floor using linear techniques (flat plane reconstruction). We aimed to evaluate the feasibility, reproducibility and potential usefulness of a new 3D technique, capable of reconstructing a curved plane of the levator hiatus. Methods We recruited a group of primiparous women to perform a 3D/4D transperineal ultrasound 3-6 months after delivery. We evaluated the levator ani warping under Valsalva's maneuver as the distance between the plane running between the pubic rami to anorectal angle and the plane of minimal hiatal dimensions on the coronal plane. Warping distance was used to reconstruct a curved plane using curved Omniview-Volume Contrast Imaging (VCI) technique (C-OV). We assessed intra-, interobserver reproducibility of C-OV as well as intermethod agreement between curved and linear Omniview-VCI (L-OV) for the measurement of pelvic hiatal area under Valsalva. Results Among the 84 women recruited measuring hiatal area using C-OV was feasible in all cases. The warping distance ranged from -3.5 to 9.7 mm, confirming that the traditionally used 1-2 cm-thick linear reconstruction is adequate for proper assessment of pelvic hiatal area in our population. C-OV showed excellent intra, interobserver reproducibility, as well as excellent agreement with the L-OC technique. No systematic difference in any of the performed reproducibility studies. Conclusions 3D reconstruction of the “warped” levator ani muscle plane is feasible and highly reproducible. In our population, the reconstruction of a curved plane to correct for levator ani warping did not offer any benefit in comparison with the traditionally performed linear reconstruction technique.
- Published
- 2017
6. Contents Vol. 42, 2017
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Natasha Macchio, Martin Stepan, Gianluigi Pilu, Zohar Nachum, Tullio Ghi, Courtney Kiss, Susan Crocker, Gabriel Quiroz, Federica Bellussi, Shawna Morrison, Giuliana Simonazzi, Anita J. Moon-Grady, Daniel Martínez, Amy J.M. McNaughton, Darrell L. Cass, Enav Yefet, F. Correa, Stéphanie Friszer, Timothy M. Crombleholme, Gregory A.L. Davies, Hubert Ducou Le Pointe, Alberto Galindo, Jean-Marie Jouannic, Anne-Gaël Cordier, Max B. Mitchell, Yanwei Xi, Naama Schwartz, Juan Manuel Carretero, Helene Perras, Flora Basson, Bienvenido Puerto, Satz Mengensatzproduktion, Mireille Cloutier, Michael Brudno, Noémie Girard, A. Mendoza, Emilie Creede, Catherine Garel, Alison Hamilton, Christina Honeywell, Ahmed I. Marwan, Olga Gómez, Ross Welch, F. Viñals, Mary E. Norton, Regina M. Reynolds, Gregory J. Anger, Alexandra Benachi, Mar Bennasar, Stephen P. Emery, Enrique García-Torres, Aly Youssef, Mahesh Choolani, Enery Gómez-Montes, Pilar Ruiz, Fatima Crispi, Michael R. Harrison, Christine M. Armour, Paul Bussière, Jaroslav Stranik, I. Cataneo, Marian Kacerovsky, Druckerei Stückle, Mark I. Evans, Joshua A. Copel, Ginevra Salsi, Ignacio Herraiz, Ahmet Baschat, Baptiste Morel, Bo Jacobsson, Xudong Liu, Benjamin Viaris de Lesegno, Kuojen Tsao, Aryan Arbabi, Francois I. Luks, Henry L. Galan, Greg Ryan, Ivana Musilova, Danna Hull, Francisco A. Guerra, Matthew Green, D. Escribano, Tillie Chiu, Jan Deprest, Bettina F. Cuneo, Johannes C. von Alvensleben, Tomas Bestvina, Josep M. Martinez, Eduard Gratacós, Catherine Egoroff, Olga Kuzmin, Claire Goldsmith, and Eléonore Blondiaux
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Embryology ,Traditional medicine ,business.industry ,Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business - Published
- 2017
7. A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign
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Ginevra Salsi, Aly Youssef, Gianluigi Pilu, Tullio Ghi, L. Cariello, I. Cataneo, Federica Bellussi, and Giuliana Simonazzi
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Adult ,medicine.medical_specialty ,Vacuum Extraction, Obstetrical ,Pubic symphysis ,Ultrasonography, Prenatal ,Labor Presentation ,Pregnancy ,medicine ,Humans ,Forehead ,Prospective Studies ,Retrospective Studies ,business.industry ,Vaginal delivery ,Retrospective cohort study ,Occiput ,General Medicine ,Fetal Presentation ,Delivery, Obstetric ,Perineum ,Surgery ,Obstetric Labor Complications ,body regions ,medicine.anatomical_structure ,Female ,Presentation (obstetrics) ,business ,Head - Abstract
Background Intrapartum ultrasound scanning has been proposed as an ancillary tool in the decision-making process of instrumental vaginal delivery. Objective The purpose of this study was to evaluate the correlation between the sonographic visualization with a transperineal scan of the fetal occiput or forehead distal to the pubic symphysis with anterior or posterior presentation, respectively (fetal occiput or forehead sign), and the outcome of a vacuum delivery. Study Design We conducted a retrospective cohort study of patients who underwent a vacuum application in our hospital from 2011–2017, excluding outlet applications. In each case, a preliminary transperineal scan was performed to confirm fetal presentation and position and to demonstrate the presence or absence of the fetal occiput or forehead sign. The head direction, angle of progression, and the head perineum distance were also noted. The primary outcome measure was the success of the vacuum. The secondary outcome measures included fetal complications and perineal lacerations. Results A total of 196 consecutive patients were enrolled in the study. The occiput or forehead sign was present in 150 and was associated with a successful vaginal extraction in all cases. Of the 46 cases without the sign, 5 babies (10.8%) were delivered by cesarean section after a failed vacuum (P=.0006). The occiput or forehead sign was also associated with fewer grade 3–4 perineal lacerations (10.7% vs 35.7%; P=.0005) and cephalohematomas, although the difference was not statistically significant (1.4% vs 4.3%). There was a good correlation between the occiput or forehead sign and the other sonographic methods that previously had been proposed to predict a successful vacuum extraction, such as head direction, angle of progression, and head perineum distance. Conclusion In our hands, the fetal occiput or forehead sign was associated strongly with successful vacuum application and with a very low rate of maternal and fetal complications.
- Published
- 2019
8. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion
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Federica Bellussi, Nicola Rizzo, L. Cariello, Ginevra Salsi, J. Krsmanovic, G. Pacella, Gianluigi Pilu, Aly Youssef, Elisa Montaguti, C. Azzarone, M. Paganotto, I. Cataneo, Youssef, A., Salsi, G., Cataneo, I., Pacella, G., Azzarone, C., Paganotto, M.C., Krsmanovic, J., Montaguti, E., Cariello, L., Bellussi, F., Rizzo, N., and Pilu, G.
- Subjects
Radiology, Nuclear Medicine and Imaging ,medicine.medical_treatment ,Anal Canal ,Avulsion ,0302 clinical medicine ,Risk Factors ,Pregnancy ,pelvic floor ,Valsalva maneuver ,Medicine ,Childbirth ,030212 general & internal medicine ,Prospective Studies ,Obstetric Labor Complication ,030219 obstetrics & reproductive medicine ,Pelvic floor ,Radiological and Ultrasound Technology ,Obstetrics ,Vaginal delivery ,4D transperineal ultrasound ,Pregnancy Outcome ,Obstetrics and Gynecology ,General Medicine ,Pelvic Floor Disorder ,medicine.anatomical_structure ,Italy ,Female ,Case-Control Studie ,Human ,Adult ,medicine.medical_specialty ,Birth weight ,fundal pressure ,Kristeller maneuver ,Pelvic Floor Disorders ,03 medical and health sciences ,Labor Stage, Second ,Pressure ,Humans ,business.industry ,Risk Factor ,Odds ratio ,Delivery, Obstetric ,Obstetric Labor Complications ,Prospective Studie ,Reproductive Medicine ,Case-Control Studies ,levator ani muscle ,business ,Body mass index - Abstract
Objective: To investigate the association between application of fundal pressure during the second stage of labor (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury. Methods: This was a prospective case–control study of women recruited immediately after their first vaginal delivery in our university hospital between March 2014 and September 2016. Women who underwent the Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched for body mass index, use of epidural analgesia, duration of second stage of labor and birth weight. All women were invited to undergo four-dimensional (4D) transperineal ultrasound (TPU) 3–6 months postpartum. The main outcome measure was the presence of LAM avulsion on 4D-TPU. TPU results were compared between cases and controls. Multivariate logistic regression analysis was performed to identify independent risk factors for LAM avulsion. Results: During the study period, 134 women in the Kristeller maneuver group and 128 women in the control group underwent TPU assessment. Women who underwent the Kristeller maneuver had a higher prevalence of LAM avulsion than did controls (38/134 (28.4%) vs 18/128 (14.1%); P = 0.005). In addition, women in the Kristeller-maneuver group had a larger hiatal area on maximum Valsalva maneuver and a greater increase in hiatal area from rest to maximum Valsalva. On multivariate logistic regression analysis, use of the Kristeller maneuver was the only independent factor associated with LAM avulsion (odds ratio, 2.5 (95% CI, 1.29–4.51)). Conclusion: The Kristeller maneuver is associated with an increased risk of LAM avulsion when applied in women during their first vaginal delivery. This should be taken into account when deciding to use fundal pressure to accelerate the second stage of labor and when counseling women following childbirth. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2019
9. Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord
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Danila Morano, Antonio Farina, I. Cataneo, Elena Contro, Contro E., Cataneo I., Morano D., and Farina A.
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Adult ,medicine.medical_specialty ,Cord ,Intrauterine growth restriction ,Single umbilical artery ,Pulsatility index ,Ultrasonography, Prenatal ,Umbilical Arteries ,Linear regressions comparison ,Umbilical Cord ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Fetus ,Two-vessel cord ,Pregnancy ,Reference Values ,Internal medicine ,Medicine ,Humans ,Longitudinal Studies ,Longitudinal cohort ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,Umbilical pulsatility index ,General Medicine ,medicine.disease ,030220 oncology & carcinogenesis ,Reference values ,cardiovascular system ,symbols ,Cardiology ,Female ,Reference curve ,business ,Doppler effect - Abstract
Purpose: To determine reference values for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord and to compare these values with standard umbilical Doppler pulsatility index curves from 23 to 40 gestational weeks. Methods: A retrospective longitudinal cohort study was conducted between January 2014 and December 2017 in a tertiary referral hospital and included 62 pregnant women with isolated single umbilical artery (two-vessel cord) and 174 measurements. Only uncomplicated term pregnancies were included. A reference curve for umbilical Doppler pulsatility index was built up and compared with a standard curve commonly used for fetuses with three-vessel cord. Results: Umbilical Doppler pulsatility index values were much lower than expected in cases with two-vessel cord compared to 3-vessel cord: mean of the regression equations was 1.02 ± 0.23 vs. 0.86 ± 0.19, respectively (p value < 0.001). This difference was quite constant across the gestational weeks considered, showing that the slopes of the two regressions were very similar. Conclusion: Reference curves for umbilical Doppler pulsatility index in two-vessel cord pregnancies were determined. Pulsatility index values were significantly different compared with those commonly used for three-vessel cord. Using lower reference values for umbilical pulsatility index in cases with two-vessel cord may allow a better identification of fetuses affected with intrauterine growth restriction, thus improving fetal surveillance.
- Published
- 2019
10. Risk of 22q11.2 deletion in fetuses with right aortic arch and without intracardiac anomalies
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G. Campobasso, V. De Robertis, Paolo Volpe, Nicola Volpe, Tiziana Frusca, Antonella Perolo, Daniela Prandstraller, Gianluigi Pilu, Tullio Ghi, and I. Cataneo
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Aortic arch ,medicine.medical_specialty ,Prenatal diagnosis ,030204 cardiovascular system & hematology ,Intracardiac injection ,03 medical and health sciences ,0302 clinical medicine ,DiGeorge syndrome ,medicine.artery ,medicine ,Radiology, Nuclear Medicine and imaging ,Pregnancy ,030219 obstetrics & reproductive medicine ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Retrospective cohort study ,General Medicine ,medicine.disease ,Surgery ,Reproductive Medicine ,Aortic Arch Syndrome ,Radiology ,business ,Fluorescence in situ hybridization - Abstract
Objective To assess the risk of 22q11.2 deletion in fetuses with a prenatal diagnosis of right aortic arch without intracardiac anomalies (RAA-no ICA). Methods This was a retrospective study of all fetuses with RAA-no ICA diagnosed prenatally at three referral centers, between 2004 and 2014. A detailed sonographic examination was performed in each case, including visualization of the thymus and of the head and neck vessels to identify the presence of an aberrant left subclavian artery (ALSA). Karyotyping and fluorescence in situ hybridization analysis for diagnosis of 22q11.2 deletion were always offered either prenatally or postnatally. Clinical and echocardiographic examinations were performed in livebirths and a postmortem examination in cases of termination of pregnancy. Results During the study period, 85 fetuses were diagnosed prenatally with RAA-no ICA. Genetic or clinical data were not available for three cases and these were excluded from analysis. 22q11.2 deletion was found in 7/82 cases (8.5% (95% CI, 3.8–17.3%)). The thymus was small or non-visualized in all seven cases and additional abnormal sonographic findings were present in four. Conclusion 22q11.2 deletion is present in a clinically significant proportion of fetuses with a prenatal diagnosis of RAA-no ICA. In such cases, a detailed sonographic examination, with assessment of the thymus in particular, may be useful to further define the level of risk for 22q11.2 deletion. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2016
11. Three-dimensional/four-dimensional transperineal ultrasound: clinical utility and future prospects
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Mar Sanz Gascòn, Ginevra Salsi, I. Cataneo, Gianluigi Pilu, Gaia Dodaro, Aly Youssef, Nicola Rizzo, Salsi, Ginevra, Cataneo, Ilaria, Gaia, Dodaro, Rizzo, Nicola, Pilu, Gianluigi, Sanz Gascón, Mar, and Youssef, Aly
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Pelvic floor ,medicine.diagnostic_test ,business.industry ,3D ultrasound ,4D ultrasound ,Obstetrics and Gynecology ,Review ,transperineal ultrasound ,Pelvic Floor Disorders ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Obstetrics and gynaecology ,TPU ,Maternity and Midwifery ,medicine ,Medical physics ,030212 general & internal medicine ,Transperineal ultrasound ,business ,4d ultrasound - Abstract
During the last decade, there has been a huge advancement in the use of transperineal ultrasound (TPU) in the field of obstetrics and gynecology. Its main applications in obstetrics include the monitoring of fetal progression in labor and recently the assessment of maternal pelvic dimensions, whereas in gynecology, TPU is at present widely used for the evaluation of the female pelvic floor, opening new boundaries for the assessment of pelvic floor disorders. The association of volumetric three-dimensional techniques has largely contributed to the remarkable progress that has occurred in the use of TPU. The aim of this paper is to offer an overview of the advantages, challenges and future perspectives of the use of TPU for womenâs imaging.
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- 2017
12. Agreement between two 3D ultrasound techniques for the assessment of the subpubic arch angle
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Nicola Rizzo, C. Azzarone, Federica Martelli, Gianluigi Pilu, Tullio Ghi, Aly Youssef, Federica Bellussi, I. Cataneo, Ginevra Salsi, Youssef, Aly, Salsi, Ginevra, Cataneo, Ilaria, Martelli, Federica, Azzarone, Carlotta, Bellussi, Federica, Ghi, Tullio, Pilu, Gianluigi, and Rizzo, Nicola
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Contrast-enhancing technique ,Reproducibility ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Contrast enhancement ,medicine.diagnostic_test ,Intraclass correlation ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,Contrast imaging ,03 medical and health sciences ,0302 clinical medicine ,Subpubic arch ,Pediatrics, Perinatology and Child Health ,medicine ,3D ultrasound ,030212 general & internal medicine ,Radiology ,subpubic arch angle ,Nuclear medicine ,business ,three-dimensional ultrasound ,Linear reconstruction - Abstract
Objectives: To assess the reliability of a new three-dimensional (3D) ultrasound technique for the measurement of the subpubic arch angle (SPA) and the agreement between two contrast-enhancing 3D ultrasound techniques. Methods: We acquired two static 3D transperineal volumes from 72 nulliparous women using two ultrasound machines equipped with two different 3D contrast enhancement and linear reconstruction softwares: 1. Oblique View Extended Imaging with HD-Volume Imaging (OVIX-HDVI™), Samsung; 2. Omniview with Volume Contrast Imaging (Omniview-VCI™), GE Healthcare. An operator measured SPA once by OVIX-HDVI, and twice by Omniview-VCI, while another operator measured SPA once by Omniview-VCI. We evaluated intra- and inter-observer reproducibility of Omniview-VCI and intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Bland–Altman method. Results: Omniview-VCI SPA measurements showed excellent intraobserver and interobserver reproducibility (ICC 0.970; 95% C.I. 0.952 to 0.981, 0.932; 95% C.I. 0.893 to 0.957, respectively). Furthermore, Omniview VCI SPA measurements demonstrated excellent agreement with those performed by OVIX-HDVI technique (ICC 0.943; 95 C.I. 0.911 to 0.964). No systematic difference was found in any of the reliability studies. Conclusions: OmniView-VCI is a reliable method for SPA assessment. Both OmniView-VCI and OVIX-HDVI can be used interchangeably for SPA measurement.
- Published
- 2017
13. P09.06: The role of fetal cerebral Doppler in the diagnosis of fetomaternal hemorrhage in women with decreased perception of fetal movements
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Ginevra Salsi, Gianluigi Pilu, Aly Youssef, F. Bellussi, I. Cataneo, Maria Gaia Dodaro, and M. Madaro
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medicine.medical_specialty ,Fetus ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,media_common.quotation_subject ,Obstetrics and Gynecology ,General Medicine ,symbols.namesake ,Reproductive Medicine ,Fetomaternal hemorrhage ,Perception ,symbols ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Doppler effect ,media_common - Published
- 2019
14. EP07.26: Interobserver reproducibility of the ultrasound measurement of fetal Sylvian fossa in the second trimester of pregnancy
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R. Rizzo, Alessandra Livi, Ginevra Salsi, F. Bellussi, Elisa Montaguti, Gianluigi Pilu, and I. Cataneo
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medicine.medical_specialty ,Pregnancy ,Fetus ,Radiological and Ultrasound Technology ,Fossa ,biology ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,Interobserver reproducibility ,General Medicine ,biology.organism_classification ,medicine.disease ,Reproductive Medicine ,Second trimester ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2019
15. OC05.07: Prediction of mode of delivery using intrapartum ultrasound in the assessment of fetal head deflexion
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Gianluigi Pilu, Alessandra Livi, Aly Youssef, A. Della Gatta, Ginevra Salsi, F. Bellussi, L. Cariello, and I. Cataneo
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Deflexion ,Mode of delivery ,Reproductive Medicine ,Intrapartum ultrasound ,Medicine ,Radiology, Nuclear Medicine and imaging ,Fetal head ,business - Published
- 2019
16. P17.04: The role of ISUOG guidelines for performance of routine mid‐trimester fetal ultrasound scan in predicting congenital cytomegalovirus infection
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Giuliana Simonazzi, A. Della Gatta, Gianluigi Pilu, I. Cataneo, and Alessandra Livi
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Fetus ,medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Ultrasound scan ,Obstetrics and Gynecology ,Medicine ,Mid trimester ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business - Published
- 2019
17. Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation
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Ginevra Salsi, Gianluigi Pilu, Tullio Ghi, Aly Youssef, I. Cataneo, Federica Bellussi, Giuliana Simonazzi, Bellussi, Federica, Ghi, Tullio, Youssef, Aly, Cataneo, Ilaria, Salsi, Ginevra, Simonazzi, Giuliana, and Pilu, Gianluigi
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Embryology ,Normal flexion ,Rotation ,Sinciput Presentation ,Ultrasonography, Prenatal ,Labor Presentation ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Ultrasound ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,reproductive and urinary physiology ,Retrospective Studies ,Orthodontics ,030219 obstetrics & reproductive medicine ,Malpresentation ,business.industry ,Brow presentation - Sinciput presentation ,Obstetrics and Gynecology ,General Medicine ,Deflexion ,Anatomy ,Dystocia ,Labor ,female genital diseases and pregnancy complications ,Intrapartum ultrasound ,Pediatrics, Perinatology and Child Health ,Female ,Occiput posterior position ,business ,Malposition - Abstract
Objective: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation. Patients and Methods: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography. Results: Normal flexion was inferred in 36/42 cases by a longitudinal sonographic view of the fetal face demonstrating the chin approaching the chest. In the remaining 6, deflexion was diagnosed by visualizing the chin separate and distant from the chest. In 3 of these cases, the orbits were at the same level of the pubis suggesting brow presentation. In the remaining 3 cases, the orbits were above the pubis, and sinciput presentation was inferred. Head deflexion was diagnosed more accurately with ultrasound than clinically and always required a cesarean section versus 36% of cases with OP flexed presentation (p = 0.0052). Conclusions: Fetuses with abnormal labor and OP rotation had deflexed presentations in 14% of cases and were never delivered vaginally. Sonography was far more accurate than the digital examination.
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- 2016
18. Risk of 22q11.2 deletion in fetuses with right aortic arch and without intracardiac anomalies
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A, Perolo, V, De Robertis, I, Cataneo, N, Volpe, G, Campobasso, T, Frusca, T, Ghi, D, Prandstraller, G, Pilu, P, Volpe, Perolo, A, De Robertis, V, Cataneo, I, Volpe, N, Campobasso, G, Frusca, T, Ghi, T, Prandstraller, D, Pilu, G, and Volpe, P
- Subjects
22q11.2 deletion ,prenatal diagnosi ,Aortic Arch Syndromes ,ultrasound ,Thymus Gland ,Ultrasonography, Prenatal ,Cohort Studies ,congenital anomalie ,right aortic arch ,Pregnancy ,Karyotyping ,Prenatal Diagnosis ,DiGeorge Syndrome ,Humans ,Female ,Di George syndrome ,Ultrasonography, Doppler, Color ,In Situ Hybridization, Fluorescence ,Retrospective Studies - Abstract
To assess the risk of 22q11.2 deletion in fetuses with a prenatal diagnosis of right aortic arch without intracardiac anomalies (RAA-no ICA).This was a retrospective study of all fetuses with RAA-no ICA diagnosed prenatally at three referral centers, between 2004 and 2014. A detailed sonographic examination was performed in each case, including visualization of the thymus and of the head and neck vessels to identify the presence of an aberrant left subclavian artery (ALSA). Karyotyping and fluorescence in situ hybridization analysis for diagnosis of 22q11.2 deletion were always offered either prenatally or postnatally. Clinical and echocardiographic examinations were performed in livebirths and a postmortem examination in cases of termination of pregnancy.During the study period, 85 fetuses were diagnosed prenatally with RAA-no ICA. Genetic or clinical data were not available for three cases and these were excluded from analysis. 22q11.2 deletion was found in 7/82 cases (8.5% (95% CI, 3.8-17.3%)). The thymus was small or non-visualized in all seven cases and additional abnormal sonographic findings were present in four.22q11.2 deletion is present in a clinically significant proportion of fetuses with a prenatal diagnosis of RAA-no ICA. In such cases, a detailed sonographic examination, with assessment of the thymus in particular, may be useful to further define the level of risk for 22q11.2 deletion. Copyright © 2015 ISUOG. Published by John WileySons Ltd.
- Published
- 2016
19. OC13.06: Dynamic changes of angle of progression at term and the mode of delivery
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S. Consolini, Gianluigi Pilu, G. Dodaro, Elisa Montaguti, Aly Youssef, and I. Cataneo
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medicine.medical_specialty ,Physical medicine and rehabilitation ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Term (time) - Published
- 2017
20. OC20.02: Dynamic assessment of pelvic hiatal dimensions at term and the mode of delivery in low-risk nulliparous women
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E. Margarito, Nicola Rizzo, Gianluigi Pilu, I. Cataneo, Aly Youssef, and Elisa Montaguti
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Physical therapy ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Dynamic assessment ,business ,Term (time) - Published
- 2017
21. OP19.06: Longitudinal changes of subpubic arch angle during pregnancy
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Adalgisa Pietropolli, Maria Vittoria Capogna, Federica Martelli, Antonella Bruno, Emilio Piccione, Elisa Montaguti, Tullio Ghi, I. Cataneo, and Aly Youssef
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Orthodontics ,Pregnancy ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Subpubic arch ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,medicine.disease - Published
- 2017
22. EP16.03: The role of middle cerebral artery Doppler in the detection of fetal anemia in pregnancy with decreased perception of fetal movements
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Gianluigi Pilu, Ginevra Salsi, F. Bellussi, Giuliana Simonazzi, I. Cataneo, R. Rizzo, and Aly Youssef
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Fetus ,medicine.medical_specialty ,Pregnancy ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Reproductive Medicine ,Fetal anemia ,medicine.artery ,Middle cerebral artery ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2017
23. OP28.09: The levator-urethral gap measurement: tomographic ultrasound imaging (TUI) versus Omniview-volume contrast imaging (VCI)
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Nicola Rizzo, G. Dodaro, Aly Youssef, E. Margarito, Elisa Montaguti, I. Cataneo, and L. Cariello
- Subjects
medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,0206 medical engineering ,Obstetrics and Gynecology ,02 engineering and technology ,General Medicine ,Contrast imaging ,020601 biomedical engineering ,Reproductive Medicine ,Ultrasound imaging ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Volume (compression) - Published
- 2017
24. P04.08: Neonatal head circumference is not a risk factor for levator ani avulsion
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F. Trezza, Aly Youssef, Gianluigi Pilu, I. Cataneo, S. Ciarlariello, and Ginevra Salsi
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Head circumference ,Avulsion ,Levator ani ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Anatomy ,Risk factor ,business - Published
- 2017
25. P04.04: The subpubic arch angle in nulliparous women at term of pregnancy with fetuses in breech presentation
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A. Youssef, I. Cataneo, W. Hussein, and N.A. Eltaweel
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Gynecology ,medicine.medical_specialty ,Fetus ,Pregnancy ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Term (time) ,Reproductive Medicine ,Breech presentation ,Subpubic arch ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2017
26. OC20.01: Larger pelvic hiatal dimensions at term are associated with shorter labour durations in low-risk nulliparous women
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Ginevra Salsi, E. Margarito, I. Cataneo, A. Hamza, Elisa Montaguti, Gianluigi Pilu, Nicola Rizzo, and Aly Youssef
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medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,Obstetrics ,business.industry ,medicine ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Term (time) - Published
- 2017
27. OC01.04: The risk of 22q11.2 deletion in fetuses with a right aortic arch and a normal heart
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Paolo Volpe, Gianluigi Pilu, Tiziana Frusca, Tullio Ghi, Antonella Perolo, I. Cataneo, Nicola Volpe, G. Campobasso, and V. De Robertis
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Aortic arch ,medicine.medical_specialty ,Fetus ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Reproductive Medicine ,Internal medicine ,medicine.artery ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,business ,Normal heart - Published
- 2015
28. P04.06: The effect of fundal pressure (Kristeller manoeuvre) on pelvic floor in primiparous women
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C. Azzarone, Ginevra Salsi, M. Paganotto, J. Krsmanovic, Nicola Rizzo, Aly Youssef, Elisa Montaguti, Giovanni Morganelli, G. Pacella, L. Cariello, I. Cataneo, and Gianluigi Pilu
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medicine.medical_specialty ,Pelvic floor ,medicine.anatomical_structure ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Kristeller manoeuvre - Published
- 2015
29. P01.08: Risk factors associated to fetal loss after chorionic villus sampling
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Elena Contro, A. Piastra, Gianluigi Pilu, Tullio Ghi, Nicola Rizzo, R. Pini, Ginevra Salsi, M. Di Giovanni, Sandro Gabrielli, G. Pacella, L. Cariello, Elisa Montaguti, I. Cataneo, and F. Bellussi
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Andrology ,Reproductive Medicine ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Medicine ,Chorionic villus sampling ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business - Published
- 2014
30. P14.10: Sonographic assessment of fetal occiput position during the second stage of labor: how reliable is the transperineal approach?
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F. Tondi, Elisa Maroni, Federica Bellussi, I. Cataneo, Elisa Montaguti, Nicola Rizzo, Gianluigi Pilu, Tullio Ghi, Aly Youssef, and F. Ravennati
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Transperineal approach ,Obstetrics and Gynecology ,General Medicine ,Surgery ,Position (obstetrics) ,Reproductive Medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Occiput posterior position ,Stage (cooking) ,business - Published
- 2013
31. When the going gets tough, the tough get larger: how is pandemic affecting fetal weight?
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Montaguti E, Fiorentini M, Tibaldi V, Cataneo I, Pellegrino A, Doroldi S, Salsi G, and Pilu G
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- Humans, Pandemics prevention & control, Fetal Weight
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- 2023
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32. A prenatal standard for fetal weight improves the prenatal diagnosis of small for gestational age fetuses in pregnancies at increased risk.
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Visentin S, Londero AP, Cataneo I, Bellussi F, Salsi G, Pilu G, and Cosmi E
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- Female, Fetus, Gestational Age, Humans, Pregnancy, Prenatal Diagnosis, Retrospective Studies, Ultrasonography, Prenatal methods, Fetal Growth Retardation diagnostic imaging, Fetal Weight
- Abstract
Objective: Our aim was to assess diagnostic accuracy in the prediction of small for gestational age (SGA <10th centile) and fetal growth restricted (FGR) (SGA <3rd centile) fetuses using three different sonographic methods in pregnancies at increased risk of fetal growth restriction: 1) fetal abdominal circumference (AC) z-scores, 2) estimated fetal weight (EFW) z-scores according to postnatal reference standard; 3) EFW z-scores according to a prenatal reference standard., Methods: Singleton pregnancies at increased risk of fetal growth restriction seen in two university hospitals between 2014 and 2015 were studied retrospectively. EFW was calculated using formulas proposed by the INTERGROWTH-21st project and Hadlock; data derived from publications by the INTEGROWTH-twenty-first century project and Hadlock were used to calculate z-scores (AC and EFW). The accuracy of different methods was calculated and compared., Results: The study group included 406 patients. Prenatal standard EFW z-scores derived from INTERGROWTH-21st project and Hadlock and co-workers performed similarly and were more accurate in identifying SGA infants than using AC z-scores or a postnatal reference standard. The subgroups analysis demonstrated that EFW prenatal standard was more or similarly accurate compared to other methods across all subgroups, defined by gestational age and birth weight., Conclusions: Prenatal standard EFW z-scores derived from either INTERGROWTH-21 st project or Hadlock and co-workers publications demonstrated a statistically significant advantage over other biometric methods in the diagnosis of SGA fetuses., (© 2022. The Author(s).)
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- 2022
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33. Maternal perception of the risk of vertically transmitted infections: the impact of expert counseling.
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Cataneo I, Carapezzi A, Livi A, Lenzi J, Fantini MP, Lazzarotto T, Gabrielli L, and Simonazzi G
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- Female, Humans, Perception, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Counseling, Quality of Life
- Abstract
Background: Insufficient and imprecise information during pregnancy can lead to an overestimation of maternal and fetal risk associated to various exposures during gestation., Objective: This study aimed to assess whether expert obstetrical counseling in cases of maternal infections at risk of vertical transmission could impact maternal perception of risk and the tendency to terminate pregnancy., Study Design: This is a monocentric prospective observational study of 185 consecutive pregnant women with confirmed diagnosis of infectious diseases at risk of vertical transmission during the first or second trimester of pregnancy. Patients were divided into 2 different groups, according to the type infectious disease: infections at high risk of fetal damages and infections at low risk. Every woman included in the study underwent medical counseling with a physician with experience of vertically transmitted infections. Moreover, each woman involved in the study was offered a detailed second trimester ultrasound scan. Maternal concern for their pregnancy and the disposition to interrupt the pregnancy were investigated by 2 questionnaires submitted to patients before and after medical expert counseling; a third questionnaire was completed only by those women who decided to undergo second trimester ultrasound scan at our hospital., Results: Of the 185 consecutive patients meeting the inclusion criteria, 171 (92.4%) filled out the visual analog scale for concern about the baby's health both before and after medical consultation. After medical consultation, there was a significant decrease in mean visual analog scale for concern: from 67.1±26.0 to 41.3±28.8 (change score, -25.8; 95% confidence interval, -29.9 to -21.7). Higher baseline levels of concern had more room for reduction, and infections at high fetal risk of damage were associated with lower decrease in concern. However, risk perception decreased in both low-risk and high-risk pregnancies. Notably, 82 patients (53.2%) underwent ultrasonography and filled out the visual analog scale after examination. The mean score after examination was 28.3±24.4 and significantly lower than the mean score registered after consultation (change score, -16.6; 95% confidence interval, -22.9 to -10.3). A total of 162 women (87.6%) declared their tendency to interrupt pregnancy both before and after the consultation. There was a significant decrease in mean tendency from 42.1±32.6 to 22.7±27.1 (change score, -19.4; 95% confidence interval, -23.6 to -15.2). Regression analysis revealed that both low- and high-risk patients significantly reduced their tendency. A total of 73 patients (45.1%) underwent ultrasonography and filled out the visual analog scale after examination. The mean score after examination was 9.9±20.6 and significantly lower than the mean score registered after consultation (change score, -13.4; 95% confidence interval, -19.1 to -7.7)., Conclusion: Our results confirm the importance of a comprehensive and sufficient expert medical counseling that, on one hand, can reduce maternal risk perception, improving quality of life for mothers, and, on the other hand, can lead to feasible results, reducing a woman's disposition to termination of pregnancy., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
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34. Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019.
- Author
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D'Antonio F, Sen C, Mascio DD, Galindo A, Villalain C, Herraiz I, Arisoy R, Ovayolu A, Eroğlu H, Canales MG, Ladella S, Cojocaru L, Turan O, Turan S, Hadar E, Brzezinski-Sinai NA, Dollinger S, Uyaniklar O, Ocakouglu SR, Atak Z, Premru-Srsen T, Kornhauser-Cerar L, Druškovič M, Ples L, Gündüz R, Ağaçayak E, Schvartzman JA, Malbran MN, Liberati M, Sebastiano FD, Oronzi L, Cerra C, Buca D, Cagnacci A, Ramone A, Barra F, Carosso A, Benedetto C, Cosma S, Pintiaux A, Daelemans C, Costa E, Özel A, Muhçu M, Lopez JSJ, Alvarado C, Piqueras AL, Oliva DE, Schera GBL, Volpe N, Frusca T, Samardjiski I, Simeonova S, Papestiev IA, Hojman J, Turkcuoglu I, Cromi A, Laganà AS, Ghezzi F, Sirico A, Familiari A, Scambia G, Sukhikh ZKGT, Gorina KA, de Sa RAM, Vaz M, Feuerschuette OHM, Gatta AND, Youssef A, Donna GD, Martinez-Varea A, Loscalzo G, Morales Roselló J, Stefanovic V, Nupponen I, Nelskylä K, Ayala R, Molpeceres RG, Vázquez AP, Sandri F, Cataneo I, Lenzi M, Haberal ET, Huertas E, Sanchez A, Arango P, Bermejo A, Alcantara MMG, Göynümer G, Okuyan E, Madalina C, Guisan AC, Schulte AM, Esposito V, De Robertis V, Zdjelar S, Lackovic M, Mihajlovic S, Jekova N, Saccone G, Aslan MM, Dedda MCD, Chalid M, Canache JEM, Daskalakis G, Antsaklis P, Vega EC, Cueto E, Taccaliti C, Aykanat Y, Özlem Genç Ş, Froessler B, Radulova PA, Morano D, Bianchi B, Marino MGL, Meccariello G, Rohatgi B, Schiattarella A, Morlando M, Colacurci N, Villasco A, Biglia N, Marques ALS, Gatti A, Luvero D, Angioli R, Pittaro A, Lila A, and Zlatohlávková B
- Subjects
- Asia, Australia, Europe, Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Pregnancy, Retrospective Studies, SARS-CoV-2, South America, COVID-19, Pregnancy Complications, Infectious diagnosis, Pregnancy Outcome epidemiology
- Abstract
Background: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations., Objective: This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection., Study Design: This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data., Results: A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P<.001) were independently associated with adverse maternal outcomes., Conclusion: High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection., (Copyright © 2021. Published by Elsevier Inc.)
- Published
- 2021
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35. Childbirth Care among SARS-CoV-2 Positive Women in Italy.
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Donati S, Corsi E, Salvatore MA, Maraschini A, Bonassisa S, Casucci P, Cataneo I, Cetin I, D'Aloja P, Dardanoni G, De Ambrosi E, Ferrazzi E, Fieni S, Franchi MP, Gargantini G, Iurlaro E, Leo L, Liberati M, Livio S, Locci M, Marozio L, Martini C, Maso G, Mecacci F, Meloni A, Mignuoli AD, Patanè L, Pellegrini E, Perotti F, Perrone E, Prefumo F, Ramenghi L, Rusciani R, Savasi V, Schettini SCA, Simeone D, Simeone S, Spinillo A, Steinkasserer M, Tateo S, Ternelli G, Tironi R, Trojano V, Vergani P, and Zullino S
- Subjects
- Cesarean Section, Child, Female, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Italy epidemiology, Pregnancy, Prospective Studies, SARS-CoV-2, COVID-19, Pregnancy Complications, Infectious epidemiology
- Abstract
The new coronavirus emergency spread to Italy when little was known about the infection's impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother-child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother-newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother's milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to "better safe than sorry" care choices. An improvement of the peripartum care indicators was observed over time.
- Published
- 2021
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36. 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
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Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MLAA, Aguilar Galán EV, López YC, De León Luis JA, Hernández IC, Herraiz I, Villalain C, Venturella R, Rizzo G, Mappa I, Gerosolima G, Hellmeyer L, Königbauer J, Ameli G, Frusca T, Volpe N, Luca Schera GB, Fieni S, Esposito E, Simonazzi G, Di Donna G, Youssef A, Della Gatta AN, Di Donna MC, Chiantera V, Buono N, Sozzi G, Greco P, Morano D, Bianchi B, Lombana Marino MG, Laraud F, Ramone A, Cagnacci A, Barra F, Gustavino C, Ferrero S, Ghezzi F, Cromi A, Laganà AS, Laurita Longo V, Stollagli F, Sirico A, Lanzone A, Driul L, Cecchini D F, Xodo S, Rodriguez B, Mercado-Olivares F, Elkafrawi D, Sisti G, Esposito R, Coviello A, Cerbone M, Morlando M, Schiattarella A, Colacurci N, De Franciscis P, Cataneo I, Lenzi M, Sandri F, Buscemi R, Gattei G, Sala FD, Valori E, Rovellotti MC, Done E, Faron G, Gucciardo L, Esposito V, Vena F, Giancotti A, Brunelli R, Muzii L, Nappi L, Sorrentino F, Vasciaveo L, Liberati M, Buca D, Leombroni M, Di Sebastiano F, Di Tizio L, Gazzolo D, Franchi M, Ianniciello QC, Garzon S, Petriglia G, Borrello L, Nieto-Calvache AJ, Burgos-Luna JM, Kadji C, Carlin A, Bevilacqua E, Moucho M, Pinto PV, Figueiredo R, Morales Roselló J, Loscalzo G, Martinez-Varea A, Diago V, Jimenez Lopez JS, Aykanat AY, Cosma S, Carosso A, Benedetto C, Bermejo A, May Feuerschuette OH, Uyaniklar O, Ocakouglu SR, Atak Z, Gündüz R, Haberal ET, Froessler B, Parange A, Palm P, Samardjiski I, Taccaliti C, Okuyan E, Daskalakis G, Moreira de Sa RA, Pittaro A, Gonzalez-Duran ML, Guisan AC, Genç ŞÖ, Zlatohlávková B, Piqueras AL, Oliva DE, Cil AP, Api O, Antsaklis P, Ples L, Kyvernitakis I, Maul H, Malan M, Lila A, Granese R, Ercoli A, Zoccali G, Villasco A, Biglia N, Madalina C, Costa E, Daelemans C, Pintiaux A, Cueto E, Hadar E, Dollinger S, Brzezinski Sinai NA, Huertas E, Arango P, Sanchez A, Schvartzman JA, Cojocaru L, Turan S, Turan O, Di Dedda MC, Molpeceres RG, Zdjelar S, Premru-Srsen T, Cerar LK, Druškovič M, De Robertis V, Stefanovic V, Nupponen I, Nelskylä K, Khodjaeva Z, Gorina KA, Sukhikh GT, Maruotti GM, Visentin S, Cosmi E, Ferrari J, Gatti A, Luvero D, Angioli R, Puri L, Palumbo M, D'Urso G, Colaleo F, Chiara Rapisarda AM, Carbone IF, Mollo A, Nazzaro G, Locci M, Guida M, Di Spiezio Sardo A, Panici PB, Berghella V, Flacco ME, Manzoli L, Bifulco G, Scambia G, Zullo F, and D'Antonio F
- Subjects
- COVID-19, COVID-19 Testing, COVID-19 Vaccines, Clinical Laboratory Techniques, Cohort Studies, Coronavirus Infections diagnosis, Coronavirus Infections epidemiology, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infectious Disease Transmission, Vertical statistics & numerical data, Pandemics, Pneumonia, Viral diagnosis, Pneumonia, Viral epidemiology, Pregnancy, Pregnancy Complications, Infectious epidemiology, Pregnancy Outcome, Reverse Transcriptase Polymerase Chain Reaction, Risk Factors, SARS-CoV-2, Abortion, Spontaneous epidemiology, Betacoronavirus genetics, Betacoronavirus isolation & purification, Coronavirus Infections complications, Fetal Death, Perinatal Death, Pneumonia, Viral complications, Pregnancy Complications, Infectious virology
- Abstract
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.
- Published
- 2020
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37. Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery.
- Author
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Bellussi F, Livi A, Cataneo I, Salsi G, Lenzi J, and Pilu G
- Subjects
- Cesarean Section, Female, Head diagnostic imaging, Humans, Infant, Newborn, Pregnancy, Ultrasonography, Prenatal, Fetus diagnostic imaging, Labor Presentation
- Abstract
Background: Malpositions and deflexed cephalic malpresentations are well recognized causes of dysfunctional labor, may result in fetal and maternal complications, and are diagnosed more precisely with an ultrasound examination than with a digital examination., Objective: This study aimed to assess the incidence of malpositions and deflexed cephalic malpresentations at the beginning of the second stage of labor and to evaluate the role of the sonographic diagnosis of deflexion in the prediction of the mode of delivery., Study Design: Women in labor with a singleton pregnancy at term with fetuses in a cephalic presentation at 10 cm of cervical dilatation were prospectively examined. A transabdominal ultrasound was performed to assess the fetal head position by demonstrating the fetal occiput or the eyes. Deflexion was assessed by the measurement of the occiput-spine angle when the occiput was anterior or transverse and by qualitative assessment of the relationship between chin and thorax when the occiput was posterior. Transperineal ultrasound was performed in occiput posterior fetuses to discriminate between sinciput, brow, and face presentation. Maternal, labor, and neonatal parameters including maternal age, induction of labor, use of epidural, birthweight, arterial pH, and neonatal intensive care unit admission were recorded. Patients were divided into 2 groups according to the sonographic diagnosis of head deflexion. Adjusted odds ratios were calculated using multivariate logistic regression to determine the association between cesarean delivery and the 2 groups. In addition, labor and neonatal characteristics were compared between occiput anterior and occiput posterior-occiput transverse fetuses., Results: Of the 200 women at the beginning of the second stage, the fetus was in occiput anterior position in 156 (78%), transverse in 11 (5.5%), and posterior in 33 (16.5%) cases. Deflexion was diagnosed in 33 of 156 (21.2%) occiput anterior fetuses and 19 of 44 (43.2%) occiput posterior and occiput transverse fetuses. Cesarean deliveries were significantly associated with fetal head deflexion both in occiput anterior (P=.001) and occiput posterior (P<.001) fetuses. Sonographic diagnosis of fetal head deflexion was an independent risk factor for cesarean delivery both in occiput anterior (adjusted odds ratio, 5.37; 95% confidence interval, 1.819-15.869) and occiput posterior (adjusted odds ratio, 13.9; 95% confidence interval, 1.958-98.671) cases, and it was an independent risk factor for cesarean delivery regardless of the occiput position (adjusted odds ratio, 5.83; 95% confidence interval, 2.47-13.73)., Conclusion: The sonographic diagnosis of fetal head deflexion at the beginning of the second stage increases the risk of cesarean delivery., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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38. A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign.
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Bellussi F, Salsi G, Simonazzi G, Youssef A, Cataneo I, Cariello L, Ghi T, and Pilu G
- Subjects
- Adult, Female, Humans, Labor Presentation, Obstetric Labor Complications diagnostic imaging, Pregnancy, Prospective Studies, Retrospective Studies, Delivery, Obstetric methods, Forehead diagnostic imaging, Head diagnostic imaging, Ultrasonography, Prenatal methods, Vacuum Extraction, Obstetrical statistics & numerical data
- Abstract
Background: Intrapartum ultrasound scanning has been proposed as an ancillary tool in the decision-making process of instrumental vaginal delivery., Objective: The purpose of this study was to evaluate the correlation between the sonographic visualization with a transperineal scan of the fetal occiput or forehead distal to the pubic symphysis with anterior or posterior presentation, respectively (fetal occiput or forehead sign), and the outcome of a vacuum delivery., Study Design: We conducted a retrospective cohort study of patients who underwent a vacuum application in our hospital from 2011-2017, excluding outlet applications. In each case, a preliminary transperineal scan was performed to confirm fetal presentation and position and to demonstrate the presence or absence of the fetal occiput or forehead sign. The head direction, angle of progression, and the head perineum distance were also noted. The primary outcome measure was the success of the vacuum. The secondary outcome measures included fetal complications and perineal lacerations., Results: A total of 196 consecutive patients were enrolled in the study. The occiput or forehead sign was present in 150 and was associated with a successful vaginal extraction in all cases. Of the 46 cases without the sign, 5 babies (10.8%) were delivered by cesarean section after a failed vacuum (P=.0006). The occiput or forehead sign was also associated with fewer grade 3-4 perineal lacerations (10.7% vs 35.7%; P=.0005) and cephalohematomas, although the difference was not statistically significant (1.4% vs 4.3%). There was a good correlation between the occiput or forehead sign and the other sonographic methods that previously had been proposed to predict a successful vacuum extraction, such as head direction, angle of progression, and head perineum distance., Conclusion: In our hands, the fetal occiput or forehead sign was associated strongly with successful vacuum application and with a very low rate of maternal and fetal complications., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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39. Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord.
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Contro E, Cataneo I, Morano D, and Farina A
- Subjects
- Adult, Female, Fetus, Humans, Infant, Newborn, Longitudinal Studies, Pregnancy, Reference Values, Retrospective Studies, Umbilical Arteries pathology, Single Umbilical Artery physiopathology, Ultrasonography, Prenatal methods, Umbilical Arteries diagnostic imaging, Umbilical Cord diagnostic imaging
- Abstract
Purpose: To determine reference values for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord and to compare these values with standard umbilical Doppler pulsatility index curves from 23 to 40 gestational weeks., Methods: A retrospective longitudinal cohort study was conducted between January 2014 and December 2017 in a tertiary referral hospital and included 62 pregnant women with isolated single umbilical artery (two-vessel cord) and 174 measurements. Only uncomplicated term pregnancies were included. A reference curve for umbilical Doppler pulsatility index was built up and compared with a standard curve commonly used for fetuses with three-vessel cord., Results: Umbilical Doppler pulsatility index values were much lower than expected in cases with two-vessel cord compared to 3-vessel cord: mean of the regression equations was 1.02 ± 0.23 vs. 0.86 ± 0.19, respectively (p value < 0.001). This difference was quite constant across the gestational weeks considered, showing that the slopes of the two regressions were very similar., Conclusion: Reference curves for umbilical Doppler pulsatility index in two-vessel cord pregnancies were determined. Pulsatility index values were significantly different compared with those commonly used for three-vessel cord. Using lower reference values for umbilical pulsatility index in cases with two-vessel cord may allow a better identification of fetuses affected with intrauterine growth restriction, thus improving fetal surveillance.
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- 2019
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40. The use of ultrasound in the evaluation of postpartum paravaginal hematomas.
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Bellussi F, Cataneo I, Dodaro MG, Youssef A, Salsi G, and Pilu G
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- Female, Hematoma diagnostic imaging, Humans, Retrospective Studies, Ultrasonography, Postpartum Period, Vagina diagnostic imaging
- Abstract
Background: Paravaginal hematoma can be a severe postpartum complication. Diagnosis is challenging because signs and symptoms are often nonspecific. Most of the available literature about diagnostic imaging in these cases focuses on the use of computed tomography or magnetic resonance imaging, and there are very limited data on the use of sonography., Objective: The purpose of this study was to evaluate the usefulness of sonography in the diagnosis of paravaginal hematomas from a review of our own experience., Study Design: This was a retrospective study that included patients with postpartum paravaginal hematoma after vaginal delivery who underwent transabdominal or transperineal ultrasound in our University Hospital in Bologna from 2014-2016. Ultrasound features, dimensions, and relationship with other pelvic organs of the paravaginal hematoma were obtained. Information on patients' characteristics, symptoms, mode of delivery, treatment, and outcomes were recorded., Results: We retrieved 11 cases of paravaginal hematoma after vaginal delivery in which ultrasound scanning was performed. The indications for ultrasound evaluation after delivery were pelvic and/or perianal pain, swelling of the vulva, and urinary retention, frequently in combination. The hematomas were always clearly visualized by sonography performed either transabdominally or transperineally with a full bladder as hypoechoic collections posterior to the vagina. The lesions were found to range in size of 4-10 cm. All patients underwent surgical treatment that consisted of incision of the hematoma and identification and ligature of any feeding vessels; packing was necessary in 8 cases (73%), and drainage was necessary in 5 cases (45%); however, 4 patients (36%) required reintervention., Conclusion: Transabdominal (performed with a full bladder) or transperineal sonography can visualize paravaginal hematomas effectively after vaginal delivery. We suggest that in cases of otherwise unexplained postpartum pelvic and perianal pain, swelling of the vulva, and/or urinary retention, ultrasound can be considered as the first-line imaging tool., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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41. Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion.
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Youssef A, Salsi G, Cataneo I, Pacella G, Azzarone C, Paganotto MC, Krsmanovic J, Montaguti E, Cariello L, Bellussi F, Rizzo N, and Pilu G
- Subjects
- Adult, Anal Canal diagnostic imaging, Case-Control Studies, Delivery, Obstetric methods, Female, Humans, Italy epidemiology, Obstetric Labor Complications epidemiology, Obstetric Labor Complications etiology, Pelvic Floor Disorders etiology, Pregnancy, Pregnancy Outcome, Prospective Studies, Risk Factors, Anal Canal injuries, Labor Stage, Second, Pelvic Floor Disorders epidemiology, Pressure adverse effects
- Abstract
Objective: To investigate the association between application of fundal pressure during the second stage of labor (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury., Methods: This was a prospective case-control study of women recruited immediately after their first vaginal delivery in our university hospital between March 2014 and September 2016. Women who underwent the Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched for body mass index, use of epidural analgesia, duration of second stage of labor and birth weight. All women were invited to undergo four-dimensional (4D) transperineal ultrasound (TPU) 3-6 months postpartum. The main outcome measure was the presence of LAM avulsion on 4D-TPU. TPU results were compared between cases and controls. Multivariate logistic regression analysis was performed to identify independent risk factors for LAM avulsion., Results: During the study period, 134 women in the Kristeller maneuver group and 128 women in the control group underwent TPU assessment. Women who underwent the Kristeller maneuver had a higher prevalence of LAM avulsion than did controls (38/134 (28.4%) vs 18/128 (14.1%); P = 0.005). In addition, women in the Kristeller-maneuver group had a larger hiatal area on maximum Valsalva maneuver and a greater increase in hiatal area from rest to maximum Valsalva. On multivariate logistic regression analysis, use of the Kristeller maneuver was the only independent factor associated with LAM avulsion (odds ratio, 2.5 (95% CI, 1.29-4.51))., Conclusion: The Kristeller maneuver is associated with an increased risk of LAM avulsion when applied in women during their first vaginal delivery. This should be taken into account when deciding to use fundal pressure to accelerate the second stage of labor and when counseling women following childbirth. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd., (Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.)
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- 2019
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42. Three-dimensional/four-dimensional transperineal ultrasound: clinical utility and future prospects.
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Salsi G, Cataneo I, Dodaro G, Rizzo N, Pilu G, Sanz Gascón M, and Youssef A
- Abstract
During the last decade, there has been a huge advancement in the use of transperineal ultrasound (TPU) in the field of obstetrics and gynecology. Its main applications in obstetrics include the monitoring of fetal progression in labor and recently the assessment of maternal pelvic dimensions, whereas in gynecology, TPU is at present widely used for the evaluation of the female pelvic floor, opening new boundaries for the assessment of pelvic floor disorders. The association of volumetric three-dimensional techniques has largely contributed to the remarkable progress that has occurred in the use of TPU. The aim of this paper is to offer an overview of the advantages, challenges and future perspectives of the use of TPU for women's imaging., Competing Interests: Disclosure The authors report no conflicts of interest in this work.
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- 2017
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43. Is curved three-dimensional ultrasound reconstruction needed to assess the warped pelvic floor plane?
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Youssef A, Cavalera M, Pacella G, Salsi G, Morganelli G, Montaguti E, Cataneo I, Pilu G, and Rizzo N
- Subjects
- Adult, Female, Humans, Imaging, Three-Dimensional, Parity, Pelvic Organ Prolapse physiopathology, Predictive Value of Tests, Pregnancy, Prospective Studies, Valsalva Maneuver, Pelvic Floor diagnostic imaging, Pelvic Organ Prolapse diagnostic imaging, Ultrasonography, Prenatal
- Abstract
Objectives: Caudal distension of the female pelvic floor is common and results in perineal descent and a caudally curved levator hiatus (warping). Image reconstruction of the pelvic floor using currently available ultrasound techniques involves a linear approach (flat-plane reconstruction). We aimed to evaluate the feasibility, reproducibility and potential usefulness of a new three-dimensional (3D) technique capable of reconstructing a curved plane of the levator hiatus., Methods: Primiparous women were recruited to undergo a 3D/four-dimensional transperineal ultrasound examination 3-6 months after delivery. Levator ani muscle warping was evaluated on Valsalva maneuver by measuring the distance between the plane extending from the pubic rami to the anorectal angle and the plane of minimal hiatal dimensions on the coronal plane. Warping distance was used to reconstruct a curved plane of the levator hiatus using the curved OmniView volume contrast imaging (VCI) technique (C-OV). Intra- and interobserver reproducibility of the C-OV technique were assessed, as was intermethod agreement between the C-OV technique and the linear OmniView-VCI (L-OV) technique, for the measurement of levator hiatal area on Valsalva maneuver., Results: Measurement of the levator hiatal area using C-OV was feasible in all 84 women recruited. The warping distance ranged from -3.5 to 9.7 mm, confirming that the 1-2-cm slice thickness traditionally used for linear reconstruction was adequate for proper assessment of levator hiatal area in our population. C-OV showed excellent intra- and interobserver reproducibility, as well as excellent agreement with the L-OV technique for measuring levator hiatal area. No systematic difference was demonstrated in any of the reproducibility studies performed., Conclusions: 3D reconstruction of the warped levator hiatal plane is feasible and highly reproducible. In our population, reconstruction of a curved plane to correct for levator hiatal warping did not offer any benefit over the traditionally performed linear reconstruction. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd., (Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.)
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- 2017
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44. Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation.
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Bellussi F, Ghi T, Youssef A, Cataneo I, Salsi G, Simonazzi G, and Pilu G
- Subjects
- Female, Humans, Pregnancy, Retrospective Studies, Labor Presentation, Ultrasonography, Prenatal
- Abstract
Objective: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation., Patients and Methods: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography., Results: Normal flexion was inferred in 36/42 cases by a longitudinal sonographic view of the fetal face demonstrating the chin approaching the chest. In the remaining 6, deflexion was diagnosed by visualizing the chin separate and distant from the chest. In 3 of these cases, the orbits were at the same level of the pubis suggesting brow presentation. In the remaining 3 cases, the orbits were above the pubis, and sinciput presentation was inferred. Head deflexion was diagnosed more accurately with ultrasound than clinically and always required a cesarean section versus 36% of cases with OP flexed presentation (p = 0.0052)., Conclusions: Fetuses with abnormal labor and OP rotation had deflexed presentations in 14% of cases and were never delivered vaginally. Sonography was far more accurate than the digital examination., (© 2017 S. Karger AG, Basel.)
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- 2017
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45. Clinical Validation of the INTERGROWTH-21st Standards of Fetal Abdominal Circumference for the Prediction of Small-for-Gestational-Age Neonates in Italy.
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Bellussi F, Cataneo I, Visentin S, Simonazzi G, Lenzi J, Fantini MP, Mimmi S, Cosmi E, and Pilu G
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- Abdomen embryology, Abdomen growth & development, Fetal Development, Gestational Age, Humans, Italy, Abdomen diagnostic imaging, Infant, Small for Gestational Age, Ultrasonography, Prenatal standards
- 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., (© 2017 S. Karger AG, Basel.)
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- 2017
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46. Risk of 22q11.2 deletion in fetuses with right aortic arch and without intracardiac anomalies.
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Perolo A, De Robertis V, Cataneo I, Volpe N, Campobasso G, Frusca T, Ghi T, Prandstraller D, Pilu G, and Volpe P
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- Aortic Arch Syndromes genetics, Cohort Studies, DiGeorge Syndrome genetics, Female, Humans, In Situ Hybridization, Fluorescence methods, Karyotyping methods, Pregnancy, Retrospective Studies, Ultrasonography, Doppler, Color methods, Ultrasonography, Prenatal methods, Aortic Arch Syndromes diagnostic imaging, DiGeorge Syndrome diagnostic imaging, Prenatal Diagnosis methods, Thymus Gland diagnostic imaging
- Abstract
Objective: To assess the risk of 22q11.2 deletion in fetuses with a prenatal diagnosis of right aortic arch without intracardiac anomalies (RAA-no ICA)., Methods: This was a retrospective study of all fetuses with RAA-no ICA diagnosed prenatally at three referral centers, between 2004 and 2014. A detailed sonographic examination was performed in each case, including visualization of the thymus and of the head and neck vessels to identify the presence of an aberrant left subclavian artery (ALSA). Karyotyping and fluorescence in situ hybridization analysis for diagnosis of 22q11.2 deletion were always offered either prenatally or postnatally. Clinical and echocardiographic examinations were performed in livebirths and a postmortem examination in cases of termination of pregnancy., Results: During the study period, 85 fetuses were diagnosed prenatally with RAA-no ICA. Genetic or clinical data were not available for three cases and these were excluded from analysis. 22q11.2 deletion was found in 7/82 cases (8.5% (95% CI, 3.8-17.3%)). The thymus was small or non-visualized in all seven cases and additional abnormal sonographic findings were present in four., Conclusion: 22q11.2 deletion is present in a clinically significant proportion of fetuses with a prenatal diagnosis of RAA-no ICA. In such cases, a detailed sonographic examination, with assessment of the thymus in particular, may be useful to further define the level of risk for 22q11.2 deletion. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd., (Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.)
- Published
- 2016
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47. Agreement between two 3D ultrasound techniques for the assessment of the subpubic arch angle.
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Youssef A, Salsi G, Cataneo I, Martelli F, Azzarone C, Bellussi F, Ghi T, Pilu G, and Rizzo N
- Abstract
Objectives: To assess the reliability of a new three-dimensional (3D) ultrasound technique for the measurement of the subpubic arch angle (SPA) and the agreement between two contrast-enhancing 3D ultrasound techniques., Methods: We acquired two static 3D transperineal volumes from 72 nulliparous women using two ultrasound machines equipped with two different 3D contrast enhancement and linear reconstruction softwares: 1. Oblique View Extended Imaging with HD-Volume Imaging (OVIX-HDVI™), Samsung; 2. Omniview with Volume Contrast Imaging (Omniview-VCI™), GE Healthcare. An operator measured SPA once by OVIX-HDVI, and twice by Omniview-VCI, while another operator measured SPA once by Omniview-VCI. We evaluated intra- and inter-observer reproducibility of Omniview-VCI and intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Bland-Altman method., Results: Omniview-VCI SPA measurements showed excellent intraobserver and interobserver reproducibility (ICC 0.970; 95% C.I. 0.952 to 0.981, 0.932; 95% C.I. 0.893 to 0.957, respectively). Furthermore, Omniview VCI SPA measurements demonstrated excellent agreement with those performed by OVIX-HDVI technique (ICC 0.943; 95 C.I. 0.911 to 0.964). No systematic difference was found in any of the reliability studies., Conclusions: OmniView-VCI is a reliable method for SPA assessment. Both OmniView-VCI and OVIX-HDVI can be used interchangeably for SPA measurement.
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- 2016
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