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1. Ultrasound-guided endoscopy to improve accuracy of persistent urogenital sinus (PUGS) diagnosis in adult patient: A case report

Author

Mariateresa Mirandola, Benedetta Gui, Angelica Naldini, Nazario Foschi, Viola Casula, Antonia Carla Testa, Giovanni Scambia, and Ursula Catena

Subjects
endoscopy, hysteroscopy, ultrasound, mullerian malformation, congenital malformation, PUGS-persistent urogenital sinus, Surgery, RD1-811
Abstract

Introductionpersistent urogenital sinus (PUGS) is a rare condition characterized by abnormal communication between the urethra and vagina, that can frequently be associated with other complex Mullerian malformation (33%). We present a case of PUGS associated with a complex Mullerian malformation diagnosed in adult age after the integration of gynecological ultrasound with hysteroscopy, both performed by expert operators.Case description27-year-old women was referred to our clinic because of frequent urinary tract infections and cyclic pelvic pain. She was virgo, with normal menstrual cycles and dysmenorrhea. A didelphys uterus and double vagina with bilateral hematocolpos was firstly diagnosed through transrectal and transabdominal ultrasound. An MRI was then performed and a monorenal and ipsilateral ureteral malformation were diagnosed; in addition, a complete absence of the lower third of the vagina and an abnormal origin of the urethra from the bladder were described. Patient underwent lower genital tract endoscopy: external vaginal orifice was obliterated, a PUGS was diagnosed and both vaginas' ostia were detected on the PUGS's posterior-lateral walls. The procedure was performed under transabdominal ultrasound guidance which confirmed the endoscopic anatomical suspicion, avoiding complications such as perforation and misdiagnosis.Discussionultrasound guided endoscopy plays an essential role in the evaluation of complex anatomic anomalies, such as persistent urogenital sinus (PUGS), leading to a dynamic one-stop diagnosis; it avoids delays and misdiagnosis in preoperative assessment possibly related to the separately application of different radiological and endoscopic techniques.

Published
2023
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2. Gestational Diabetes Mellitus Does Not Worsen Obstetrical and Neonatal Outcomes of Twin Pregnancy

Author

Alice Ronco, Sofia Roero, Silvana Arduino, Arianna Arese, Isabella Ferrando, Gabriella Scaltrito, Viola Casula, Teresa Fea, Mattia Mazza, Carlotta Bossotti, Roberto Zizzo, and Alberto Revelli

Subjects
pregnancy outcome, General Medicine, twin pregnancy, gestational diabetes mellitus
Abstract

The specific effects of gestational diabetes mellitus (GDM) on twin pregnancy outcomes, which are at high risk per se, are unclear. The present study analyzes outcomes of twin pregnancies complicated by GDM (n = 227) by comparing them with GDM singleton pregnancies (n = 1060) and with twin pregnancies without GDM (n = 1008), all followed up at Sant’Anna Hospital, Turin (Italy), between January 2010 and March 2020. The prevalence of GDM among twin pregnancies (n = 1235) was 18.4%. Compared to GDM singletons, GDM twins had higher rates of preeclampsia (aOR 2.0; 95% CI 1.2–3.8), cesarean section (aOR 7.5; 95% CI 5.2–10.8), and neonatal hypoglycemia (aOR 2.5; 95% CI 1.1–5.3). They had a higher incidence of abnormal 2 h OGTT values (aOR 7.1; 95% CI: 3.2–15.7) and were less likely to require insulin therapy (aOR 0.5; 95% CI: 0.3–0.7). In comparison with twin pregnancies without GDM, women with GDM twins were significantly older (35.0 vs. 33.0 years; p < 0.001) and had higher BMI (23.0 versus 22.0 kg/m2; p < 0.001); they had a higher incidence of LGA newborns (aOR 5.3; 95% CI 1.7–14.8), and lower incidence of low APGAR scores (0.5; 95% CI 0.3–0.9). Overall, GDM does not worsen outcomes of twin pregnancy, which is per se at high risk for adverse outcomes.

Published
2023

3. The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

Author

Elisa Longhitano, Rossella Siligato, Massimo Torreggiani, Rossella Attini, Bianca Masturzo, Viola Casula, Ida Matarazzo, Gianfranca Cabiddu, Domenico Santoro, Elisabetta Versino, and Giorgina Barbara Piccoli

Subjects
General Medicine
Abstract

About 5–10% of pregnancies are complicated by one of the hypertensive disorders of pregnancy. The women who experience these disorders have a greater risk of having or developing kidney diseases than women with normotensive pregnancies. While international guidelines do not provide clear indications for a nephrology work-up after pregnancy, this is increasingly being advised by nephrology societies. The definitions of the hypertensive disorders of pregnancy have changed greatly in recent years. The objective of this short review is to gather and comment upon the main definitions of the hypertensive disorders of pregnancy as a support for nephrologists, who are increasingly involved in the short- and long-term management of women with these disorders.

Published
2022

4. Plant-Based Diets Improve Maternal-Fetal Outcomes in CKD Pregnancies

Author

Rossella Attini, Filomena Leone, Antoine Chatrenet, Elisa Longhitano, Viola Casula, Alice Tomasi Cont, Gaia Zaccaria, Eleonora Dalmasso, Ana Maria Manzione, Bianca Masturzo, Massimo Torreggiani, Alberto Revelli, Gianfranca Cabiddu, and Giorgina Barbara Piccoli

Subjects
Adult, Nutrition and Dietetics, chronic kidney disease, plant-based diets, preeclampsia, pregnancy complications, preterm delivery, small for gestational age, Diet, Vegetarian, Infant, Newborn, Pregnancy Outcome, Proteinuria, Pregnancy, Diet, Protein-Restricted, Humans, Premature Birth, Female, Renal Insufficiency, Chronic, Food Science
Abstract

Reducing protein intake in patients with chronic kidney disease (CKD) limits glomerular stress induced by hyperfiltration and can prevent the progression of kidney disease; data in pregnancy are limited. The aim of this study is to analyze the results obtained in CKD patients who followed a plant-based moderately protein-restricted diet during pregnancy in comparison with a propensity-score-matched cohort of CKD pregnancies on unrestricted diets. A total of 52 CKD pregnancies followed up with a protein-restricted plant-based diet (Torino, Italy) were matched with a propensity score based on kidney function and proteinuria with CKD pregnancies with unrestricted protein intake (Cagliari Italy). Outcomes included preterm (

Published
2022

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