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Copyright of Sociologia Italiana is the property of EGEA S.p.A and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Il periodo perinatale rappresenta non solo una fase di transizione, bensì un insieme di processi rispetto ai quali sia la madre che il bambino, che porta con sé in grembo, sono esposti ad una serie di fattori in grado di apportare notevoli modifiche sia morfologiche che epigenetiche. Entrambe nel loro insieme se da un lato sono promotrici di un cambiamento neurobiologico e psichico, dall’altro confermano la presenza di un vero e proprio scambio intrauterino rispetto al quale il background materno è in grado di tradursi in un bagaglio neurochimico pronto ad essere trasmesso al feto. Quest’ultimo infatti se sotto il profilo genetico erediterà un patrimonio genitoriale, sotto quello epigenetico acquisirà viceversa un’impalcatura morfologica e comportamentale correlata ad uno stile espressivo dei geni pronti a guidarlo in maniera adattiva e/o disfunzionale. La salute materna pertanto, riflette quella condizione psichica e biologica che durante la gravidanza può apportare al feto notevoli modifiche, quali riflesso di un proprio modo di stare al mondo. La presenza di una modalità di autoregolazione emotiva disfunzionale in gravidanza, può dunque determinare l’insorgenza di una condizione di stress cronica e ripetitiva in grado di intaccare la lunghezza dei telomeri. I quali possono a loro volta aumentare le probabilità di una ipermetilazione del DNA correlata al possibile esordio di una carcinogenesi.

The perinatal period represents not only a transitional phase but a set of processes with respect to which both mother and child, whom she carries in her womb, are exposed to a series of factors capable of bringing about significant morphological and epigenetic changes. While these are, on the one hand, promoters of neurobiological and psychic changes, on the other, they confirm the presence of a real intrauterine exchange which, depending on the mother's background, is capable of translating into neurochemical baggage ready to be transmitted to the fetus. In fact, while the latter, from a genetic point of view inherits a parental heritage, vice versa from an epigenetic point of view it will acquire a morphological and behavioral framework correlated with a future adaptive and/or dysfunctional mode of expression. Maternal health therefore reflects a psychic and biological condition which, during pregnancy, can bring about considerable changes in the fetus as a reflection of its own way of being in the world. Therefore, the presence of a dysfunctional emotional self-regulation mode in pregnancy, if cumulative, can lead in the long term to the onset of a chronic and/or repetitive stress condition, which risks affecting at a biological level an internal portion of chromatin and more specifically the length of telomeres. These consequently affect the possible increase in DNA methylation related to the possible onset of carcinogenesis. [ABSTRACT FROM AUTHOR]

Acquired haemophilia A (AHA) is a rare bleeding disorder caused by auto-antibodies against clotting factor VIII (FVIII). FVIII auto-antibodies are polyclonal immunoglobulin G directed against the FVIII pro-coagulant activity. There are well-established clinical associations with AHA such as malignancy, autoimmune disease and pregnancy. However, up to 50% of reported cases remain idiopathic. The clinical manifestations of AHA include spontaneous haemorrhages into skin, muscles and soft tissues, or mucous membranes. AHA should be suspected when a patient, with no previous history of bleeding, presents with bleeding and an unexplained prolonged activated partial thromboplastin time (aPTT). The diagnosis is confirmed by specific tests performed by the clinical laboratory. These include: a prolonged aPTT, not-corrected by incubation with normal plasma, the absence of lupus anticoagulant, the selective deficiency of FVIII and, finally, the measurement of the anti-FVIII inhibitor. Here we describe a case of a young women who had given birth two months before, presenting at the First Aid department with a large subcutaneous hematoma on the left lower limb. The coagulation tests showed a prolonged aPTT-Ratio (2.50; r.i. 0.85--1.20), not corrected by incubating a sample of the patient plasma with equal volumes of normal plasma (mixing study). A low FVIII level was detected (3.6 %; r.i. 50-150) and a FVIII inhibitor of 4.79 Bethesda unit (BU) was measured. Corticosteroid treatment was started with prompt resolution of AHA. [ABSTRACT FROM AUTHOR]

Insomnia symptoms are common during peripartum and are considered a critical risk factor for postpartum psychopathology. Sleep is particularly vulnerable during pregnancy and postnatal period and its alterations are associated with risks for mental health. Nonetheless, often insomnia disorder during pregnancy doesn't receive appropriate clinical attention, with consequent lack of proper treatment offer. Evaluation and treatment of insomnia during the prenatal period should be a priority in the clinical practice and should consider the whole family context. Cognitive-behavioral treatment is recognized as first line intervention for insomnia disorder from international guidelines. Many authors highlighted that during pregnancy and during the first months of child's life psychotherapy seems to be more adequate and more favorably accepted from patients than pharmacological treatment. This is also linked with possible negative consequences associated to the assumption of drugs, both for the fetus and the newborn. The aim of this paper is to examine in depth, through a narrative review, the importance of a correct evaluation of the insomnia disorder during the prenatal period and the characteristics of cognitive-behavioral therapy.. [ABSTRACT FROM AUTHOR]

Copyright of Summa, Animali da Reddito is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Upside down, a couple of weeks before birth, the baby "listens" to the extrauterine world that awaits him, traslated and interpreted by the organic reactions of the mother's body. [ABSTRACT FROM AUTHOR]

In this article the author considers the symptom of the post-natal depression as a crisis which bears a meaning and has a direction, and which can represent an opportunity to start up a process of awareness about the complexes that have emerged. Through a detailed description of a clinical case she shows, moreover, the usefulness of dream exploration and the crucial importance of the relation between the analyst and the patient. [ABSTRACT FROM AUTHOR]

Background. The literature claims that an increased risk of complications from pertussis and influenza exists for pregnant women and infants. Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines seem to decrease this risk so that several countries are committed to increase vaccination uptake, but not all of them know their own vaccination coverage and factors that motivate this population to vaccination. Study Design. A cross-sectional survey was conducted. Methods. We conducted this survey to estimate among pregnant women: 1) the vaccine coverage, 2) the availability of information, 3) the knowledge about maternal Tdap and influenza vaccination, 4) the factors that could have driven unvaccinated pregnant women to have themselves vaccinated. In addition, determinants of Tdap and influenza vaccine uptake and correct knowledge about vaccine-preventable diseases and vaccination in pregnancy were assessed using univariate and multivariate analyses. Results. Of the 250 women included in the present study, only 58 (23.2%, 95% Confidence Interval (CI): 18-28.4%) and 21 (8.1%, 95% CI: 5-11.8%) reported that they had been vaccinated with Tdap and influenza vaccine, respectively, during their current pregnancy. The most common reasons cited for getting themselves vaccinated was having background knowledge of the health problems due to the diseases prevented by Tdap and influenza vaccines, awareness regarding these vaccines being recommended in pregnancy, knowledge of their effectiveness and/or side effects, and having been informed about vaccination by a healthcare professional. Conclusions. Influenza and Tdap vaccine uptake among pregnant women in Italy is low, however, the present study showed that women are available to get vaccinated during pregnancy when adequately informed about the vaccines recommended. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Insomnia is a key risk factor for depression and mental disorders, both in general and during peripartum. Covid-19 pandemic outbreak was associated with an alarming increase of insomnia symptoms. This case report aims to describe a digital Cognitive Behavioral Therapy for Insomnia (CBT-I) intervention adapted for pregnancy during the pandemic situation. This article describes the case of a 38 years old woman with significant problems in initiating and maintaining sleep. The intervention was conducted online. The assessment included a clinical psychological interview, semi-structured interview about sleep, sleep diaries and validated questionnaires. Adapted CBT-I protocol was performed including 5 sections lasting 45 minutes each. The case-report description follows CAse REport (CARE) guidelines. The intervention was effective in reducing insomnia symptoms as highlighted by questionnaires and sleep diaries. Furthermore, results showed positive findings with regard to depression symptomatology, stress levels and difficulties in emotion regulation. These positive results were confirmed at post-partum follow ups. Evidence-based CBT-I protocol was applied with relevant benefits for the patient. Furthermore, it was stressed the importance of considering emotions during psychotherapy. High-quality clinical trials evaluating the efficacy of adapted CBT-I in large samples of expecting mothers are suggested to guide changes in gynecological primary care for pregnancy, especially for the post-pandemic time. [ABSTRACT FROM AUTHOR]

Copyright of Animal Technology & Welfare is the property of Institute of Animal Technology of Great Britain and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present paper aims to offer a general picture of sexuality during the perinatal period (from gestation to the first years of the child's life). The physical and psychological changes associated with pregnancy, childbirth and postpartum can influence both the woman's sex life and the couple's sexual health. It is essential to investigate these topics that are often overlooked, considered separately and still surrounded by too many taboos and prejudices. This article reviews existing studies dealing with these topics to offer a general overview and to deepen and discuss their limits for wider considerations. The literature highlights a decline in sexual functions during pregnancy, which then continues to experience in the postpartum period. Most of the studies address the issue of sexuality in pregnancy by examining above all the female experience and highlighting the physical, hormonal and psychological differences during the three trimesters of pregnancy (endogestation) but unfortunately no research deals with the analysis of the post-partum (exogestation). Furthermore, the analysis of the experience of the male partner is almost completely omitted both during pregnancy and during postpartum. The sexuality between the two partners, which in this period undergoes a reduction or even an interruption, is the main theme of this study. There are still too many specialists who recommend abstinence in pregnancy, in any case, without this being supported by scientific evidence. This generates an atmosphere of unfounded fears and anxieties, which undermine the unity of the couple, in a such delicate and special moment, in which a healthy sexual activity would be the cornerstone for maintaining a good relationship in the couple and to prevent and protect the future of the family. It is therefore essential that couples are accompanied by professionals prepared to answer their questions related to sexuality, in order to clarify, without taboos, the many perplexities on an such intimate and complex issue. It is essential to consider the modality of sexual intercourse of each specific couple before pregnancy, in order to be able to speak of decline, normality or pathology in postpartum. It is essential to encourage open and sincere communication between partners, rather than dictating general rules, based on false myths, which influence the frequency, spontaneity or even block sexuality during pregnancy and puerperium. In order to generate by default the natural rapprochement between the two partners, it is necessary to involve the father by structuring the birth accompaniment courses for couple, so that not only the psychological experiences of the mother are explained, but also those of the future father. Giving proper attention to both would represent a revolution that would help to prevent serious problems such as postpartum depression or the increase in divorces (a phenomenon most frequently encountered within the first three years of the child's birth). This contribution also wants to make clear the similarity between the sexual act and the childbirth, which are events influenced by the same identical hormones (oxytocin, endorphins, adrenaline, etc.), which are very sensitive to the context and the environment. In fact the more or less pleasant outcome of the sexual encounter or of the experience of childbirth derives from the hormonal combination. An unprocessed traumatic birth brings with it negative consequences on sexual intercourse in the postpartum. This is why adequate pre-birth training, combined with post-partum sexual counseling, are essential for the support of the two partners, so that they do not feel abandoned to themselves and lacking in communication tools. In conclusion, these are the services that should therefore be increased to resolve the current situation, which is contaminated by misinformation and false myths: refresher courses for health professionals, so that taboos of medical staff are broken; birth accompaniment courses for couples, to ensure that the mother feels supported, the father is informed and prepared and that effective communication develops between the two before the birth of the child; post-partum sexual counseling for couples who have difficulty resuming sexual understanding. Birth is a crucial moment for the development of the ability to love, so the commitment and willingness to know everything around it represents a fundamental help both for couples and for future generations. [ABSTRACT FROM AUTHOR]

L’articolo prende spunto dai gruppi di accompagnamento alla genitorialità organizzati dall’area perinatale di SIPRe Milano durante il primo lockdown causato dal COVID-19, per portare alcune riflessioni inerenti l’esperienza di diventare genitori durante l’insorgere della pandemia. Questo ci ha portato ad osservare alcune tematiche comuni, quale la fatica elaborativa e l’iniziale paralisi del pensiero rispetto alla genitorialità, ma anche come la pandemia è stato un amplificatore di alcune vicissitudini proprie dell’Io soggetto e della sua evoluzione da figlio a genitore e, non meno importante, della sua capacità di trasformare un imprevisto in un’opportunità creativa.

L’articolo tratta il fenomeno della migrazione dal punto di vista psicoanalitico insieme alle tematiche dell’interculturalità e della genitorialità. Tale lavoro vuol fare emergere la condizione di particolare vulnerabilità che caratterizza i soggetti migranti, nel loro confrontarsi con il complesso passaggio alla genitorialità. Le autrici intendono presentare le potenziali difficoltà connesse ai processi migratori, in particolare per quanto riguarda la sofferenza che molte donne vivono lasciando il loro paese d’origine e le violenze fisiche e psicologiche che spesso sono costrette a subire. Il complesso tema della migrazione viene affrontato con riguardo agli aspetti dell’integrazione e alle relative dinamiche che la caratterizzano, all’interno di una visione epistemica dell’essere umano, in cui ciascun soggetto mette a disposizione le proprie fragilità, risorse e competenze in un’ottica di crescita umana. Attraverso il viaggio terapeutico, il viaggio migratorio assume dignità e consistenza permettendo così ad entrambi di esistere.

Copyright of Summa, Animali da Reddito is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Reddito is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pulmonary Arterial Hypertension (PAH) is a rare form of pulmonary hypertension and includes an heterogeneous group of clinical conditions: PAH can be associated to connective tissue disease, HIV infection, portal hypertension, congenital heart disease, schistosomiasis or, in the absence of predisposing diseases, it can be “isolated" (idiopathic, heritable and drug and toxin-induced PAH). In PAH the increase of pulmonary pressure is due to an intrinsic disease of the pulmonary resistance vessels, characterized by vascular proliferation and remodeling. Epidemiological data show a clear preponderance of females; this is particularly evident in the “isolated" PAH forms, while in PAH associated to other diseases the gender ratio is influenced by the epidemiological features of the predisposing condition. The main hypotheses explaining the greater female incidence involve the role of sexual hormones (estrogen), autoimmunity, or an X-linked locus in disease predisposition. Female gender is not associated with a different clinical presentation. However, the age of onset tends to be earlier in females while male patients are at greater risk of mortality despite similar therapeutic management: this could be linked to the influence of sexual hormones which could favor the development of the disease but could also have favorable effects on outcome, especially on treatment response (the “estrogen paradox"). The link between pregnancy and PAH is uncertain. However, the haemodynamic changes that occur during gestation are poorly tolerated by PAH patients: this is reflected in the timing of clinical deterioration and the increased mortality in the late stages of pregnancy when the maximum increase in blood volume and cardiac output occurs. The use of female hormones for birth control and postmenopausal replacements in PAH patients still remains controversial; in fact, even if they have been suspected to be trigger factors for PAH development, a formal association has not been documented. [ABSTRACT FROM AUTHOR]

È noto come la nutrizione della donna in gravidanza condizioni la salute futura del nascituro, ma sempre di più sta emergendo, alla luce dei progressi della ricerca scientifica in epigenetica e biologia molecolare, come lo stato nutrizionale prima del concepimento abbia una profonda influenza, non soltanto sulla salute materna, sulla fertilità, sull'esito delle future gravidanze ma anche sullo stato di salute del nascituro, influendo infatti, sullo sviluppo e funzione dell'unità feto placentare e sul " fetal programming". Nutrienti, sostanze bioattive di origine alimentare o metabolica, sostanze esogene tossiche ed inquinanti, sono in grado di modulare l'espressione genica attivando o reprimendo geni deputati alla regolazione di organi e sistemi, del metabolismo, dell'adipogenesi, del sistema immunitario e dei meccanismo di protezione dai tossici e resistenza allo stress. [ABSTRACT FROM AUTHOR]

Sia in emodialisi che in dialisi peritoneale le gravidanze sono rare e il rischio di eventi avversi per la madre o per il feto è aumentato. Recenti lavori retrospettivi e reviews di casi in DP mostrano un probabile miglioramento degli esiti nel tempo. Tuttavia l'incompletezza dei dati disponibili rende auspicabile la raccolta sistematica di dati prospettici per conoscere la reale frequenza delle gravidanze, delle complicanze e degli esiti e per elaborare raccomandazioni circa la dose dialitica utile a favorire l'esito positivo della gravidanza.

La malattia renale policistica autosomica dominante (ADPKD) rappresenta una delle malattie genetiche più comuni con un’incidenza di 1/1000 nati vivi e, costituisce la principale causa genetica di IRC dell’adulto. Quando una donna affetta da ADPKD pianifica una gravidanza, sia la madre che il feto possono andare in contro a rischi che devono essere attentamente identificati e soppesati per tempo al fine di determinare una scelta più serena e consapevole della gravidanza stessa. L’apporto del team multidisciplinare, utilizzando raccomandazioni e percorsi condivisi, consente di instaurare un opportuno counseling e di migliorare gli outcomes sia materni che fetali e della nefropatia. In questo articolo viene presentata una rassegna della letteratura sulla gravidanza in donne con ADPKD, con particolare attenzione ai rischi per la madre e per il nascituro. Infine, viene riportato un caso clinico emblematico di una gravidanza in una donna con ADPKD risoltosi positivamente.

La diagnosi differenziale nei casi d'insufficienza renale acuta del postpartum associata ad anemia emolitica microangiopatica e trombocitopenia, include, tra le altre: pre-clampsia grave/eclampsia, grave eclampsia, la sindrome HELLP (Hemolysis, Elevated Liver enzyme, Low Platelet), la acute fatty liver of pregnancy (AFLP), la porpora trombotica trombocitopenica/sindrome emolitico-uremica associata alla gravidanza (TTP/aHUS), esordio acuto o flare di LES in gravidanza e la sindrome catastrofica da anticorpi antifosfolipidi (CAPS). Si tratta di condizioni potenzialmente pericolose per la vita data la presenza di disfunzione multiorgano. Il verificarsi di uno stato di ipercoagulabilità e la concentrazione decrescente di ADAMTS 13 in gravidanza e nel post-parto aumentano il rischio di sviluppare porpora trombotica trombocitopenica (TTP). Vi è però una notevole sovrapposizione riguardo la clinica ed i test di laboratorio tra queste condizioni, e quindi la diagnosi può essere un problema anche per clinici esperti. Tuttavia è importante stabilire un'accurata diagnosi poiché la gestione e le complicanze di tali sindromi possono essere differenti. Il caso presentato sottolinea la complessità connessa alla diagnosi differenziale dei quadri clinici che includono anemia emolitica microangiopatica e trombocitopenia connessi alla gravidanza ed il ruolo del plasma exchange nella loro gestione.

La pre-eclampsia è una complicanza relativamente comune della gravidanza, che interessa circa il 3% delle gravidanze. Attualmente, la patogenesi non è stata ancora completamente chiarita. Comunque, la disfunzione endoteliale materna, specialmente a livello della placenta, sembra essere il fattore chiave per lo sviluppo di questa malattia che clinicamente coinvolge molti organi, come reni, cervello e fegato, e che è caratterizzata da ipertensione, proteinuria ed edema. Lavori recenti suggeriscono il ruolo patogenetico di un'alterata espressione di fattori anti-angiogenici placentari con conseguenti modifiche dello stato redox che provocano stress ossidativo. La risposta all'azione dei fattori anti-angiogenetici produce una disfunzione endoteliale sistemica con ipertensione, proteinuria e altre manifestazioni sistemiche, come, per esempio, l'encefalopatia. In questo articolo verranno descritte le conoscenze più recenti nella fisiopatologia della pre-eclampsia, cercando di dare un'ipotesi patogenetica comune per conciliare le ano-malie a livello feto-placentare e le caratteristiche cliniche della sindrome materna e fornire una spiegazione logica per i potenziali futuri interventi profilattici e terapeutici di questa complicanza della gravidanza.

Pregnancy is a time of great physical and psychological changes that affect the identity of the woman, the bond in the couple relationship and the environmental system. The psychoanalytic therapy through the elaboration of lived experiences, the representations and dreams help to accept, elaborate and deal with the difficulties of women in this important step in life. The intense and often conflicting emotional states, the imminence of childbirth emerge and prevail especially in women at first pregnancy. Real and tangible aspects require partial modification of the classical psychoanalytic technique to be able to intervene on the profound changes and the necessary readjustments. The therapist should have predominantly a containing function, rather than an interpretive approach, accompanying the patient and providing a space for reflection. The aim of our work is to make a contribution, in the light of clinical experience of dreams in pregnancy trying to capture and analyze the woman's unconscious world, her conflicts, defenses, changes of identity and the aspects shared by pregnant women in the transition from daughter to being a mother [ABSTRACT FROM AUTHOR]

As with other psychiatric disorders, the literature, also in relation to the etiology of the PPD, asserts the presence of multiple co-causative variables, which already operate during pregnancy, as well as in the postpartum, with the appearance of depressive symptoms. The purpose is to examine the relationship between psychosocial risk variables and the mood of the pregnant, with also the attention on the development of the maternal-fetal bond. A sample of forty-six women, during the third trimester of pregnancy, was administered the EPDS, in order to verify the mood; the psychosocial risk factors form; the PBI, to reveal the early dependence bond; the PAI, to examine the maternal-fetal bond. A week after childbirth and after three months, telephone reviews were carried out and the EPDS was proposed again. The results show that depressive symptoms are already in pregnancy, most intense in the first week after birth compared with that recorded in the third measurement. Their appearance is associated with the presence of stress events before pregnancy; anxiety before and during pregnancy; poor support network; low satisfaction of the couple; low self-esteem; low education. The higher maternal-fetus bonding is associated with an age less than 35 years and with being primiparous. In conclusion, the results identified confirm the central role that some psychosocial risk factors have in the appearance of depressive symptoms already existing during pregnancy and then in the postpartum. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the incidence and causes of renal stones in pregnant women, investigate the reliability and accuracy of diagnostic investigations and to consider the various therapeutic options available. METHODS: A review of the literature was conducted, searching for relevant papers on the physiology of urinary apparatus changes during pregnancy, as well as the etiology, diagnosis and management of renal colic in pregnant women. RESULTS: Standards of care in renal colic during pregnancy include accurate diagnosis primarily with ultrasound, or MRI if necessary, conservative therapy and careful surgical approach for urinary drainage in the first place or ureterorenoscopy when needed. CONCLUSIONS: Renal colic during pregnancy is potentially troublesome and likely to lead to serious adverse effects on both mother and fetus. A multi-disciplinary approach is needed, which includes experts in the fields of Urology, Obstetrics, Radiology and Anesthesiology, to ensure the optimal care of this delicate cohort of patients. [ABSTRACT FROM AUTHOR]