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3 results on '"Giulia Dal Molin"'

1. Mode of birth in women with low-lying placenta: protocol for a prospective multicentre 1:3 matched case–control study in Italy (the MODEL-PLACENTA study)

Author

Fabio Facchinetti, Massimo Candiani, Federico Prefumo, Camilla Bulfoni, Patrizia Vergani, Sara Benedetti, Michele Vignali, Sara Lazzarin, Sara Ornaghi, Elisabetta Colciago, Isadora Vaglio Tessitore, Alessandra Abbamondi, Laura Antolini, Anna Locatelli, Annalisa Inversetti, Armando Pintucci, I Cetin, Benedetta Bracco, Elisa Fabbri, Valentina Sala, Mario Meroni, Grazia Volpe, Annamaria Marconi, Federica Lagrasta, Cinzia Lucia Paolini, Elisabetta Mazza, Luca Valsecchi, Maddalena Smid, Federica Pasi, Mirko Pozzoni, Maria Castoldi, Giulia Dal Molin, Alice Guarano, Antonio Pellegrino, Clelia Callegari, Marta Betti, Cristina Zanardini, Valentina Parolin, Anna Catalano, Edoardo Barbolini, Patrizio Antonazzo, Lucrezia Pignatti, Mauro Tintoni, Federico Spelzini, Anna Martinelli, and G Chiossi

Subjects
Medicine
Abstract

Introduction The term placenta praevia defines a placenta that lies over the internal os, whereas the term low-lying placenta identifies a placenta that is partially implanted in the lower uterine segment with the inferior placental edge located at 1–20 mm from the internal cervical os (internal-os-distance). The most appropriate mode of birth in women with low-lying placenta is still controversial, with the majority of them undergoing caesarean section. The current project aims to evaluate the rate of vaginal birth and caesarean section in labour due to bleeding by offering a trial of labour to all women with an internal-os-distance >5 mm as assessed by transvaginal sonography in the late third trimester.Methods and analysis The MODEL-PLACENTA is a prospective, multicentre, 1:3 matched case–control study involving 17 Maternity Units across Lombardy and Emilia-Romagna regions, Italy. The study includes women with a placenta located in the lower uterine segment at the second trimester scan. Women with a normally located placenta will be enrolled as controls. A sample size of 30 women with an internal-os-distance >5 mm at the late third trimester scan is needed at each participating Unit. Since the incidence of low-lying placenta decreases from 2% in the second trimester to 0.4% at the end of pregnancy, 150 women should be recruited at each centre at the second trimester scan. A vaginal birth rate ≥60% in women with an internal-os-distance >5 mm will be considered appropriate to start routinely admitting to labour these women.Ethics and dissemination Ethical approval for the study was given by the Brianza Ethics Committee (No 3157, 2019). Written informed consent will be obtained from study participants. Results will be disseminated by publication in peer-reviewed journals and presentation in international conferences.Trial registration number NCT04827433 (pre-results stage)

Published
2021
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2. Immune Response and Transplacental Antibody Transfer in Pregnant Women after COVID-19 Vaccination

Author

Chiara Lubrano, Alessandro Mancon, Gaia Maria Anelli, Gloria Gagliardi, Roberta Corneo, Micol Bianchi, Chiara Coco, Giulia Dal Molin, Michele Vignali, Irene Schirripa, Nicoletta Di Simone, Giulia Pavone, Antonio Pellegrino, Maria Rita Gismondo, Valeria Maria Savasi, and Irene Cetin

Subjects
COVID-19, SARS-CoV-2, immunization in pregnancy, humoral response, T-cell response, transplacental antibody transfer, Medicine (miscellaneous)
Abstract

COVID-19 infection is associated with increased risk of pregnancy complications, making vaccination during pregnancy critical for mother-neonate dyads. Few data, often with an unrepresentative sample size, are available on SARS-CoV-2 vaccine-induced humoral and cell-mediated response. Here, we evaluated anti-S antibody and interferon-gamma (IFN-γ) production elicited by SARS-CoV-2 immunization in maternal and neonatal plasma. Pregnant women (n = 230) were prospectively enrolled and classified as unvaccinated (n = 103) and vaccinated (n = 127); after serological screening for previous infections, assays were performed on 126 dyads, 15 mothers and 17 newborns. Positive anti-S antibodies were found in most of the vaccinated subjects, regardless of timespan between immunization and delivery (range: 7–391 days). A total of 89 of 92 vaccinated women showed a broad response to COVID-19 immunization and highly effective placental transfer, as attested by anti-S positive rates (maternal = 96.7%, cord = 96.6%). Most of our subjects had indeterminate results in an IGRA assay, preventing a conclusive evaluation of IFN-γ production. Indeed, pregnancy-related hormonal changes may influence T-cell response with an impact on IFN-γ production. Positive pregnancy and perinatal outcomes reinforce the evidence that the anti-SARS-CoV-2 immunization is effective and well-tolerated in pregnant women and also protective for the fetus/neonate, even though it was not possible to define the related IFN-γ production and role.

Published
2023
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3. Different antecedents and neonatal condition in neonatal arterial ischemic stroke and hypoxic-ischemic neonatal encephalopathy

Author

Francesca Moltrasio, Laura Lambicchi, Giuseppe Paterlini, Giulia Dal Molin, Patrizia Vergani, Sara Ornaghi, Davide Paolo Bernasconi, Lambicchi, L, Ornaghi, S, Dal Molin, G, Paterlini, G, Bernasconi, D, Moltrasio, F, and Vergani, P

Subjects
Resuscitation, medicine.medical_specialty, Placenta, Encephalopathy, hypoxic-ischemic neonatal, Umbilical cord, Group A, Group B, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, umbilical artery pH, 030212 general & internal medicine, sentinel event, perinatal asphyxia, Ischemic Stroke, Retrospective Studies, Asphyxia Neonatorum, 030219 obstetrics & reproductive medicine, neonatal arterial ischemic stroke, Obstetrics, business.industry, Neonatal encephalopathy, Infant, Newborn, Obstetrics and Gynecology, General Medicine, encephalopathy, medicine.disease, Perinatal asphyxia, medicine.anatomical_structure, Case-Control Studies, placental histology, Hypoxia-Ischemia, Brain, Apgar Score, neonatal seizure, Apgar score, Female, business
Abstract

Objective To define similarities and differences between neonatal arterial ischemic stroke (NAIS) and hypoxic-ischemic neonatal encephalopathy (HINE). Methods A retrospective case-control study was conducted of neonates born at 35 weeks or more and weighing 1800 g or more at a tertiary care university hospital, between 2005 and 2016, with NAIS (group A), perinatal asphyxia (PA) with Stage II-III HINE (group B), and PA with or without Stage I HINE (group C). Ante- and intrapartum data, neonatal characteristics, and placental histopathology were compared. Results Eleven neonates were identified in group A, 10 in group B, and 227 in group C. Sentinel events occurred exclusively in groups B (80%) and C (41.4%). Umbilical cord blood gas values and Apgar score were worse in groups B and C compared to group A. No group A neonates required resuscitation at birth, whereas all group B and one-third of group C neonates did. Seizures developed only in neonates in groups A and B. One neonatal death occurred in group A. There were no significant differences in placental histopathology. Conclusion NAIS and PA/HINE cases have different intrapartum and neonatal features. PA does not seem necessary for the occurrence of NAIS. More research is needed regarding associated placental abnormalities.

Published
2021

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