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1. NT >99th centile and cystic hygroma: Which diagnosis, which management and outcome.

Author

Vasciaveo, L., Mastricci, A. L., De Lucia, G., Zanzarelli, E., De Feo, V., Giansiracusa, E., Di Biase, S., and Nappi, L.

Abstract

Objectives: To evaluate the prevalence of chromosomal anomalies in fetuses affected by increased nuchal translucency(iNT >99Th centile), cystic hygroma (CH) and cases progressing to fetal hydrops (NIHF) in order to correlate this result to prognosis and perinatal fetal outcomes, improving patient's counseling. Methods: From January 2020 to December 2023, first trimester screening according to FMF criteria were performed in "Maternal fetal medicine Unit" of Foggia's hospital. We studied and collected clinical data of fetuses affected by nuchal translucency >99th centile (iNT), CH and cases progressing to Fetal Hydrops (non‐immune fetal hydrop, NIFH). In these selected cases, we evaluated fetal Karyotype to demonstrate the presence of chromosomal abnormalities, associated to fetal structural anomalies and different pregnancy outcome. Results: We have evaluated 45 cases of iNT, CH, and NIFH, identified by ultrasound during first trimester screening. Of these 45 pregnant women, four were lost to follow‐up. Of the 41 pregnancies, 20 cases (48.8%) delivered at our division with newborns discharged in good health. Of the 21 patients (51.2%) who miscarried, only two miscarried spontaneously; the other 19 decided on a medical termination of pregnancy (MTP). The 19 patients who decided for MTP showed genetic abnormalities and/or malformation. The 20 cases of fetuses discharged as healthy newborns were enrolled with the following diagnoses: 5 had a diagnosis of CH (20% of cases), 1 case of NIFH (5% of cases), and 14 of iNT (75% of cases). All these fetuses had a normal karyotype and no major malformations. Conclusions: Isolated CH diagnosis is more frequent than described in Literature (5 cases out of 12: 41.7%) and their prognosis are better than previously described, with the same outcomes of fetuses with iNT without associated anomalies. The possibility of early diagnosis of chromosomal anomalies, associated malformations or the evolution into hydrops is essential for a complete consultation. [ABSTRACT FROM AUTHOR]

Published
2024
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2. miRNA as a liquid biomarker to detect malignancy in small testicular masses

Author

Chavarriaga, J., primary, Langleben, C., additional, Lobo, J., additional, Nappi, L., additional, Yousef, G.M., additional, Janfaza, S., additional, Tavares, N.T., additional, Ding, Q., additional, Bobrowski, A., additional, Prendeville, S., additional, Anson-Cartwright, L., additional, Jeronimo, C., additional, Wagner, H., additional, Jarvi, K., additional, O’malley, M., additional, Leao, R., additional, Lajkosz, K., additional, and Hamilton, R., additional

Published
2024
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5. Reduced prevalence of fetal exposure to alcohol in Italy: a nationwide survey

Author

Camandona, F, Vaccari, L, Travan, L, Maso, G, Stampalija, T, Zanazzo, L, Pisana, P, Driul, L, Barbui, E, Caissutti, C, Valente, E, Ricchi, A, Bettiga, E, Piccolo, E, Pati, M, Pedori, S, Antonazzo, P, Sottile, G, Lo Faro, F, Tini, A, Massacesi, M, Rapisarda, C, Vivirito, G, Pinna, G, D'Anna, M, Klein, L, Bucolo, A, D'Anna, R, Monaco, C, La Ferrera, G, Capobianco, G, Olzai, M, Angioni, S, D'Alterio, M, Serravalle, P, Vicquery, C, Scalchi, S, Morando, C, Meneghin, M, Scapolan, C, Maggino, T, Guarinoni, B, Cristina Napolitano, G, De Vita, M, Di Carlo, C, Interlandi, F, Bisceglia, M, Michelangelo, B, Arnulfo, A, Finale, E, Marozio, L, Natali, I, Grazia, S, Staffler, A, Tarani, L, Coriale, G, Messina, M, D'Angelo, A, Bonito, M, Haass, C, Capasso, L, Raimondi, F, De Bernardo, G, Iacobelli, P, Spadarella, S, Enrica, M, Rabuano, R, Calzatini, F, Bossi, A, Aversa, S, Prefumo, F, Bellan, C, Leone, G, Ciammella, M, Von-Wunster, S, Liguori, A, Ornaghi, S, Fumagalli, S, Sanguineti, F, Gianola, G, Cagnacci, A, Amidani, A, Sisto, A, Di Marcello, F, Santillo, V, Di Bartolomeo, C, Gerli, S, Cagnoli, G, Petrisano, M, Pesce, S, Di Lascio, N, Falvino, S, Appio, P, Targiani, V, Cavaliere, A, Turrini, I, Belli, G, Beatrice, G, Florio, P, Innocenti, E, Magi, L, Civitelli, F, Nappi, L, Sorrentino, F, Silvestris, T, Indrio, F, Laforgia, N, Rizzo, V, La Rocca, M, Pradal, U, Memo, L, Diaz, C, Riscica, P, Bazzo, S, La Maida, N, Di Giorgi, A, Pellegrini, M, Ceccanti, M, Caruso, S, Ricci, G, Neri, I, Lana, S, Minutillo, A, Berretta, P, Busardo, F, Pichini, S, Camandona F., Vaccari L., Travan L., Maso G., Stampalija T., Zanazzo L., Pisana P., Driul L., Barbui E., Caissutti C., Valente E., Ricchi A., Bettiga E., Piccolo E., Pati M., Pedori S., Antonazzo P., Sottile G., Lo Faro F., Tini A., Massacesi M., Rapisarda C., Vivirito G., Pinna G., D'anna M., Klein L., Bucolo A., D'Anna R., Monaco C., La Ferrera G., Capobianco G., Olzai M. G., Angioni S., D'Alterio M. N., Serravalle P., Vicquery C., Scalchi S., Morando C., Meneghin M., Scapolan C., Maggino T., Guarinoni B., Cristina Napolitano G. M., De Vita M. G., Di Carlo C., Interlandi F., Bisceglia M., Michelangelo B., Arnulfo A., Finale E., Marozio L., Natali I., Grazia S. M., Staffler A., Tarani L., Coriale G., Messina M. P., D'Angelo A., Bonito M., Haass C., Capasso L., Raimondi F., De Bernardo G., Iacobelli P., Spadarella S., Enrica M., Rabuano R., Calzatini F., Bossi A., Aversa S., Prefumo F., Bellan C., Leone G., Ciammella M., Von-Wunster S., Liguori A., Ornaghi S., Fumagalli S., Sanguineti F., Gianola G., Cagnacci A., Amidani A., Sisto A., Di Marcello F., Santillo V., Di Bartolomeo C., Gerli S., Cagnoli G., Petrisano M., Pesce S., Di Lascio N., Falvino S., Appio P., Targiani V., Cavaliere A. F., Turrini I., Belli G., Beatrice G., Florio P., Innocenti E. D., Magi L., Civitelli F., Nappi L., Sorrentino F., Silvestris T., Indrio F., Laforgia N., Rizzo V., La Rocca M., Pradal U., Memo L., Diaz C., Riscica P., Bazzo S., La Maida N., Di Giorgi A., Pellegrini M., Ceccanti M., Caruso S., Ricci G., Neri I., Lana S., Minutillo A., Berretta P., Busardo F. P., Pichini S., Camandona, F, Vaccari, L, Travan, L, Maso, G, Stampalija, T, Zanazzo, L, Pisana, P, Driul, L, Barbui, E, Caissutti, C, Valente, E, Ricchi, A, Bettiga, E, Piccolo, E, Pati, M, Pedori, S, Antonazzo, P, Sottile, G, Lo Faro, F, Tini, A, Massacesi, M, Rapisarda, C, Vivirito, G, Pinna, G, D'Anna, M, Klein, L, Bucolo, A, D'Anna, R, Monaco, C, La Ferrera, G, Capobianco, G, Olzai, M, Angioni, S, D'Alterio, M, Serravalle, P, Vicquery, C, Scalchi, S, Morando, C, Meneghin, M, Scapolan, C, Maggino, T, Guarinoni, B, Cristina Napolitano, G, De Vita, M, Di Carlo, C, Interlandi, F, Bisceglia, M, Michelangelo, B, Arnulfo, A, Finale, E, Marozio, L, Natali, I, Grazia, S, Staffler, A, Tarani, L, Coriale, G, Messina, M, D'Angelo, A, Bonito, M, Haass, C, Capasso, L, Raimondi, F, De Bernardo, G, Iacobelli, P, Spadarella, S, Enrica, M, Rabuano, R, Calzatini, F, Bossi, A, Aversa, S, Prefumo, F, Bellan, C, Leone, G, Ciammella, M, Von-Wunster, S, Liguori, A, Ornaghi, S, Fumagalli, S, Sanguineti, F, Gianola, G, Cagnacci, A, Amidani, A, Sisto, A, Di Marcello, F, Santillo, V, Di Bartolomeo, C, Gerli, S, Cagnoli, G, Petrisano, M, Pesce, S, Di Lascio, N, Falvino, S, Appio, P, Targiani, V, Cavaliere, A, Turrini, I, Belli, G, Beatrice, G, Florio, P, Innocenti, E, Magi, L, Civitelli, F, Nappi, L, Sorrentino, F, Silvestris, T, Indrio, F, Laforgia, N, Rizzo, V, La Rocca, M, Pradal, U, Memo, L, Diaz, C, Riscica, P, Bazzo, S, La Maida, N, Di Giorgi, A, Pellegrini, M, Ceccanti, M, Caruso, S, Ricci, G, Neri, I, Lana, S, Minutillo, A, Berretta, P, Busardo, F, Pichini, S, Camandona F., Vaccari L., Travan L., Maso G., Stampalija T., Zanazzo L., Pisana P., Driul L., Barbui E., Caissutti C., Valente E., Ricchi A., Bettiga E., Piccolo E., Pati M., Pedori S., Antonazzo P., Sottile G., Lo Faro F., Tini A., Massacesi M., Rapisarda C., Vivirito G., Pinna G., D'anna M., Klein L., Bucolo A., D'Anna R., Monaco C., La Ferrera G., Capobianco G., Olzai M. G., Angioni S., D'Alterio M. N., Serravalle P., Vicquery C., Scalchi S., Morando C., Meneghin M., Scapolan C., Maggino T., Guarinoni B., Cristina Napolitano G. M., De Vita M. G., Di Carlo C., Interlandi F., Bisceglia M., Michelangelo B., Arnulfo A., Finale E., Marozio L., Natali I., Grazia S. M., Staffler A., Tarani L., Coriale G., Messina M. P., D'Angelo A., Bonito M., Haass C., Capasso L., Raimondi F., De Bernardo G., Iacobelli P., Spadarella S., Enrica M., Rabuano R., Calzatini F., Bossi A., Aversa S., Prefumo F., Bellan C., Leone G., Ciammella M., Von-Wunster S., Liguori A., Ornaghi S., Fumagalli S., Sanguineti F., Gianola G., Cagnacci A., Amidani A., Sisto A., Di Marcello F., Santillo V., Di Bartolomeo C., Gerli S., Cagnoli G., Petrisano M., Pesce S., Di Lascio N., Falvino S., Appio P., Targiani V., Cavaliere A. F., Turrini I., Belli G., Beatrice G., Florio P., Innocenti E. D., Magi L., Civitelli F., Nappi L., Sorrentino F., Silvestris T., Indrio F., Laforgia N., Rizzo V., La Rocca M., Pradal U., Memo L., Diaz C., Riscica P., Bazzo S., La Maida N., Di Giorgi A., Pellegrini M., Ceccanti M., Caruso S., Ricci G., Neri I., Lana S., Minutillo A., Berretta P., Busardo F. P., and Pichini S.

Published
2023

7. The ART of Thromboprophylaxis in the Prevention of Gestational Venous Thromboembolism

Author

Grandone, E., Barcellona, D., Intrieri, M., Tiscia, G., Nappi, L., and Othman, M.

Subjects
assisted reproductive techniques, venous thromboembolism, pregnancy, risk factors, Hematology, Cardiology and Cardiovascular Medicine
Abstract

Assisted reproductive techniques (ART) allow infertile couples to conceive. Use of hormones to obtain a controlled ovarian stimulation and an adequate growth of the endometrium preparatory for embryo implantation are not riskless. Among others, thrombotic events can occur during the ovulation induction or pregnancy following ART. As the number of women approaching ART to conceive is steadily increasing, the issue of thrombotic risk in this setting is relevant. Data on the weight of each risk factor and on potential benefit of thromboprophylaxis are largely lacking. In this review, we discuss risk of venous thromboembolism during pregnancy following ART, with a focus on general (i.e.: age, body mass index, thrombophilia, bed rest, transfusions) and ART-specific (i.e., polycystic ovarian syndrome, ovarian hyperstimulation syndrome) risk factors. We also attempt to provide some suggestions to guide clinical practice, based on available data and studies performed outside ART.

Published
2022

9. Adverse intrapartum outcome in pregnancies complicated by small for gestational age and late fetal growth restriction undergoing induction of labor with Dinoprostone, Misoprostol or mechanical methods: A systematic review and meta-analysis

Author

Familiari, A, Khalil, A, Rizzo, G, Odibo, A, Vergani, P, Buca, D, Hidaka, N, Di Mascio, D, Nwabuobi, C, Simeone, S, Mecacci, F, Visentin, S, Cosmi, E, Liberati, M, D'Amico, A, Flacco, M, Martellucci, C, Manzoli, L, Nappi, L, Iacovella, C, Bahlmann, F, Melchiorre, K, Scambia, G, Berghella, V, D'Antonio, F, Familiari A., Khalil A., Rizzo G., Odibo A., Vergani P., Buca D., Hidaka N., Di Mascio D., Nwabuobi C., Simeone S., Mecacci F., Visentin S., Cosmi E., Liberati M., D'Amico A., Flacco M. E., Martellucci C. A., Manzoli L., Nappi L., Iacovella C., Bahlmann F., Melchiorre K., Scambia G., Berghella V., D'Antonio F., Familiari, A, Khalil, A, Rizzo, G, Odibo, A, Vergani, P, Buca, D, Hidaka, N, Di Mascio, D, Nwabuobi, C, Simeone, S, Mecacci, F, Visentin, S, Cosmi, E, Liberati, M, D'Amico, A, Flacco, M, Martellucci, C, Manzoli, L, Nappi, L, Iacovella, C, Bahlmann, F, Melchiorre, K, Scambia, G, Berghella, V, D'Antonio, F, Familiari A., Khalil A., Rizzo G., Odibo A., Vergani P., Buca D., Hidaka N., Di Mascio D., Nwabuobi C., Simeone S., Mecacci F., Visentin S., Cosmi E., Liberati M., D'Amico A., Flacco M. E., Martellucci C. A., Manzoli L., Nappi L., Iacovella C., Bahlmann F., Melchiorre K., Scambia G., Berghella V., and D'Antonio F.

Abstract

Objective: To investigate the outcome of pregnancies with small baby, including both small for gestational age (SGA) and late fetal growth restriction (FGR) fetuses, undergoing induction of labor (IOL) with Dinoprostone, Misoprostol or mechanical methods. Study design: Medline, Embase and Cochrane databases were searched. Inclusion criteria were non-anomalous singleton pregnancies complicated by the presence of a small fetus, defined as a fetus with estimated fetal weight (EFW) or abdominal circumference (AC) <10th centile undergoing IOL from 34 weeks of gestation with vaginal Dinoprostone, vaginal misoprostol, or mechanical methods (including either Foley or Cook balloon catheters). The primary outcome was a composite measure of adverse intrapartum outcome. Secondary outcomes were the individual components of the primary outcome, perinatal mortality and morbidity. All the explored outcomes were reported in three different sub-groups of pregnancies complicated by a small fetus including: all small fetuses (defined as those with an EFW and/or AC <10th centile irrespective of fetal Doppler status), late FGR fetuses (defined as those with EFW and/or AC <3rd centile or AC/EFW <10th centile associated with abnormal cerebroplacental Dopplers) and SGA fetuses (defined as those with EFW and/or AC <10th but >3rd centile with normal cerebroplacental Dopplers). Quality assessment of each included study was performed using the Risk of Bias in Non-randomized Studies-of Interventions tool (ROBINS-I), while the GRADE methodology was used to assess the quality of the body of retrieved evidence. Meta-analyses of proportions and individual data random-effect logistic regression were used to analyze the data. Results: 12 studies (1711 pregnancies) were included. In the overall population of small fetuses, composite adverse intra-partum outcome occurred in 21.2 % (95 % CI 10.0−34.9) of pregnancies induced with Dinoprostone, 18.0 % (95 % CI 6.9−32.5) of those with Miso

Published
2020

10. Reproductive and pregnancy outcomes of fertility-sparing treatments for early-stage endometrial cancer or atypical hyperplasia: A systematic review and meta-analysis

Author

De Rocco, S., Buca, D., Oronzii, L., Petrillo, M., Fanfani, Francesco, Nappi, L., Liberati, M., D'Antonio, F., Scambia, Giovanni, Leombroni, M., Dessole, M., Lucidi, A., Fanfani F. (ORCID:0000-0003-1991-7284), Scambia G. (ORCID:0000-0003-2758-1063), De Rocco, S., Buca, D., Oronzii, L., Petrillo, M., Fanfani, Francesco, Nappi, L., Liberati, M., D'Antonio, F., Scambia, Giovanni, Leombroni, M., Dessole, M., Lucidi, A., Fanfani F. (ORCID:0000-0003-1991-7284), and Scambia G. (ORCID:0000-0003-2758-1063)

Abstract

Objective: To report the pregnancy outcomes of women with prior endometrial cancer and endometrial hyperplasia managed with fertility-sparing treatments. Methods: Medline and Embase databases were searched. Inclusion criteria were studies reporting the pregnancy outcomes of women who had undergone fertility-sparing treatments for endometrial hyperplasia or early endometrioid endometrial cancer. Outcomes explored were pregnancy, miscarriage and livebirth rates according to the type of progestin treatment used. Subgroup analyses according to the type of diagnostic follow-up were also performed. Meta-analyses of proportions using a random effects model were used to combine data. Results: Twenty-nine studies (1036 women) were included, and 82.8% [95% confidence interval (CI) 72.3–91.2] of women achieved complete remission. Pregnancy rates were 56.3% (95% CI 41.6–70.5) with megestrol (MA) or medroxyprogesterone acetate (MPA), 63.1% (95% CI 37.0–85.6) with levonorgestrel-releasing intrauterine device (LNG-IUD), 57.9% (95% CI 37.7–76.8) with MA or MPA and metformin, 59.8% (95% CI 48.3–70.7) with MPA and LNG-IUD, 15.4% (95% CI 4.3–42.2) with gonadotropin-releasing hormone analogue (GnRHa) combined with LNG-IUD or letrozole, and 40.7% (95% CI 24.5–59.3) with LNG-IUD and GnRHa. Miscarriage rates were 17.4% (95% CI 12.2–23.4), 14.3% (95% CI 6.4–24.7), 57.9% (95% CI 37.7–76.8), 26.9% (95% CI 14.6–39.3), 100% (95% CI 34.0–100) and 18.2% (95% CI 5.1–47.7), respectively, and livebirth rates were 68.8% (95% CI 56.0–80.3), 80.8% (95% CI 69.5–90.0), 69.9% (95% CI 56.1–82.0), 25.97 (95% CI 14.6–39.3), 0% (95% CI 0–66.0) and 81.8% (95% CI 52.3–94.8), respectively. Finally, stratifying the analysis considering the endometrial sampling method alone, the pregnancy rate was 68.6% (95% CI 51.2–83.6; 10 studies, I2 = 83.5%) in women who underwent hysteroscopy and 60.5% (95% CI 53.4–67.5; 13 studies, I2 = 39.8%) in women managed with dilatation and curettage biopsy; the miscarriage and livebi

Published
2022

11. Pre- and postnatal brain hemodynamics in pregnancies at term: correlation with Doppler ultrasound, birthweight, and adverse perinatal outcome

Author

Buca, D., Liberati, M., Rizzo, G., Gazzolo, D., Chiarelli, F., Giannini, C., Tizio, L. D., D'Adamo, E., Nappi, L., Scambia, G., D'Antonio, F., Scambia G. (ORCID:0000-0003-2758-1063), D'Antonio F., Buca, D., Liberati, M., Rizzo, G., Gazzolo, D., Chiarelli, F., Giannini, C., Tizio, L. D., D'Adamo, E., Nappi, L., Scambia, G., D'Antonio, F., Scambia G. (ORCID:0000-0003-2758-1063), and D'Antonio F.

Abstract

Purpose: To elucidate the correlation between pre- and postnatal cerebral Doppler in pregnancies close to term and to explore whether they are associated with perinatal outcome. Materials and methods: Prospective study on singleton pregnancies at 36–37 weeks of gestation. The primary outcome was a composite score of perinatal morbidity, while secondary outcomes were adverse intra-partum outcome and abnormal acid–base status. All pregnancies underwent ultrasound assessment of umbilical artery (UA), middle cerebral artery (MCA), uterine arteries (UtAs) pulsatility index (PI), and cerebroplacental ratio (CPR). At birth, neonatal MCA PI was measured 72 h from delivery and correlated with prenatal Doppler, primary and secondary outcomes. Fisher’s test and multivariate logistic regression analysis were used to analyze the data. Results: One hundred and sixty-six fetuses with both pre- and postnatal Doppler assessment of the MCA were included in the study. The risk of composite perinatal morbidity was higher in fetuses (OR: 5.7, 95% CI 2.2–14.6) and newborns (OR: 4.1, 95% CI 1.8–9.6) with fetal MCA PI < 10th centile. Likewise, the incidence of abnormal acid–base status was higher both in fetuses (20 versus 4.2%, p =.026) and newborns (17.1 versus 3.2%, p =.001) with a low MCA PI before and at birth, respectively. At logistic regression analysis, fetal and neonatal MCAPI were independently associated with composite perinatal morbidity and abnormal acid–base status, but not with adverse intra-partum outcome. In small for gestational age (SGA) fetuses, the incidence of composite perinatal morbidity was higher in fetuses and new-borns presenting compared to those not presenting with an MCA PI < 10th centile (61.5 versus 20%, p =.003 and 52.6% versus 7.1%, p =.008, respectively), while such association was lost when considering non-SGA fetuses. Conclusion: A low MCA PI is associated with adverse perinatal outcome in pregnancies at term and tends to persist after birt

Published
2022

12. Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study

Author

Di Mascio, D., Villalain, C., Rizzo, G., Morales-Rossello, J., Sileo, F. G., Maruotti, G. M., Prefumo, F., Galindo, A., D'Antonio, F., Buca, D., Herraiz, I., Loscalzo, G., Finarelli, A., Bertucci, E., Facchinetti, F., Brunelli, R., Giancotti, A., Muzii, L., Carbone, L., Saccone, G., D'Amico, A., Tinari, S., Cerra, C., Nappi, L., Greco, P., Monaci, R., Fichera, A., Fratelli, N., Liberati, M., Di Mascio, D., Villalain, C., Rizzo, G., Morales-Rossello, J., Sileo, F. G., Maruotti, G. M., Prefumo, F., Galindo, A., D'Antonio, F., Buca, D., Herraiz, I., Loscalzo, G., Finarelli, A., Bertucci, E., Facchinetti, F., Brunelli, R., Giancotti, A., Muzii, L., Carbone, L., Saccone, G., D'Amico, A., Tinari, S., Cerra, C., Nappi, L., Greco, P., Monaci, R., Fichera, A., Fratelli, N., and Liberati, M.

Subjects
induction of labor, Neonatal intensive care unit, Cohort Studies, fetal growth restriction, prostaglandins, 0302 clinical medicine, Pregnancy, Oxytocics, Medicine, Cook balloon catheter, dinoprostone, Foley balloon catheter, late fetal growth restriction, mechanical induction, 030212 general & internal medicine, 030219 obstetrics & reproductive medicine, Fetal Growth Retardation, Vaginal delivery, Obstetrics, Incidence (epidemiology), Pregnancy Outcome, Obstetrics and Gynecology, General Medicine, Italy, Settore MED/40, Administration, Administration, Intravaginal, Adult, Catheterization, Cesarean Section, Dinoprostone, Female, Humans, Infant, Newborn, Labor, Induced, Spain, Urinary Catheterization, prostaglandin, Human, Cohort study, Uterine tachysystole, medicine.medical_specialty, Lower risk, NO, 03 medical and health sciences, Intravaginal, business.industry, Induced, Infant, Odds ratio, medicine.disease, Newborn, Labor, Oxytocic, Cohort Studie, business
Abstract

Introduction: The aim of this study was to compare vaginal dinoprostone and mechanical methods for induction of labor (IOL) in pregnancies complicated by late fetal growth restriction. Material and methods: Multicenter, retrospective, cohort study involving six referral centers in Italy and Spain. Inclusion criteria were pregnancies complicated by late fetal growth restriction as defined by Delphi consensus criteria. The primary outcome was the occurrence of uterine tachysystole; secondary outcomes were either cesarean delivery or operative vaginal delivery for non-reassuring fetal status, a composite score of adverse neonatal outcome and admission to neonatal intensive care unit (NICU). Univariate and multivariate logistic regression analysis was used to analyze the data. Results: A total of 571 pregnancies complicated by late fetal growth restriction undergoing IOL (391 with dinoprostone and 180 with mechanical methods) were included in the analysis. The incidence of uterine tachysystole (19.2% vs. 5.6%; p = 0.001) was higher in women undergoing IOL with dinoprostone than in those undergoing IOL with mechanical methods. Similarly, the incidence of cesarean delivery or operative delivery for non-reassuring fetal status (25.6% vs. 17.2%; p = 0.027), composite adverse neonatal outcome (26.1% vs. 16.7%; p = 0.013) and NICU admission (16.9% vs. 5.6%; p

Published
2021

17. Face masks during COVID-19 pandemic lockdown and self-reported seasonal allergic rhinitis symptoms

Author

Liccardi, G., primary, Bilo, M.B., additional, Milanese, M., additional, Martini, M., additional, Calzetta, L., additional, Califano, F., additional, Carucci, L., additional, Cicarelli, A., additional, Cutajar, M., additional, D'Auria, P., additional, De Bartolomeis, F., additional, Dello Iacono, I., additional, Franzese, A., additional, Gargano, D., additional, Inciso, G., additional, Giordano, A.C., additional, Iannaccone, R., additional, Lo Schiavo, M., additional, Nappi, L., additional, Madonna, F., additional, Montera, C., additional, Onorati, G., additional, Papa, A., additional, Savoia, A., additional, Scopano, E., additional, Iannotta, M.P., additional, Bartiromo, M., additional, Del Marco, G., additional, and Rogliani, P., additional

Published
2021
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18. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection

Author

Saccone, G. Sen, C. Di Mascio, D. Galindo, A. Grünebaum, A. Yoshimatsu, J. Stanojevic, M. Kurjak, A. Chervenak, F. Suárez, M.J.R. Gambacorti-Passerini, Z.M. de los Angeles Anaya Baz, M. Galán, E.V.A. López, Y.C. Luis, J.A.D.L. Hernández, I.C. Herraiz, I. Villalain, C. Venturella, R. Rizzo, G. Mappa, I. Gerosolima, G. Hellmeyer, L. Königbauer, J. Ameli, G. Frusca, T. Volpe, N. Schera, G.B.L. Fieni, S. Esposito, E. Simonazzi, G. Di Donna, G. Youssef, A. Gatta, A.N.D. 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. Laganà, A.S. Longo, V.L. Stollagli, F. Sirico, A. Lanzone, A. Driul, L. Cecchini, 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, F.D. 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. Liberati, M. Buca, D. Leombroni, M. Di Sebastiano, F. 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. Viana Pinto, P. Figueiredo, R. Morales Roselló, J. Loscalzo, G. Martinez-Varea, A. Diago, V. Jimenez Lopez, J.S. Aykanat, A.Y. Cosma, S. Carosso, A. Benedetto, C. Bermejo, A. Feuerschuette, O.H.M. Uyaniklar, O. Ocakouglu, S.R. Atak, Z. Gündüz, 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. Genç, S.Ö. Zlatohlávková, 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. Brzezinski-Sinai, N.A. 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. Kornhauser-Cerar, L. Druškovic, M. De Robertis, V. Stefanovic, V. Nupponen, I. Nelskylä, 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. Manzoli, L. Flacco, M.E. Nazzaro, G. Locci, M. Guida, M. Sardo, A.D.S. Panici, P.B. Khalil, A. Berghella, V. Bifulco, G. Scambia, G. Zullo, F. D'Antonio, F. The WAPM (World Association of Perinatal Medicine) Working Group on COVID-19

Abstract

Objectives: To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. Methods: This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. Results: In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251 (27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. Conclusions: SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. © 2020 International Society of Ultrasound in Obstetrics and Gynecology. © 2020 International Society of Ultrasound in Obstetrics and Gynecology

Published
2021

19. Perinatal emotional states: a comparative study between two cohorts recruited in a Mediterranean environment

Author

Universitat Rovira i Virgili, Voltas N; Arija V; Hernández-Martínez C; Nappi L; Cibelli G; Basora J; Canals J, Universitat Rovira i Virgili, and Voltas N; Arija V; Hernández-Martínez C; Nappi L; Cibelli G; Basora J; Canals J

Abstract

© 2020 Taylor & Francis Group, LLC. Experiencing negative emotional states during pregnancy has been linked to adverse outcomes for mother and offspring. Our study aims were to compare the perinatal emotional states and obstetrical variables between pregnant women recruited in Spain (n = 202) and Italy (n = 103), and to investigate prenatal anxiety related factors. The study had two phases. In the 1st phase (3rd trimester of pregnancy), prenatal anxiety was assessed using the State-Trait Anxiety Inventory (STAI); other prenatal and sociodemographic variables were also collected. In the 2nd phase (40 days postpartum), the STAI and the Edinburgh Postnatal Depression Scale were administered. Compared to the Spanish sample, the Italian sample presented higher STAI state and STAI factor 1 mean scores (22.5 vs. 18.6 and 10.0 vs. 7.2), shorter gestations (mean gestation weeks: 39.1 vs. 39.8), more unplanned pregnancies (31.1% vs. 16.4%), and more cesareans deliveries (42.5% vs. 16.0%). Low socioeconomic levels, younger ages, previous miscarriages and unplanned pregnancies were related to prenatal anxiety. Postpartum depression rates was 31.3% and there were no differences between countries. Our results suggested that it may be interesting in both countries to create a prenatal monitoring protocol that attaches more importance to emotional wellbeing both during pregnancy and in the long term.

Published
2021

20. Outcome of twin–twin transfusion syndrome according to Quintero stage of disease: systematic review and meta‐analysis

Author

Mascio, DD, Khalil, A, D'Amico, A, Buca, D, Panici, PB, Flacco, ME, Manzoli, L, Liberati, M, Nappi, L, Berghella, V, and D'Antonio, F

Abstract

Objectives\ud To report the outcome of pregnancies complicated by twin–twin transfusion syndrome (TTTS) according to Quintero stage.\ud \ud Methods\ud MEDLINE, EMBASE and CINAHL databases were searched for studies reporting the outcome of pregnancies complicated by TTTS stratified according to Quintero stage (I–V). The primary outcome was fetal survival rate according to Quintero stage. Secondary outcomes were gestational age at birth, preterm birth (PTB) before 34, 32 and 28 weeks' gestation and neonatal morbidity. Outcomes are reported according to the different management options (expectant management, laser therapy or amnioreduction) for pregnancies with Stage‐I TTTS. Only cases treated with laser therapy were considered for those with Stages‐II–IV TTTS and only cases managed expectantly were considered for those with Stage‐V TTTS. Random‐effects head‐to‐head meta‐analysis was used to analyze the extracted data.\ud \ud Results\ud Twenty‐six studies (2699 twin pregnancies) were included. Overall, 610 (22.6%) pregnancies were diagnosed with Quintero stage‐I TTTS, 692 (25.6%) were Stage II, 1146 (42.5%) were Stage III, 247 (9.2%) were Stage IV and four (0.1%) were Stage V. Survival of at least one twin occurred in 86.9% (95% CI, 84.0–89.7%) (456/552) of pregnancies with Stage‐I, in 85% (95% CI, 79.1–90.1%) (514/590) of those with Stage‐II, in 81.5% (95% CI, 76.6–86.0%) (875/1040) of those with Stage‐III, in 82.8% (95% CI, 73.6–90.4%) (172/205) of those with Stage‐IV and in 54.6% (95% CI, 24.8–82.6%) (5/9) of those with Stage‐V TTTS. The rate of a pregnancy with no survivor was 11.8% (95% CI, 8.4–15.8%) (69/564) in those with Stage‐I, 15.0% (95% CI, 9.9–20.9%) (76/590) in those with Stage‐II, 18.6% (95% CI, 14.2–23.4%) (165/1040) in those with Stage‐III, 17.2% (95% CI, 9.6–26.4%) (33/205) in those with Stage‐IV and in 45.4% (95% CI, 17.4–75.2%) (4/9) in those with Stage‐V TTTS. Gestational age at birth was similar in pregnancies with Stages‐I–III TTTS, and gradually decreased in those with Stages‐IV and ‐V TTTS. Overall, the incidence of PTB and neonatal morbidity increased as the severity of TTTS increased, but data on these two outcomes were limited by the small sample size of the included studies. When stratifying the analysis of pregnancies with Stage‐I TTTS according to the type of intervention, the rate of fetal survival of at least one twin was 84.9% (95% CI, 70.4–95.1%) (94/112) in cases managed expectantly, 86.7% (95% CI, 82.6–90.4%) (249/285) in those undergoing laser therapy and 92.2% (95% CI, 84.2–97.6%) (56/60) in those after amnioreduction, while the rate of double survival was 67.9% (95% CI, 57.0–77.9%) (73/108), 69.7% (95% CI, 61.6–77.1%) (203/285) and 80.8% (95% CI, 62.0–94.2%) (49/60), respectively.\ud \ud Conclusions\ud Overall survival in monochorionic diamniotic pregnancies affected by TTTS is higher for earlier Quintero stages (I and II), but fetal survival rates are moderately high even in those with Stage‐III or ‐IV TTTS when treated with laser therapy. Gestational age at birth was similar in pregnancies with Stages‐I–III TTTS, and gradually decreased in those with Stages‐IV and ‐V TTTS treated with laser and expectant management, respectively. In pregnancies affected by Stage‐I TTTS, amnioreduction was associated with slightly higher survival compared with laser therapy and expectant management, although these findings may be confirmed only by future head‐to‐head randomized trials.

Published
2020

21. Outcome of fetuses with congenital cytomegalovirus infection and normal ultrasound at diagnosis: systematic review and meta‐analysis

Author

Buca, D., primary, Di Mascio, D., additional, Rizzo, G., additional, Giancotti, A., additional, D'Amico, A., additional, Leombroni, M., additional, Makatsarya, A., additional, Familiari, A., additional, Liberati, M., additional, Nappi, L., additional, Flacco, M. E., additional, Manzoli, L., additional, Salomon, L. J., additional, Scambia, G., additional, and D'Antonio, F., additional

Published
2021
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22. Cancer in pregnancy: Proposal of an italian multicenter study. gynecologic oncology group of the italian society of gynecology and obstetrics (sigo)

Author

Sartori, E, Franchi, M, Capelli, G, Cicinelli, E, Colacurci, N, De Vincenzo, R, Landoni, F, Maggino, T, Masturzo, B, Parazzini, F, Scarfone, G, Peccatori, F, Romagnolo, C, Scibilia, G, Scollo, P, Zola, P, Garzon, S, Raffaelli, R, Busato, E, Cetin, I, Giovannini, M, Zanni, G, Greggi, S, Marconi, A, Rizzo, N, Ruspa, G, Meroni, M, Volpi, E, Simoncini, T, Gadducci, A, Ghezzi, F, Lagana, A, Melis, G, Paoletti, A, Strobelt, N, Spinillo, A, Severi, F, Frusca, T, Greco, P, Nappi, L, Ricci, G, Vizza, E, Papaccio, M, Ratti, M, Scambia, G, Sartori E., Franchi M., Capelli G., Cicinelli E., Colacurci N., De Vincenzo R., Landoni F., Maggino T., Masturzo B., Parazzini F., Scarfone G., Peccatori F., Romagnolo C., Scibilia G., Scollo P., Zola P., Garzon S., Raffaelli R., Busato E., Cetin I., Giovannini M., Zanni G. C., Greggi S., Marconi A. M., Rizzo N., Ruspa G., Meroni M. G., Volpi E. O., Simoncini T., Gadducci A., Ghezzi F., Lagana A. S., Melis G. B., Paoletti A. M., Strobelt N., Spinillo A., Severi F. M., Frusca T., Greco P., Nappi L., Ricci G., Vizza E., Papaccio M., Ratti M., Scambia G., Sartori, E, Franchi, M, Capelli, G, Cicinelli, E, Colacurci, N, De Vincenzo, R, Landoni, F, Maggino, T, Masturzo, B, Parazzini, F, Scarfone, G, Peccatori, F, Romagnolo, C, Scibilia, G, Scollo, P, Zola, P, Garzon, S, Raffaelli, R, Busato, E, Cetin, I, Giovannini, M, Zanni, G, Greggi, S, Marconi, A, Rizzo, N, Ruspa, G, Meroni, M, Volpi, E, Simoncini, T, Gadducci, A, Ghezzi, F, Lagana, A, Melis, G, Paoletti, A, Strobelt, N, Spinillo, A, Severi, F, Frusca, T, Greco, P, Nappi, L, Ricci, G, Vizza, E, Papaccio, M, Ratti, M, Scambia, G, Sartori E., Franchi M., Capelli G., Cicinelli E., Colacurci N., De Vincenzo R., Landoni F., Maggino T., Masturzo B., Parazzini F., Scarfone G., Peccatori F., Romagnolo C., Scibilia G., Scollo P., Zola P., Garzon S., Raffaelli R., Busato E., Cetin I., Giovannini M., Zanni G. C., Greggi S., Marconi A. M., Rizzo N., Ruspa G., Meroni M. G., Volpi E. O., Simoncini T., Gadducci A., Ghezzi F., Lagana A. S., Melis G. B., Paoletti A. M., Strobelt N., Spinillo A., Severi F. M., Frusca T., Greco P., Nappi L., Ricci G., Vizza E., Papaccio M., Ratti M., and Scambia G.

Abstract

A pregnancy related cancer is defined as a neoplasm diagnosed in a woman during gestation or within 12 months following childbirth or abortion. Breast, thyroidal, melanoma, cervical and hematological malignancies are those most commonly diagnosed during pregnancy, with a reported incidence considered lower than those estimated of 1 case on 1000 pregnancies. The clinical complexity is generated by the co-presence of mother and fetus, and the consequent conflict represented by the need to identify a therapeutic strategy that is effective for the maternal prognosis and, at the same time, safeguards the fetal well-being. Moreover, the counseling, diagnosis, staging and management of these cases are further complicated because most of the scientific literature consists in case reports or small retrospective studies and lacks in guidelines and prospective clinical trials. On that basis, the Study Group on Cancer in Pregnancy (members of S.I.G.O.-Italian Society of Gynecology and Obstetrics) presents the TIGRE Trial, an Italian multicenter observational study aimed at establishing a shared database for the collection of epidemiological and clinical data of the patients affected by pregnancy related cancer in Italy, with the final objective to improve the outcome of a mother and a child involved in a such pathology.

Published
2018

23. Needlestick injuries among obstetrics and gynecology trainees: A study design to investigate an underestimated priority

Author

Scambia, G, Raffaelli, R, Baggio, S, Garzon, S, Lagana, A, Sartori, E, Vanzo, F, Vizza, E, Angioli, R, Benedetto, C, Cagnacci, A, Candiani, M, Carta, G, Caserta, D, Cherchi, P, Ciavattini, A, Cicinelli, E, Cobellis, L, Cosmi, E, D'Anna, R, De Leo, V, Di Paola, R, Di Pinto, A, Ercoli, A, Facchinetti, F, Ferrazzi, E, Frusca, T, Ghezzi, F, Greco, P, Liberati, M, Loverro, G, Nappi, L, Palumbo, M, Neri, M, Perino, A, Clemenza, S, Piccione, E, Peterlunger, I, Rizzo, N, Negri, B, Simoncini, T, Spinillo, A, Venturini, P, Vergani, P, Zullo, F, Chiantera, A, Colacurci, N, Viora, E, Franchi, M, Scambia G., Raffaelli R., Baggio S., Garzon S., Lagana A. S., Sartori E., Vanzo F., Vizza E., Angioli R., Benedetto C., Cagnacci A., Candiani M., Carta G., Caserta D., Cherchi P. L., Ciavattini A., Cicinelli E., Cobellis L., Cosmi E., D'anna R., De Leo V., Di Paola R., Di Pinto A., Ercoli A., Facchinetti F., Ferrazzi E., Frusca T., Ghezzi F., Greco P., Liberati M., Loverro G., Nappi L., Palumbo M., Neri M., Perino A., Clemenza S., Piccione E., Peterlunger I., Rizzo N., Negri B., Simoncini T., Spinillo A., Venturini P. L., Vergani P., Zullo F., Chiantera A., Colacurci N., Viora E., Franchi M., Scambia, G, Raffaelli, R, Baggio, S, Garzon, S, Lagana, A, Sartori, E, Vanzo, F, Vizza, E, Angioli, R, Benedetto, C, Cagnacci, A, Candiani, M, Carta, G, Caserta, D, Cherchi, P, Ciavattini, A, Cicinelli, E, Cobellis, L, Cosmi, E, D'Anna, R, De Leo, V, Di Paola, R, Di Pinto, A, Ercoli, A, Facchinetti, F, Ferrazzi, E, Frusca, T, Ghezzi, F, Greco, P, Liberati, M, Loverro, G, Nappi, L, Palumbo, M, Neri, M, Perino, A, Clemenza, S, Piccione, E, Peterlunger, I, Rizzo, N, Negri, B, Simoncini, T, Spinillo, A, Venturini, P, Vergani, P, Zullo, F, Chiantera, A, Colacurci, N, Viora, E, Franchi, M, Scambia G., Raffaelli R., Baggio S., Garzon S., Lagana A. S., Sartori E., Vanzo F., Vizza E., Angioli R., Benedetto C., Cagnacci A., Candiani M., Carta G., Caserta D., Cherchi P. L., Ciavattini A., Cicinelli E., Cobellis L., Cosmi E., D'anna R., De Leo V., Di Paola R., Di Pinto A., Ercoli A., Facchinetti F., Ferrazzi E., Frusca T., Ghezzi F., Greco P., Liberati M., Loverro G., Nappi L., Palumbo M., Neri M., Perino A., Clemenza S., Piccione E., Peterlunger I., Rizzo N., Negri B., Simoncini T., Spinillo A., Venturini P. L., Vergani P., Zullo F., Chiantera A., Colacurci N., Viora E., and Franchi M.

Abstract

Risk of needlestick injuries (NSIs) is high in surgical staff. Medical students and trainees have reported the highest rate of NSIs, and Obstetrics and Gynecology is considered a high-risk specialty. The risk associated to NSIs is further increased by the high prevalence of blood borne pathogens in the population. Nevertheless, the degree of concern about contraction of these serious infections has been reported significantly lower over time, showing diminishing attitudes toward prevention of exposure and lack of consideration as a major problem, in fact most of NSIs resulted unreported. Therefore, education is fundamental to change individual attitudes and behaviors, to improve awareness and increase the use of standard protections, in order to reduce the injury rate and implement reporting to hospital surveillance systems. The proposed study aims to assess NSIs in trainees currently attending residency programs in Obstetrics and Gynecology in all academic hospitals of Italy, with a standardized, pre-piloted, national-based survey. At this purpose, we developed the Obstetrics Needlestick Injury Questionnaire (ONSI-Q), a 40-items survey that will be completed via a web-based platform. The ONSI-Q investigates real incidence of NSIs, adopted protection practices, presence of associated risk factors, and attitudes and rate of the reported accidents among trainees during obstetric procedures (suture of perineal tear/episiotomy and cesarean section). These results will provide the opportunity to investigate an underestimated priority, in order to encourage educational practices with the aim to improve prevention and reporting strategies, and therefore increase occupational safety in this high-risk surgical specialty.

Published
2018

24. Outcome of fetuses with congenital cytomegalovirus infection: a systematic review and meta-analysis

Author

Buca, D, Di Mascio, D, Rizzo, G, Giancotti, A, D'Amico, Adele, Leombroni, M, Makatsarya, A, Familiari, A, Liberati, M, Nappi, L, Flacco, M Elena, Manzoli, Lamberto, Salomon, L, Scambia, Giovanni, and D'Antonio, Francesco

Subjects
Settore MED/40 - GINECOLOGIA E OSTETRICIA, prenatal diagnosis, ultrasound, Settore MED/40, fetuses, cytomegalovirus, infection, neonatal outcome
Published
2020

25. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: international multicenter study

Author

Di Mascio, D, Khalil, A, Thilaganathan, B, Rizzo, G, Buca, D, Liberati, M, Celentano, C, Melchiorre, K, Caulo, M, Pilu, G, Salsi, G, Toni, F, Stampalija, T, Fantasia, I, Luise, G, Gregori, M, Volpe, P, Olivieri, C, Giancotti, A, D'Ambrosio, V, Brunelli, R, Panici, PB, Manganaro, L, Antonelli, A, Ercolani, G, Pasquini, L, Masini, G, Di Maurizio, M, Lees, C, Bracalente, G, Morales-Rosello, J, Loscalzo, G, Saccone, G, Carbone, L, Sarno, L, Maruotti, GM, Zullo, F, Ghi, T, Frusca, T, Dall'Asta, A, Volpe, N, Ormitti, F, Buongiorno, S, De Santis, M, D'Oria, L, Lanzone, A, Prefumo, F, Pinelli, L, Bertucci, E, Sileo, FG, Flacco, ME, Manzoli, L, Giangiordano, I, Mastricci, L, Meccariello, G, Vasciaveo, L, Nappi, L, Familiari, A, Scambia, G, Berghella, V, D'Antonio, F, and ENSO Working Grp

Subjects
prenatal diagnosis, fetal ultrasound, fetal magnetic resonance imaging, central nervous system, ventriculomegaly, MRI, neurosonography
Abstract

Objectives To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain. Methods This was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0-11.9 mm) or moderate (ventricular atrial diameter, 12.0-14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra-CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anomalies detected exclusively on prenatal MRI and missed on ultrasound, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed on prenatal imaging (ultrasound and MRI). Subgroup analysis according to gestational age at MRI (< 24 vs >= 24 weeks), laterality of VM (unilateral vs bilateral) and severity of dilatation (mild vs moderate VM) were also performed. Results Five hundred and fifty-six fetuses with a prenatal diagnosis of isolated mild or moderate VM on ultrasound were included in the analysis. Additional structural anomalies were detected on prenatal MRI and missed on ultrasound in 5.4% (95% CI, 3.8-7.6%) of cases. When considering the type of anomaly, supratentorial intracranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly were detected in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected on MRI in 6.7% of cases, while dysgenesis was detected in 3.3%. Fetuses with an associated anomaly detected only on MRI were more likely to have moderate than mild VM (60.0% vs 17.7%; P

Published
2020

26. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: a multicenter study

Author

Mascio, Dd, Khalil, A, Thilaganathan, B, Rizzo, G, Buca, D, Liberati, M, Celentano, C, Melchiorre, K, Caulo, M, Pilu, G, Salsi, G, Toni, F, Stampalija, T, Fantasia, Fabrizio, Luise, G, Gregori, M, Volpe, P, Olivieri, C, Giancotti, A, D'Ambrosio, Viola, Brunelli, Chiara, Panici, Pb, Manganaro, L, Antonelli, A, Ercolani, G, Pasquini, Annalisa, Masini, G, Di Maurizio, M, Lees, C, Bracalente, G, Morales-Roselló, J, Loscalzo, G, Saccone, G, Carbone, L, Sarno, L, Maruotti, Gm, Zullo, F, Ghi, T, Frusca, T, Dall'Asta, A, Volpe, N, Ormitti, F, Buongiorno, Silvia, De Santis, Marco, D'Oria, L, Lanzone, Antonio, Prefumo, F, Pinelli, L, Bertucci, E, Sileo, Fg, Flacco, Me, Manzoli, L, Giangiordano, I, Mastricci, L, Meccariello, G, Vasciaveo, L, Nappi, L, Familiari, Alessandra, Scambia, Giovanni, Berghella, Vincenzo, D'Antonio, Francesco, Fantasia I, D'Ambrosio V, Brunelli R, Pasquini L, Buongiorno S, De Santis M (ORCID:0000-0002-1388-0014), Lanzone A (ORCID:0000-0003-4119-414X), Familiari A (ORCID:0000-0002-6353-9383), Scambia G (ORCID:0000-0003-2758-1063), Berghella V, D'Antonio F., Mascio, Dd, Khalil, A, Thilaganathan, B, Rizzo, G, Buca, D, Liberati, M, Celentano, C, Melchiorre, K, Caulo, M, Pilu, G, Salsi, G, Toni, F, Stampalija, T, Fantasia, Fabrizio, Luise, G, Gregori, M, Volpe, P, Olivieri, C, Giancotti, A, D'Ambrosio, Viola, Brunelli, Chiara, Panici, Pb, Manganaro, L, Antonelli, A, Ercolani, G, Pasquini, Annalisa, Masini, G, Di Maurizio, M, Lees, C, Bracalente, G, Morales-Roselló, J, Loscalzo, G, Saccone, G, Carbone, L, Sarno, L, Maruotti, Gm, Zullo, F, Ghi, T, Frusca, T, Dall'Asta, A, Volpe, N, Ormitti, F, Buongiorno, Silvia, De Santis, Marco, D'Oria, L, Lanzone, Antonio, Prefumo, F, Pinelli, L, Bertucci, E, Sileo, Fg, Flacco, Me, Manzoli, L, Giangiordano, I, Mastricci, L, Meccariello, G, Vasciaveo, L, Nappi, L, Familiari, Alessandra, Scambia, Giovanni, Berghella, Vincenzo, D'Antonio, Francesco, Fantasia I, D'Ambrosio V, Brunelli R, Pasquini L, Buongiorno S, De Santis M (ORCID:0000-0002-1388-0014), Lanzone A (ORCID:0000-0003-4119-414X), Familiari A (ORCID:0000-0002-6353-9383), Scambia G (ORCID:0000-0003-2758-1063), Berghella V, and D'Antonio F.

Abstract

OBJECTIVES: To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild and moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound (US) evaluation of fetal brain. METHODS: Multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, United Kingdom, and Spain. Inclusion criteria were fetuses affected by isolated VM on US, defined as VM with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on US, undergoing detailed assessment of fetal brain via a multiplanar approach as suggested by ISUOG guidelines on fetal neurosonogram. The primary outcome of the study was to report the rate of additional CNS anomalies detected exclusively at prenatal MRI and missed at US, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed at prenatal imaging (US and MRI). Sub-group analyses according to the gestational age at MRI (< vs ≥ 24 weeks of gestation), laterality of VM (unilateral vs bilateral), and severity of dilatation (mild vs moderate VM) were also performed. RESULTS: Five-hundreds and fifty-six fetuses with a prenatal diagnosis of isolated fetal VM on US were included in the analysis. Additional structural anomalies were detected at prenatal MRI and missed at US in 5.4% (95% CI 3.8-7.6) of cases. When considering the type of anomalies, supra-tentorial intra-cranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected at MRI in 6.7% of cases, while dysgenesis in 3.3%. Fetuses with an associated anomaly detected only at MRI were more likely to have moderate compared to mild VM (60.0% vs 17.7%, p<0.001), while there was no significant difference between the proportion of cases with bilateral VM between the two groups (p=

Published
2020

27. Outcome of twin-to-twin transfusion syndrome in monochorionic monoamniotic twin pregnancy: systematic review and meta-analysis

Author

Murgano, D., Khalil, A., Prefumo, F., Mieghem, T. V., Rizzo, G., Heyborne, K. D., Melchiorre, K., Peeters, S., Lewi, L., Familiari, Alessandra, Lopriore, E., Oepkes, D., Murata, M., Anselem, O., Buca, D., Liberati, M., Hack, K., Nappi, L., Baxi, L. V., Scambia, Giovanni, Acharya, G., D(')antonio, F., Familiari, A. (ORCID:0000-0002-6353-9383), Scambia, G. (ORCID:0000-0003-2758-1063), Murgano, D., Khalil, A., Prefumo, F., Mieghem, T. V., Rizzo, G., Heyborne, K. D., Melchiorre, K., Peeters, S., Lewi, L., Familiari, Alessandra, Lopriore, E., Oepkes, D., Murata, M., Anselem, O., Buca, D., Liberati, M., Hack, K., Nappi, L., Baxi, L. V., Scambia, Giovanni, Acharya, G., D(')antonio, F., Familiari, A. (ORCID:0000-0002-6353-9383), and Scambia, G. (ORCID:0000-0003-2758-1063)

Abstract

Objectives To explore the outcome of monochorionic monoamniotic (MCMA) twin pregnancies affected by twin-to-twin transfusion syndrome (TTTS).Methods MEDLINE and EMBASE databases were searched for studies reporting the outcome of MCMA twin pregnancies complicated by TTTS. The primary outcome was intrauterine death (IUD); secondary outcomes were miscarriage, single IUD, double IUD, neonatal death (NND), perinatal death (PND), survival of at least one twin, survival of both twins and preterm birth (PTB) before 32 weeks' gestation. Outcomes were assessed in MCMA twins affected by TTTS not undergoing intervention and in those treated with amniodrainage, laser therapy or cord occlusion. Subgroup analysis was performed including cases diagnosed before 24 weeks. Random-effects meta-analysis of proportions was used to analyze the data.Results Fifteen cohort studies, including 888 MCMA twin pregnancies, of which 44 were affected by TTTS, were included in the review. There was no randomized trial comparing the different management options in MCMA twin pregnancies complicated by TTTS. In cases not undergoing intervention, miscarriage occurred in 11.0% of fetuses, while the incidence of IUD, NND and PND was 25.2%, 12.2% and 31.2%, respectively. PTB complicated 50.5% of these pregnancies. In cases treated by laser surgery, the incidence of miscarriage, IUD, NND and PND was 19.6%, 27.4%, 7.4% and 35.9%, respectively, and the incidence of PTB before 32weeks' gestation was 64.9%. In cases treated with amniodrainage, the incidence of IUD, NND and PND was 31.3%, 13.5% and 45.7% respectively, and PTB complicated 76.2% of these pregnancies. Analysis of cases undergoing cord occlusion was affected by the very small number of included cases. Miscarriage occurred in 19.2%, while there was no case of IUD or NND of the surviving twin. PTB before 32weeks occurred in 50.0% of these cases.Conclusions MCMA twin pregnancies complicated by TTTS are at high risk of perinatal mortality and PTB. Furt

Published
2020

31. Outcome of twin‐to‐twin transfusion syndrome in monochorionic monoamniotic twin pregnancy: systematic review and meta‐analysis

Author

Murgano, D., primary, Khalil, A., additional, Prefumo, F., additional, Mieghem, T. Van, additional, Rizzo, G., additional, Heyborne, K. D., additional, Melchiorre, K., additional, Peeters, S., additional, Lewi, L., additional, Familiari, A., additional, Lopriore, E., additional, Oepkes, D., additional, Murata, M., additional, Anselem, O., additional, Buca, D., additional, Liberati, M., additional, Hack, K., additional, Nappi, L., additional, Baxi, L. V., additional, Scambia, G., additional, Acharya, G., additional, and D'antonio, F., additional

Published
2020
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33. Cancer in pregnancy: proposal of an Italian multicenter study. Gynecologic Oncology Group of the Italian Society of Gynæcology and Obstetrics (SIGO)

Author

Sartori, E., Franchi, M., Capelli, G., Cicinelli, E., Colacurci, N., Vincenzo, R., Landoni, F., Maggino, T., Masturzo, B., Parazzini, F., Scarfone, G., Peccatori, F., Romagnolo, C., Scibilia, G., Scollo, P., Zola, P., Garzon, S., Raffaelli, R., Busato, E., Cetin, I., Giovannini, M., Zanni, G. C., Greggi, S., Marconi, A. M., Rizzo, N., Ruspa, G., Meroni, M. G., Volpi, E. O., Simoncini, T., Gadducci, A., Ghezzi, F., Laganà, A. S., Melis, G. B., Paoletti, A. M., Strobelt, N., Spinillo, A., Severi, F. M., Frusca, T., Greco, P., Nappi, L., Ricci, G., Enrico Vizza, Papaccio, M., Ratti, M., Scambia, G., Sartori, E, Franchi, M, Capelli, G, Cicinelli, E, Colacurci, N, De Vincenzo, R, Landoni, F, Maggino, T, Masturzo, B, Parazzini, F, Scarfone, G, Peccatori, F, Romagnolo, C, Scibilia, G, Scollo, P, Zola, P, Garzon, S, Raffaelli, R, Busato, E, Cetin, I, Giovannini, M, Zanni, G, Greggi, S, Marconi, A, Rizzo, N, Ruspa, G, Meroni, M, Volpi, E, Simoncini, T, Gadducci, A, Ghezzi, F, Lagana, A, Melis, G, Paoletti, A, Strobelt, N, Spinillo, A, Severi, F, Frusca, T, Greco, P, Nappi, L, Ricci, G, Vizza, E, Papaccio, M, Ratti, M, Scambia, G, Sartori, Enrico, Franchi, Massimo, Capelli, Giovanni, Cicinelli, Ettore, Colacurci, Nicola, De Vincenzo, Rosa, Landoni, Fabio, Maggino, Tiziano, Masturzo, Bianca, Parazzini, Fabio, Scarfone, Giovanna, Peccatori, Fedro, Romagnolo, Cesare, Scibilia, Giuseppe, Scollo, Paolo, Zola, Paolo, Garzon, Simone, Raffaelli, Ricciarda, Busato, Enrico, Cetin, Irene, Giovannini, Massimo, Zanni, Giuliano Carlo, Greggi, Stefano, Marconi, Anna Maria, Rizzo, Nicola, Ruspa, Giovanni, Meroni, Mario Giuseppe, Volpi, Eugenio Oreste, Simoncini, Tommaso, Gadducci, Angiolo, Ghezzi, Fabio, Laganà, Antonio Simone, Melis, Gian Benedetto, Paoletti, Anna Maria, Strobelt, Nicola, Spinillo, Arsenio, Severi, Filiberto Maria, Frusca, Tiziana, Greco, Pantaleo, Nappi, Luigi, Ricci, Giuseppe, Vizza, Enrico, Papaccio, Marta, Ratti, Martina, and Scambia, Giovanni

Subjects
TIGER Trial, fetal development, Pregnancy related cancer, chemotherapy, teratogenic risk, fetal development, multicenter observational study, TIGER Trial, Obstetrics and Gynecology, Chemotherapy, Fetal development, Multicenter observational study, Pregnancy related cancer, Teratogenic risk, Tiger trial, multicenter observational study, chemotherapy, teratogenic risk
Abstract

A pregnancy related cancer is defined as a neoplasm diagnosed in a woman during gestation or within 12 months following childbirth or abortion. Breast, thyroidal, melanoma, cervical and hematological malignancies are those most commonly diagnosed during pregnancy, with a reported incidence considered lower than those estimated of 1 case on 1000 pregnancies. The clinical complexity is generated by the co-presence of mother and fetus, and the consequent conflict represented by the need to identify a therapeutic strategy that is effective for the maternal prognosis and, at the same time, safeguards the fetal well-being. Moreover, the counseling, diagnosis, staging and management of these cases are further complicated because most of the scientific literature consists in case reports or small retrospective studies and lacks in guidelines and prospective clinical trials. On that basis, the Study Group on Cancer in Pregnancy (members of S.I.G.O.-Italian Society of Gynecology and Obstetrics) presents the TIGRE Trial, an Italian multicenter observational study aimed at establishing a shared database for the collection of epidemiological and clinical data of the patients affected by pregnancy related cancer in Italy, with the final objective to improve the outcome of a mother and a child involved in a such pathology.

Published
2018

35. Prevalence and predictors of atypical histology in endometrial polyps removed by hysteroscopy: a secondary analysis from the SICMIG hysteroscopy trial

Author

Garuti, G, Luerti, M, Leone, Fpg, Perriini, G, Dealberti, D, Vitelli, V, Angioni, S, Vitagliano, A, Sardo, Ad, Benassi, G, De Angelis, C, Nappi, L, Bettocchi, S, Casadio, P, Marchino, Gl, Lanzo, G, Busato, E, Calzolari, S, Castellacci, E, Giarre, G, Personeni, C, Mangino, F, Scrimin, F, Cela, V, and Florio, P

Subjects
Original Paper, endometrial polyp, hysteroscopy, atypical hyperplasia, endometrial cancer, polypectomy, Endometrial polyp, Atypical hyperplasia, Endometrial cancer, Hysteroscopy, Polypectomy
Abstract

Background The aim of this study is to assess the prevalence of atypical hyperplasia (AH) and endometrial cancer (EC) within endometrial polyps (EPs) removed by hysteroscopy. Methods Hysteroscopic polypectomy interventions were performed over 1436 consecutive patients with Eps to complete a prospective observational trial (Canadian Task Force Classification II-2) including 19 Italian Gynecologic Departments (University-Affiliated or Public Hospitals) for a secondary multicenter analysis. Results At histological analysis, in 1404 patients (97.8%) EPs were classified as benign, whereas in 32 patients (2.2%) EPs were diagnosed as atypical (i.e. with AH or EC). Specifically, AH and EC were found in 17 (1.2%) and 15 (1.0%) cases, respectively. Risk factor analysis showed that menopausal status, BMI and size of EPs were associated with increased risk of atypical EPs (p

Published
2019

36. Lack of Effectiveness of Postchemotherapy Lymphadenectomy in Bladder Cancer Patients with Clinical Evidence of Metastatic Pelvic or Retroperitoneal Lymph Nodes Only: A Propensity Score-based Analysis

Author

Necchi, A. Mariani, L. Lo Vullo, S. Yu, E.Y. Woods, M.E. Wong, Y.-N. Harshman, L.C. Alva, A. Sternberg, C.N. Bamias, A. Grivas, P. Koshkin, V.S. Roghmann, F. Dobruch, J. Eigl, B.J. Nappi, L. Milowsky, M.I. Niegisch, G. Pal, S.K. De Giorgi, U. Recine, F. Vaishampayan, U. Berthold, D.D. Bowles, D.W. Baniel, J. Theodore, C. Ladoire, S. Srinivas, S. Agarwal, N. Crabb, S. Sridhar, S. Golshayan, A.-R. Ohlmann, C. Xylinas, E. Powles, T. Rosenberg, J.E. Bellmunt, J. van Rhijn, B. Galsky, M.D. Hendricksen, K.

Abstract

Background: Limited data is available on the role, and extent of, postchemotherapy lymphadenectomy (PC-LND) in patients with clinical evidence of pelvic (cN1–3) or retroperitoneal (RP) lymph node spread from urothelial bladder carcinoma. Objective: To compare the outcomes of operated versus nonoperated patients after first-line chemotherapy. Design, setting, and participants: Data from 34 centers was collected, totaling 522 patients, treated between January 2000 and June 2015. Criteria for patient selection were the following: bladder primary tumor, lymph node metastases (pelvic ± RP) only, first-line platinum-based chemotherapy given. Intervention: LND (with cystectomy) versus observation after first-line chemotherapy for metastatic urothelial bladder carcinoma. Outcome measures and statistical analysis: Overall survival (OS) was the primary endpoint. Multiple propensity score techniques were adopted, including 1:1 propensity score matching and inverse probability of treatment weighting. Additionally, the inverse probability of treatment weighting analysis was performed with the inclusion of the covariates, that is, with doubly robust estimation. Results and limitations: Overall, 242 (46.4%) patients received PC-LND and 280 (53.6%) observation after chemotherapy. There were 177 (33.9%) and 345 (66.1%) patients with either RP or pelvic LND only, respectively. Doubly robust estimation-adjusted comparison was not significant for improved OS for PC-LND (hazard ratio [HR]: 0.86, 95% confidence interval [CI]: 0.56–1.31, p = 0.479), confirmed by matched analysis (HR: 0.91, 95% CI: 0.60–1.36, p = 0.628). This was also observed in the RP subgroup (HR: 1.12, 95% CI: 0.68–1.84). The retrospective nature of the data and the heterogeneous patient population were the major limitations. Conclusions: Although there were substantial differences between the two groups, after accounting for major confounders we report a nonsignificant OS difference with PC-LND compared with observation only. These findings may be hypothesis-generating for future prospective trials. Patient summary: We found no differences in survival by adding postchemotherapy lymphadenectomy in patients with pelvic or retroperitoneal lymph node metastatic bladder cancer. The indication to perform postchemotherapy lymphadenectomy in the most suitable patients requires additional studies. © 2017 European Association of Urology In contemporary cohorts of patients with metastatic pelvic or retroperitoneal lymph nodes from bladder cancer, we found no survival benefit from postchemotherapy surgery versus observation in a retrospective study. Performing postchemotherapy lymphadenectomy remains investigational in patients with metastatic bladder cancer. © 2017 European Association of Urology

Published
2019

44. Three-dimensional echocardiographic evaluation of the right ventricle in patients with uncomplicated systemic lupus erythematosus

Author

Buonauro, A, primary, Sorrentino, R, additional, Esposito, R, additional, Nappi, L, additional, Lobasso, A, additional, Santoro, C, additional, Rivellese, F, additional, Sellitto, V, additional, Rossi, F W, additional, Liccardo, B, additional, Tufano, A, additional, Galderisi, M, additional, and Paulis, A de, additional

Published
2019
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45. Plasma miR-371a-3p for detection of non-teratomatous viable germ cell tumor in testicular cancer

Author

Nappi, L., primary, Thi, M., additional, Eigl, B.J., additional, Lum, A., additional, Huntsman, D., additional, Martin, C., additional, Neil, B.O., additional, Khalaf, D.J., additional, Chi, K.N., additional, Gleave, M.E., additional, So, A., additional, Black, P., additional, Daneshmand, S., additional, Nichols, C.R., additional, and Kollmannsberger, C.K., additional

Published
2018
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46. Uterine leiomyosarcoma: report of three cases and review of the literature

Author

Nappi, L, Mele, G, Angioni, S, Cicinelli, E, Greco, P., DI SPIEZIO SARDO, ATTILIO, Nappi, L, Mele, G, Angioni, S, DI SPIEZIO SARDO, Attilio, Cicinelli, E, and Greco, P.

Subjects
Adult, Leiomyosarcoma, Uterine Neoplasms, Socio-culturale, Humans, Female, Middle Aged, Human
Abstract

This is the report of three cases of unsuspected uterine leiomyosarcoma diagnosed by pathologist after hysteroscopic resection. The literature on this issue has been reviewed. Mesenchymal uterine tumors are rare malignancies, occurring in only 17 per one million women annually. The three most common variants of uterine sarcoma are endometrial stromal sarcoma, leiomyosarcoma, and malignant mixed Müllerian tumour. Less than one percent of women believed to have a leiomyoma actually have a sarcoma at hysterectomy. According to the authors' experience and the available literature reviewed, the removal of the whole myomatosus lesion, even if its appearance suggests a typical submucosal myoma, represents the only method to definitively rule out the presence of sarcomatous tissue.

Published
2014

47. Cytotoxic Chemotherapy and Targeted Agents

Author

Bjartell A, de Santis M, Albers P, Armstrong A, Briganti A, Chi K, Culig Z, Danila D, Efstathiou E, Esch L, Gandaglia G, Gillessen S, Gleave M, Heidenreich A, Kitamura T, Lee R, Lobiaw A, Loriot Y, Bindu Musurunu H, Nappi L, Omlin A, Pienta K, Saad F, Schulz W, Schweizer M, Smith M, Suzuki M., Bjartell, A, de Santis, M, Albers, P, Armstrong, A, Briganti, A, Chi, K, Culig, Z, Danila, D, Efstathiou, E, Esch, L, Gandaglia, G, Gillessen, S, Gleave, M, Heidenreich, A, Kitamura, T, Lee, R, Lobiaw, A, Loriot, Y, Bindu Musurunu, H, Nappi, L, Omlin, A, Pienta, K, Saad, F, Schulz, W, Schweizer, M, Smith, M, and Suzuki, M.

Published
2014

48. Endomtrial polypectomy: outpatient versus inpatient treatment

Author

Nappi, L, Spinelli, M, Mastricci, L, Bettocchi, S, Greco, P., DI SPIEZIO SARDO, ATTILIO, Nappi L, Di Spiezio Sardo A, Spinelli M, Mastricci L, Bettocchi S, Greco P., Nappi, L, DI SPIEZIO SARDO, Attilio, Spinelli, M, Mastricci, L, Bettocchi, S, and Greco, P.

Published
2009

50. Office preparation of partially intramural miomas (OPPIuM): a pilot study

Author

Bettocchi, S, Guida, M, Greco, E, Nappi, L, Pontrelli, G, DI SPIEZIO SARDO, ATTILIO, NAPPI, CARMINE, Bettocchi S, Di Spiezio Sardo A, Guida M, Greco E, Nappi L, Pontrelli G, Nappi C., Bettocchi, S, DI SPIEZIO SARDO, Attilio, Guida, M, Greco, E, Nappi, L, Pontrelli, G, and Nappi, Carmine

Published
2008

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