Intraoperative aorta balloon occlusion: fertility preservation in patients with placenta previa accreta/increta.

Objective: To evaluate whether aorta balloon occlusion decreases the rate of hysterectomies and maternal morbidity during extirpative surgery of placenta previa accreta or increta.

Methods: We prospectively assessed 33 consecutive patients with placenta praevia and MRI diagnosis of multifocal accreta or increta. Manual removal of the placenta was performed during a scheduled caesarean delivery.

Multipotent stem/progenitor cells in the human foetal biliary tree.

Background & Aims: Biliary tree, liver, and pancreas share a common embryological origin. We previously demonstrated the presence of stem/progenitor cells of endodermal origin in the adult human extrahepatic biliary tree. This study evaluated the human foetal biliary trees as sources of stem/progenitor cells of multiple endodermal-derived mature fates.

Maternal C-reactive protein at hospital admission is a simple predictor of funisitis in preterm premature rupture of membranes.

Aim: To analyze the prognostic value of maternal serum C-reactive protein (CRP) in predicting funisitis in patients with preterm premature rupture of membranes (pPROM).

Methods: 66 patients (gestational age 24-33 weeks) hospitalized 1-12 h after pPROM were enrolled. White blood cell count (WBC), platelet count (PLT) and plasma concentration of CRP were assessed every 3 days.

Immunoglobulin therapy of fetal cytomegalovirus infection occurring in the first half of pregnancy--a case-control study of the outcome in children.

Background: Primary cytomegalovirus (CMV) infection early in gestation causes severe disease.

Methods: Case patients were 32 congenitally infected children aged 1-5 years who had either hearing deficit and/or psychomotor retardation and whose mothers had a confirmed or probable primary CMV infection at ≤ 20 weeks' gestation. Control subjects were 32 congenitally infected normal children whose mothers had a confirmed primary infection at ≤ 20 weeks' gestation.

Biliary tree stem/progenitor cells in glands of extrahepatic and intraheptic bile ducts: an anatomical in situ study yielding evidence of maturational lineages.

Stem/progenitors have been identified intrahepatically in the canals of Hering and extrahepatically in glands of the biliary tree. Glands of the biliary tree (peribiliary glands) are tubulo-alveolar glands with mucinous and serous acini, located deep within intrahepatic and extrahepatic bile ducts. We have shown that biliary tree stem/progenitors (BTSCs) are multipotent, giving rise in vitro and in vivo to hepatocytes, cholangiocytes or pancreatic islets.

MR imaging in the evaluation of placental abruption: correlation with sonographic findings.

Purpose: To evaluate the accuracy of magnetic resonance (MR) imaging and color Doppler ultrasonography (US) in the diagnosis of abruption, to assess the accuracy of the different MR imaging sequences in the visualization of clots, and to evaluate the correlation between MR imaging findings and clinical outcome.

Materials And Methods: This study protocol was approved by the institutional review board, and written informed consent was obtained from all patients. Between March 2008 and June 2010, 60 consecutive patients (mean gestational age, 30.

Reverse end-diastolic flow in a fetus with a rare liver malformation: a case report.

Introduction: We describe a case of early and persistent reverse end-diastolic flow in the middle cerebral artery in a fetus with severe ascites. These features are associated with a rare liver malformation known as ductal plate malformation.

Case Presentation: A 28-year-old Caucasian woman was referred to our high-risk obstetric unit at 24 weeks' gestation for fetal ascites detected during a routine ultrasound examination.

Role of the infections in recurrent spontaneous abortion.

Embryo-fetal infections have been reported to cause recurrent spontaneous abortions (RSAs) at a rate lower than 4%. The possible mechanisms include production of toxic metabolic byproducts, fetal or placental infection, chronic endometrial infection, and chorio-amnionitis. Viruses appear to be the most frequently involved pathogens, since some of them can produce chronic or recurrent maternal infection.

Acute abdominal and pelvic pain in pregnancy: MR imaging as a valuable adjunct to ultrasound?

Background: To investigate the usefulness of magnetic resonance imaging (MRI) in the evaluation of pregnant women with acute abdominal and pelvic pain after sonographically (US) indeterminate findings.

Methods: Forty pregnant patients with acute abdominal and/or pelvic pain, in whom ultrasound was indeterminate, were included in this study. Multiplanar MR images of the abdomen and pelvis were obtained and independently reviewed by two radiologists with discrepancies were resolved by consensus.

Intervillous circulation in intra-uterine growth restriction. Correlation to fetal well being.

Magnetic resonance imaging requested for a potentially serious indication, provided a unique opportunity to explore the intervillous circulation of placentas from pregnancies complicated by Intra Uterine Growth Restriction (IUGR) and to compare them to normal cases. This allowed an innovative characterization of in vivo utero-placental blood flow, correlating a compromised intervillous circulation in IUGR to the deterioration of fetal condition. MR imaging was requested to rule out suspected posterior placental adhesive disorders in 26 patients.

Antibody treatment promotes compensation for human cytomegalovirus-induced pathogenesis and a hypoxia-like condition in placentas with congenital infection.

Human cytomegalovirus (HCMV) is the major viral cause of birth defects worldwide. Affected infants can have temporary symptoms that resolve soon after birth, such as growth restriction, and permanent disabilities, including neurological impairment. Passive immunization of pregnant women with primary HCMV infection is a promising treatment to prevent congenital disease.

Transplacental transfer of antiretroviral drugs and newborn birth weight in HIV-infected pregnant women.

Although it is well known that antiretroviral drugs (ARVs) across the placenta in different extents, few data are available concerning the impact of the transplacental passage of ARVs on newborn outcome. The aim of this study is to evaluate the transplacental diffusion of ARVs and the clinical assessment of the newborn. Mother and cord lopinavir, nelfinavir, atazanavir and nevirapine plasma levels were determined by high-performance liquid chromatography.

First trimester PAPP-A levels associated with early prediction of pregnancy induced hypertension.

Objective: Previous studies have suggested an association between low levels of first trimester serum Pregnancy Associated Plasma Protein-A (PAPP-A) and the occurrence of hypertension in pregnancy (PIH). The purpose of this study was to determine the predictive value of maternal PAPP-A levels in the identification of women at risk of PIH.

Methods: Maternal serum PAPP-A was measured between 11-13 + 6 wks' gestation, as part of the first trimester screening of aneuploidies.

Guidelines on CMV congenital infection.

Congenital cytomegalovirus (CMV) infection occurs in 0.6-0.7% of all newborns and is the most prevalent infection-related cause of congenital neurological handicap.

Review and meta-analysis: Benefits and risks of multiple courses of antenatal corticosteroids.

Background: Preterm birth causes infant morbidity and mortality. A single course of antenatal corticosteroids (ACS) should be considered routine for preterm delivery. Benefits of therapy before 34 weeks' gestation have been established for infants born between 24 h and 7 days after treatment.

Preterm delivery at low gestational age: risk factors for short latency. A multivariated analysis.

Objective: The aim of this study is to identify the risk factors for a short latency in preterm delivery at low gestational ages (GA).

Study Design: A retrospective analysis involving, between January 2004 and May 2006, 204 singleton pregnancies with admission diagnosis of preterm labor and, in particular, 91 pregnant women admitted between 24+0 and 31+6 weeks' gestation.

Results: In pregnant women with a diagnosis of preterm labor at 24-31+6 weeks' gestation, at ROC curve, a value of considering WBC and cervical dilatation, combined in the following formula (75.

Magnetic resonance imaging in the evaluation of placental adhesive disorders: correlation with color Doppler ultrasound.

The purpose of this study was to compare the value of pelvic ultrasound with color Doppler and magnetic resonance imaging (MRI) in: (1) the diagnosis of placental adhesive disorders (PADs), (2) the definition of the degree of placenta invasiveness, (3) determining the topographic correlation between the diagnostic images and the surgical results. Fifty patients in the third trimester of pregnancy with a diagnosis of placenta previa and at least one previous caesarean section underwent color Doppler ultrasound (US) and MRI. The sonographic and MRI diagnoses were compared with the final pathologic or operative findings.

Treatment and prevention of malaria in pregnancy and newborn.

Pregnant women are at increased risk for malaria infection. Although important advances have been made in the last years, the mechanisms that explain the increased susceptibility are not yet fully understood. Malaria infection in pregnancy is associated with maternal and fetal morbidity and mortality.

Validity of amniotic fluid index in preterm rupture of membranes.

Background: Preterm premature rupture of membranes (pPROM) complicates up to one-third of preterm deliveries. We studied the Amniotic Fluid Index (AFI) in order to ascertain its validity as a predictive variable of maternal-fetal outcome in pregnancies complicated by pPROM.

Study Design: One hundred and fourteen pregnant women with gestational age between 24 and 34 weeks' gestation at the time of pPROM.

Mean platelet volume: association with adverse neonatal outcome.

The aim of the study was to investigate on a possible association between maternal mean platelet volume (MPV) and oxygen-metabolic changes in pregnancies affected by altered maternal-fetal Doppler velocimetry. We considered the altered maternal-fetal Doppler velocimetry group (n = 57) pregnant women admitted to our Institution for a pregnancy complication associated to the event Pre-eclampsia (PE) and intrauterine growth retardation (IUGR), with altered Doppler velocimetry in the umbilical artery ( UA) (high pulsatility index, absence or reverse end diastolic flow (ARED), blood flow cephalisation) and/or bilateral increased resistance in uterine arteries. Out of these cases, 25 pregnancies were complicated by PE and 32 pregnancies were complicated by IUGR.

Nuchal translucency as a predictor of adverse pregnancy outcome.

Background: Thickened nuchal translucency (NT) has been related to fetal genetic syndromes, structural abnormalities, and other diseases. The aim of this research was to evaluate the association of NT with adverse pregnancy outcomes.

Study Design: In the period 2002-2004 in 2104 pregnant women between 10+6 and 13+5 weeks' gestation, NT was evaluated as a parameter for aneuploidy screening: out of these, 734 singleton pregnant women that underwent 2nd trimester amniocentesis and whose pregnancy outcome were known were selected.

The combined effect of betamethasone and ritodrine on the middle cerebral artery in low risk third trimester pregnancies.

Aims: To evaluate the effect of antenatal betamethasone and ritodrine in third trimester low risk singleton pregnancies by Doppler technology.

Subjects And Methods: Eighty-four third trimester pregnant women who received a full course of betamethasone and delivering uneventfully were recruited. The Doppler examination included the assessment of the pulsatility index (PI) of the umbilical artery (UA PI) and the middle cerebral artery (MCA PI) prior to treatment (baseline), and 48, 72 and 96 h after the second dose of betamethasone.