Upcoming strategies in obstetrics: how the technology of clinical audit may reduce cesarean birth.

Background: The rate of cesarean delivery is currently increasing all over Europe. In Italy it reaches 38% of all child births. Therefore, it is important to identify the clinical and organizational variables that determine the appropriateness of elective cesarean delivery.

Time remaining in labor and probability of vaginal delivery as a function of the angle of progression in a low risk population with a normal first stage of labor. In-house observational study and comparison with the data in the literature.

Background: The aim of the study was to investigate whether the angle of progression (AoP), as measured by transperineal ultrasound, was predictive of both the time remaining in labor and vaginal delivery.

Methods: This was a prospective observational cohort study involving 270 low-risk women with singleton pregnancies at term. The AoP, measured at the end of the first stage of labor, was used as a predictive variable of time remaining in labor and mode of delivery.

Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial.

Background: To evaluate whether sonographic (US) diagnosis of the fetal spine position could increase the success rate of manual rotation of the fetal occiput (MRFO) in second-stage arrest in persistent occiput posterior position (OPP).

Methods: In this randomized controlled parallel single-center trial, 58 nulliparous in second-stage arrest of labor with fetus in cephalic presentation and OPP diagnosed by US were randomly assigned to group A where the fetal spine position was not known by the operator or to group B where the operator knew it. The main outcome was the success of MRFO in the two groups.

Helicobacter pylori seropositivity and pregnancy-related diseases: a prospective cohort study.

The relationship between Helicobacter pylori infection and extragastric disease is well established. This study prospectively investigated whether maternal H. pylori seropositivity, detected during the first half of pregnancy, could be associated with the development of the major pregnancy-related pathological conditions during the late second or third trimester in a general population.

Chronic kidney disease may be differentially diagnosed from preeclampsia by serum biomarkers.

Preeclampsia, affecting 5-8% of pregnancies, is the main cause of fetal-maternal mortality and morbidity. The differential diagnosis with chronic kidney disease (CKD) is a challenge owing to the overlapping clinical features. No biomarker has been found to discriminate between the two conditions.

Helicobacter pylori's virulence and infection persistence define pre-eclampsia complicated by fetal growth retardation.

Aim: To better understand the pathogenic role of Helicobacter pylori (H. pylori) in pre-eclampsia (PE), and whether it is associated or not with fetal growth retardation (FGR).

Methods: Maternal blood samples were collected from 62 consecutive pregnant women with a diagnosis of PE and/or FGR, and from 49 women with uneventful pregnancies (controls).