Clinical practice evaluation of combination of atosiban, ritodrine and ketoprofen for inhibiting preterm labor.

Aim: The aim of this study was to compare the efficacy and tolerability of atosiban vs ritodrine administered as single-drug or as combination therapy with the COX inhibitor ketoprofen in the treatment of preterm labor and to investigate how frequent is the need for combination therapy with ketoprofen.

Methods: Ninety-one women with diagnosis of threatened preterm delivery at 24-33 weeks' gestation were enrolled in an observational case-control study. Forty-seven received IV atosiban (6.

Uterine artery embolization in the treatment and prevention of postpartum hemorrhage.

Objectives: The study was conducted to evaluate the efficacy of superselective transcatheter uterine artery embolization for control of obstetric hemorrhage.

Methods: Between January 2002 and December 2005, 14 consecutive patients underwent uterine artery embolization to control postpartum hemorrhage, and two to prevent hemorrhage before second-trimester therapeutic abortion.

Results: Embolization was performed by transfemoral arterial catheterization.

Integrated monitoring of fetal growth restriction by computerized cardiotocography and Doppler flow velocimetry.

Objective: To investigate the correlations between Doppler flow velocimetry and computerized cardiotocography (cCTG) in fetal growth restriction.

Study Design: Fifty growth-restricted foetuses with abdominal circumference below the 10th percentile and no major abnormalities were studied. A total of 186 cCTG tracings (at least two per patient) analysed using the HP2CTG system were compared with the corresponding umbilical artery pulsatility index (PI), the PI ratio of umbilical artery to middle cerebral artery, and the ductus venosus systolic/atrial ratio.

[Dinoprostone: slow release vaginal insert (Propess) and intracervical gel (Prepidil) for the induction of labour with unriped cervix].

Aim: The purpose of the present study is to compare the effectiveness and safety of a slow release vaginal PGE2 insert (Propess) with intracervical PGE2 gel (Prepidil gel) in the induction of cervical ripening and labour.

Methods: For the induction of labour we selected 103 single pregnancies at term presenting a Bishop score of less than 5. Fifty-one were induced with Propess, and 52 with intracervical Prepidil.

Meconium-stained amniotic fluid and fetal oxygen saturation measured by pulse oximetry during labour.

Background And Aim Of The Work: The high false-positive rate of electronic fetal heart rate monitoring is the major obstacle to the correct prediction and diagnosis of intrapartum fetal distress. Fetal pulse oximetry is a safe and accurate indicator of fetal oxygenation. The aim of this study was to evaluate the clinical use of this technique for the diagnosis of fetal hypoxia and for prevention of fetal metabolic acidosis and asphyxia during labour, in the presence of meconium-stained amniotic fluid with or without abnormal fetal heart rate patterns, using a threshold value of 30% oxygen saturation.

[Epidural analgesia during labour: maternal, fetal and neonatal aspects].

Aim: The most effective technique for eliminating labour and childbirth pain is continuous lumbar epidural analgesia. The preoccupation regarding the possible negative effects on the time taken for labour and on dystocias in general represents one of the greatest hindrances in the way of its wider use. The purpose of the present study is to monitor the effects of continuous lumbar epidural analgesia on delivery times, on the state of the fetus, on the incidence of dystocic deliveries and on neonatal outcome.

[Vertical transmission of HIV infection: risk factors and prevention strategies].

In this study it has been evaluated the connection between the maternal immune status and the obstetrical factors on the one hand end the perinatal transmission of HIV in the other as well as, the effects of zidovudine prophylaxis and elective caesarean section on vertical HIV transmission. From January 1987 to September 1999, 60 HIV infected pregnant women were followed with their 64 infants. From July 1995 15 women and their respective children were treated with zidovudine prophylaxis (protocol ACTG 076); from June 1997, in 8 of these patients a systematic caesarean section was performed (7 electively and 1 on an emergent basis).

[Childbirth preparation courses: obstetrical and neonatal evaluation].

From 1997, R.A.T.

[Early discharge project appropriate for the healthy newborn].

Recently the stay in the hospital of the pueperae and of their newborns has progressively been shortened in several Countries. A lot of reports evaluating the risks of early discharges have not shown any significant differences in the hospital readmission rates between newborn early discharged and case-controls. This phenomenon is occurring also in Italy and the early discharge after the delivery is one of the aims of the "Percorso-Nascita" in the National Health Program of 1998-2000.

[Risk of materno-fetal transmission of the HIV infection with antiretroviral therapy and cesarean section: experience of the Parma group].

Vertical transmission of HIV is by far the most important way of infection in pediatric patients. Transmission rate of infection varies between 15-40% in the absence of antiretroviral prophylaxis. Only 2% of infected pregnant women who underwent caesarean section and zidovudine treatment transmitted the infection to their newborns.

[Vertical transmission of the hepatitis C virus].

The incidence of hepatitis C in childhood is approximately 0.4%. The mode of transmission can be parenteral, sexual, occupational and also vertical.

[Pre-partum cardiotocography: comparison between the traditional and the computed systems].

The objective of our study was to determine the usefulness of a computerized antepartum fetal heart rate (FHR) analysis instead of the common visual evaluation of cardiotocographic parameters. From a total of 4,000 antepartum FHR tracings performed in our institute in the years 1994-1996, and analyzed on-line by the software HP 2CTG, 100 were visually assessed by five physicians in three different moments. To each reader a qualitative and quantitative interpretation was required.

[Preliminary data on early discharge after delivery].

Puerpera and baby's early discharging falls within a bigger project that deals with the reduction of medical treatment and with the razionalization of economic resources. We can talk about early discharging when it occurs by 48 hours after a vaginal childbirth and by 96 hours after a cesarean section. When the mother and the baby have been discharged from hospital, their health will chiefly depend on the efficiency of the sanitary organization that works on the territory.

[Innovations of the Stark method for cesarean section. Comparison of techniques].

Background: The evolution of surgical techniques for cesarean section have improved the neonatal outcome as well as maternal morbidity and mortality. Aim of this study is to compare the conventional technique with a personally modified Stark's technique, in order to evaluate its effectiveness.

Methods: A prospective study has been carried out on a group of patients submitted to cesarean section by two different teams.

Intravesicular prostaglandin E2 for the prophylaxis of urinary retention after colpohysterectomy.

The aim of this study was to assess the efficacy of PGE2 in enhancing bladder function after vaginal hysterectomy. A total of 110 women with or without urinary incontinence underwent vaginal hysterectomy and cystourethropexy surgery because of grade II or III genital prolapse. Preoperatively the patients were randomly assigned to two groups: group 1 (n = 50) received on the fourth post-operative day, before removal of the bladder catheter, an intravesicular solution of 1.

[Term pregnancy: the review and development of fetal surveillance protocols].

The authors have analyzed the reasons behind the changes in clinical and biophysical monitoring of term and post-term pregnancies. In particular, there is an assessment of the results of NST monitoring over a one-year period. Furthermore, the importance of the introduction of new methods of labour induction by means of intracervical PGE2 is also discussed and there is a reference to the results.

Plasma concentration, urinary excretion and renal clearance of L-carnitine during pregnancy: a reversible secondary L-carnitine deficiency.

Plasma concentration, urinary excretion and renal clearance of free, total and esterified L-carnitine were monitored monthly in 14 women during the last 6 months of pregnancy and 1 month after delivery. Plasma concentration and renal clearance measured 1 month after delivery overlapped with normal values for females of comparable age, and were considered the reference values for further comparisons. Plasma concentration of free, total and esterified L-carnitine decreased during pregnancy, reaching values as low as half of those measured 1 month after delivery, whereas urinary excretion and renal clearance, mainly of L-carnitine esters, increased, with renal clearance reaching a peak at the 16th week of pregnancy.

Fetal distress: role of cardiotocography.

The FHR monitoring in 320 patients with fetal distress were randomly analyzed and revised over 16 years. The aim of our study, in so long a period, was to evaluate the role of cardiotocography in order to preserve the fetus from irreversible damage. The results show a progressive improvement of neonatal outcome, due to the development of the experience with this method, and to the improvement in interpretative criteria.

[Echographic diagnosis of gestational age and law 194].

The authors examine the various biometrics parameters evidentiable at the 13th week of pregnancy, which is so important age for the limits imposed by the law 194, that regulates the legal abortion. These findings are studied as for their evidentiability and their diagnostic predictivity aiming to single out the most reliable. As for the results obtained examining the singular parameters, the authors conclude that the goal of the echographist is to search for the fetal CRL and BPD: they are characterised of an optimum predictivity and a good evidentiability, besides they provide direct data about the embryo dimensions.

[Thermal therapy in gynecology].

The Authors consider the importance of Thermal Therapy in a large part of gynaecological diseases. They emphasize of its utility mostly in the chronic flogosis of the female genitalia. However other indications emerged from this research, such as female sterility, pelvic vascular disease, climaterie syndrome and post-operatory affects.

[Echographic diagnosis of fetal malformations].

The Authors report their experience about ultrasound diagnosis of congenital anomalies, related to 15 cases from approximately 4000 gravides. They emphasize the impossibility to carry out total antenatal population screening by sonar and the usefulness to carefully select the gravidas at high risk for harboring a fetus with a birth defect. They also suggest that, in looking for physical defects, it is best to make ultrasound examination at 17a-18a weeks' gestation; at this moment, the ultrasound evaluation is particularly favorable for diagnosis and treatment.

[Congenital cardiac disease: cardiotocographic manifestations (author's transl)].

The Authors have studied in retrospect the cardiotocographic registrations of women who had given birth to foetus affected by congenital cardiac disease. The observations of several authors (Heinriche Seideschnur; Fischer) are confirmed that persistent bradycardia in pregnancy or in labour could be a sign of a congenital cardiac anomaly. Furthermore, the high incidence of C.

[Down syndrome: cardiotocographic alterations (author's transl)].

The Authors describe the results of a study on the cardiotocographic tracings during labour of pregnant women, whose fetuses were affected by Down syndrome. The high incidence of cardiotocographic alterations in these fetuses does not seem to be in relation with congenital cardiac disease.