Publications by authors named "Luigi Raio"

The role of classification criteria is particularly important in rheumatic diseases compared with other medical disorders, as the complexity and overlapping symptoms of these conditions make diagnosis challenging. Moreover, the absence of established diagnostic criteria further complicates diagnosing patients. Classification criteria can assist health-care professionals and patients as a diagnostic aid.

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  • * Investigating placental pathology is vital for diagnosing health issues in both the mother and fetus, understanding potential risks for future pregnancies, and determining causes of complications like growth restrictions.
  • * Improved terminology and classification of placental conditions aim to enhance collaboration among healthcare professionals in diagnosing and treating related obstetric and fetal disorders.
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Objectives: Data are lacking regarding the long-term consequences of SARS-CoV-2 and COVID-19 mRNA vaccine on infants exposed in utero. We aimed to evaluate the neurodevelopment of infants exposed prenatally to SARS-CoV-2 or mRNA-COVID-19 vaccine during pregnancy at 12 months after birth.

Methods: Infants born to mothers exposed to SARS-CoV-2 or mRNA-COVID-19 vaccine during pregnancy, or unexposed to either the virus or the vaccine were enrolled from 2021 to 2023.

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  • * Researchers collected and analyzed placentas from 61 SARS-CoV-2 infected pregnant women and 10 healthy controls to assess signs of viral presence and damage.
  • * Results showed active virus replication in the placenta linked to severe maternal COVID-19 symptoms, with significant replication noted in cases of stillbirth, indicating a possible connection between the virus and adverse pregnancy outcomes.
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Background: Cardiovascular diseases represent a leading cause of maternal morbidity and mortality in industrialized countries. High blood pressure during pregnancy is a major driver of short- and long-term cardiovascular health in both mother and child. Screening and adequate treatment of elevated blood pressure before pregnancy significantly reduce mortality risk to mother and child.

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Introduction: Switzerland was amongst the first countries to offer cell-free fetal DNA (cffDNA) testing covered by the health insurance to pregnant women with a risk ≥ 1:1000 for trisomies at first trimester combined screening (FTCS). The aim of this study is to evaluate the implementation of this contingent model in a single tertiary referral centre and its effect on gestational age at diagnosing trisomy 21.

Materials And Methods: Between July 2015 and December 2020 all singleton pregnancies at 11-14 weeks of gestation without major fetal malformation were included and stratified according to their risk at FTCS.

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  • RH1 incompatibility can lead to hemolytic disease in newborns, prompting Switzerland to recommend fetal genotyping from maternal blood starting at 18 weeks gestation since 2020.
  • This method allows for the targeted administration of RH immunoglobulin (RHIG) specifically to RH1 negative women expecting RH1 positive fetuses.
  • Data from 30 months of noninvasive fetal screening showed valid results from 7072 samples, helping to avoid unnecessary RHIG treatments for over one-third of RH1 negative pregnant women, thus enhancing safety and conserving medical resources.
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  • Hyperhemolysis syndrome (HHS) is a rare and severe complication after blood transfusions that leads to the destruction of both the recipient's and the donor's red blood cells.
  • The exact causes of HHS are not well understood, making it challenging to manage, especially in pregnant individuals.
  • This report highlights a case of HHS in a pregnant woman with sickle cell disease and emphasizes the importance of recognizing HHS as a potential diagnosis in patients with worsening anemia despite receiving blood transfusions.
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Background: Pregnant women with obesity are more likely to experience cesarean birth compared to women without obesity. Yet, little is known about the underlying mechanisms. The objective of this study was therefore to evaluate how mediators contribute to the association between obesity and prelabor/intrapartum cesarean birth.

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Introduction: Maternal anti-Ro/SSA antibodies can cause fetal atrioventricular blocks (AVB). This pilot study aims to apply previously published echocardiographic reference ranges of the fetal atrioventricular (AV) intervals in the setting of anti-Ro/SSA antibody-positive pregnancies in order to exclude a 1° AVB.

Materials And Methods: Between January 2018 and September 2022, we included all women with known anti-Ro/SSA antibodies followed up at the prenatal ultrasound department of the University Hospital of Bern.

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  • FMF London created a new first trimester screening method for predicting preterm preeclampsia (pPE) that is more effective than traditional methods based on maternal risk factors.
  • A multicenter study was conducted in Switzerland from June 2020 to May 2021, collecting data on singleton pregnancies at hospitals in Basel, Lucerne, and Bern to validate this screening algorithm.
  • Preliminary results showed that out of 1,027 patients, 16.9% were identified as at risk for pPE, with low rates of preeclampsia leading to hopes for effective integration into routine practice and the use of low-dose aspirin as prevention.
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Background: Gastroschisis and omphalocele are the 2 most common congenital fetal abdominal wall defects. Both malformations are commonly associated with small-for-gestational-age neonates. However, the extent and causes of growth restriction remain controversial in both gastroschisis and omphalocele without associated malformations or aneuploidy.

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Introduction: Gynecological sarcomas are rare malignant tumors with an incidence of 1.5-3/100,000 and are 3-9% of all malignant uterine tumors. The preoperative differentiation between sarcoma and myoma becomes increasingly important with the development of minimally invasive treatments for myomas, as this means undertreatment for sarcoma.

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Autoimmune rheumatic diseases (ARD) can affect women and men during fertile age, therefore reproductive health is a priority issue in rheumatology. Many topics need to be considered during preconception counselling: fertility, the impact of disease-related factors on pregnancy outcomes, the influence of pregnancy on disease activity, the compatibility of medications with pregnancy and breastfeeding. Risk stratification and individualized treatment approach elaborated by a multidisciplinary team minimize the risk of adverse pregnancy outcomes (APO).

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Introduction: This study aimed to investigate the extent to which gestational diabetes mellitus (GDM) can be predicted in the first trimester by combining a marker of growing interest, glycosylated hemoglobin A1c (HbA1c), and maternal characteristics.

Material And Methods: This observational study was conducted in the outpatient obstetric department of our institution. The values of HbA1c and venous random plasma glucose were prospectively assessed in the first trimester of pregnancy.

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Hypertensive disorders of pregnancy (HDP) contribute substantially to perinatal morbidity and mortality. Epigenetic changes point towards cardio-metabolic dysregulation for these vascular disorders. In early pregnancy, epigenetic changes using cell free DNA (cfDNA) are largely unexplored.

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The aim of our study was to evaluate the mental health of pregnant individuals during the early COVID-19 pandemic and the potential factors associated. A Swiss online survey was proposed to individuals who gave birth during the pandemic period from March 2020. The Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7 questions (GAD-7), and Impact Event Scale-Revised (IES-R) were evaluated and used to defined mental health impairment as a composite outcome.

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Management of severe postpartum hemorrhage (PPH) includes transcatheter pelvic arterial embolization (TAE). Data regarding subsequent fertility and obstetrical outcomes is limited, as most fertility outcomes derive from TAE in uterine fibroma. The purpose of our study was to evaluate the long-term outcomes of patients undergoing TAE, particularly concerning subsequent fertility and following pregnancies.

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Fetal growth restriction (FGR) and resulting low birth weight are risk factors for impaired lung development. However, both are often correlated with other factors, especially prematurity. Therefore, the question whether lung function changes in individuals with FGR are driven by gestational age, fetal growth, or both often remains unanswered.

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Aim: Individuals with SARS-CoV-2 infection and (pre-existing) diabetes, including pregnant women, present with more severe morbidity, as compared to non-diabetic subjects. To date, evidence is limited concerning the role of gestational diabetes (GDM) in severity of SARS-CoV-2 infection during pregnancy, or vice versa. The aim of our study was to investigate the prevalence of GDM in a SARS-CoV-2 infected pregnant population and evaluate risk factors for and from severe infection in these patients.

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Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area.

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Background: The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation.

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