Publications by authors named "Miriam Dellino"

This study aimed to evaluate our center's experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features.

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  • Genetic anomalies during oocyte maturation pose significant challenges to fertility and embryonic development.
  • The review highlights various genetic and molecular factors, including chromosomal mutations, signaling pathway errors, and mitochondrial defects, that negatively impact oocyte quality.
  • Understanding these genetic factors is essential for improving fertility treatments and outcomes, especially for couples experiencing repeated IVF failures.
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The elucidation of oocyte maturation mechanisms is paramount for advancing embryo development within the scope of assisted reproductive technologies (ART). Both cytoplasmic and nuclear maturation represent intricate processes governed by tightly regulated cellular pathways, which are essential for ensuring the oocyte's competence for fertilization and subsequent embryogenesis. A comprehensive grasp of these mechanisms is vital, as the maturation stage of the oocyte significantly influences chromosomal integrity, spindle formation, and its ability to support the initial stages of embryonic development.

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  • Birth weight is influenced by both maternal and paternal factors, including genetics, environment, and diet, with maternal characteristics having a stronger impact on fetal growth and infant health.
  • While maternal factors like age and prior pregnancies greatly affect birth weight, the role of paternal characteristics, particularly age and height, is still being studied but shows a correlation with variations in newborn size and health outcomes.
  • Research suggests that taller fathers may lead to higher birth weights and lower chances of small for gestational age infants, indicating a complex relationship between parental attributes and fetal development that warrants further exploration.
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  • Prostaglandins (PGs) are vital in second trimester medical abortions but can lead to complications like maternal fever and uterine rupture (UR).
  • This systematic review aimed to evaluate the safety of PGs, especially in women with a scarred uterus, using data from multiple medical databases published between 1990 and 2022.
  • Although PGs are effective for medical abortion, they are associated with risks, necessitating the use of well-equipped and skilled obstetric teams for safer procedures.
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Asynclitism, a misalignment of the fetal head with respect to the plane of passage through the birth canal, represents a significant obstetric challenge. High degrees of asynclitism are associated with labor dystocia, difficult operative delivery, and cesarean delivery. Despite its clinical relevance, the diagnosis of asynclitism and its influence on the outcome of labor remain matters of debate.

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Objective: To evaluate the reproductive outcomes of patients bearing BRCA-1 and BRCA-2 mutations.

Methods: In this retrospective observational cohort study, we assessed data from BRCA-1 and BRCA-2 carriers, analyzing demographics, oncological history, and reproductive outcomes. Statistical analysis compared BRCA-1 and BRCA-2 carriers.

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Background: The endometrium remains a difficult tissue for the analysis of microbiota, mainly due to the low bacterial presence and the sampling procedures. Among its pathologies, endometrial cancer has not yet been completely investigated for its relationship with microbiota composition. In this work, we report on possible correlations between endometrial microbiota dysbiosis and endometrial cancer.

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Aim: We investigated the potential benefits of administering a nutraceutical combination of Bromelain (200 mg) and Boswellia serrata Casperome® (200 mg) on post-operative outcomes of hernioplasty with mesh.

Methods: One hundred eighty patients (27 females, 153 males) were enrolled to undergo open tension-free hernioplasty with the use of Progrip®. Patients were randomized to receive either one tablet of Siben® (study group) or placebo (control group) on an empty stomach, every twelve hours for eleven postoperative days.

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Introduction: This Special Report aims to highlight the importance of tailored therapies in women with Polycystic Ovary Syndrome (PCOS), avoiding prescribing generalized or unsuitable therapies based on oral contraceptive pills (OCPs).

Areas Covered: This article discusses the benefits and risks of OCP-based therapy, highlighting the possible undesirable effects, especially in those patients exhibiting risk factors as women with PCOS, and the importance of carefully evaluated tailored therapeutic approaches. Literature searches were performed with the use of PubMed, Google Scholar, and Web of Science between January and February 2024.

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In eutocic labor, the autonomic nervous system is dominated by the parasympathetic system, which ensures optimal blood flow to the uterus and placenta. This study is focused on the detection of the quantitative presence of catecholamine (C) neurofibers in the internal uterine orifice (IUO) and in the lower uterine segment (LUS) of the pregnant uterus, which could play a role in labor and delivery. A total of 102 women were enrolled before their submission to a scheduled cesarean section (CS); patients showed a singleton fetus in a cephalic presentation outside labor.

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The position of the fetal head during engagement and progression in the birth canal is the primary cause of dystocic labor and arrest of progression, often due to malposition and malrotation. The authors performed an investigation on pregnant women in labor, who all underwent vaginal digital examination by obstetricians and midwives as well as intrapartum ultrasonography to collect four "geometric parameters", measured in all the women. All parameters were measured using artificial intelligence and machine learning algorithms, called AIDA (artificial intelligence dystocia algorithm), which incorporates a human-in-the-loop approach, that is, to use AI (artificial intelligence) algorithms that prioritize the physician's decision and explainable artificial intelligence (XAI).

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Up to 70-80% of women of reproductive age may be affected with the most common uterine tumors, known as fibroids or myomas. These benign tumors are the second most prevalent cause of surgery among premenopausal women. Predictions show that the occurrence of myomas in pregnancy will increase, and that the risk of having myomas during pregnancy increases with advanced maternal age.

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: Despite advancements in detection and treatment, cervical cancer remains a significant health concern, particularly among young women of reproductive age. Limited data exists in the literature regarding fertility-sparing treatment (FST) of cervical cancers with tumor sizes greater than 2 cm. The objective of this systematic review was to evaluate the reproductive outcomes of women diagnosed with cervical cancer greater than 2 cm who underwent FST.

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Article Synopsis
  • Aggressive angiomyxoma (AAM) is a rare tumor found mostly in the pelvic area of young women, known for its slow growth and tendency to invade nearby tissues without a clear boundary.
  • Diagnosing AAM before surgery is challenging due to its rarity and lack of specific symptoms, making complete removal difficult during treatment.
  • Despite surgical excision being the primary approach, recurrence occurs in up to 40% of cases, sometimes many years later; this paper aims to provide updated information on diagnosis and management of AAM based on recent clinical experiences.
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Human genital papilloma virus infection is the most prevalent sexually transmitted infection in the world. It is estimated that more than 75% of sexually active women contract this infection in their lifetime. In 80% of young women, there is the clearance of the virus within 18-24 months.

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  • - Colorectal cancer (CRC) during pregnancy is very rare, occurring in about 0.8 out of every 100,000 pregnancies, and presents significant diagnostic challenges due to overlapping symptoms and limited imaging options.
  • - The study highlights two advanced CRC cases in pregnant patients and includes a systematic review of 66 relevant studies, revealing that severe symptoms and acute abdomen were linked to earlier delivery compared to milder cases.
  • - Findings suggest that pregnant women who received chemotherapy had better delivery outcomes and similar neonatal health compared to those who did not, indicating that interdisciplinary collaboration is crucial for managing CRC in pregnant individuals.
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The uterus is a highly innervated organ, and during labor, this innervation is at its highest level. Oxytocinergic fibers play an important role in labor and delivery and, in particular, the Lower Uterine Segment, cervix, and fundus are all controlled by motor neurofibers. Oxytocin is a neurohormone that acts on receptors located on the membrane of the smooth cells of the myometrium.

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Introduction: Hemostasis is an important step in all surgical procedures. Mechanical methods of hemostasis have been gradually abandoned in favor of electrosurgery. The aim of this systematic review was to evaluate the effectiveness of electrosurgical instruments utilized in minimally invasive gynecological procedures.

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Objective: The COVID-19 pandemic had significant effects on healthcare systems worldwide, including the disruption of routine screening programs for cervical cancer. This study aimed to compare the incidence of cervical intra-epithelial neoplasia (CIN)2 and CIN3 lesions, adenocarcinoma, and squamous carcinoma of the cervix before and after the COVID-19 pandemic.

Methods: A retrospective analysis was performed using archive data from the Policlinico di Bari, Unit of Gynecology and Obstetrics.

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More than three and a half years have passed since the start of the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and there have been several studies in the literature about the different damage and symptom patterns related to the condition; particular attention has been paid to the transmission of the disease from pregnant mothers to fetus. In this report, we present the case of a 36-year-old patient with a history of two cesarean sections (CS), two miscarriages, and hypothyroidism on replacement therapy, who contracted COVID-19 during the 15th week of gestation. Ultrasound (US) examination at 22 weeks revealed regular fetal biometry and bilateral ventriculomegaly, highly suggestive of massive intracerebral hemorrhage.

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Endometrial osseous metaplasia (EOM) is an uncommon clinical entity with the presence of bone in the endometrium which requires clinical and therapeutic framework. It is also described by various other names such as endometrial ossification, ectopic intrauterine bone, and heterotopic intrauterine bone. Ossification could have various locations as the cervix the ovary, and the vagina.

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Article Synopsis
  • Uterine leiomyomas (ULs) are common non-cancerous tumors in women, but how they affect fertility is still not well understood.
  • A new classification system from 2008 helps categorize these fibroids better, especially focusing on a special type called "type 3 UL" that can cause more problems for women trying to get pregnant.
  • This review aims to explain how type 3 ULs can affect fertility and explore ways to treat them better, since there's not much solid information available right now.
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