Obstetric outcomes in pregnant COVID-19 women: the imbalance of von Willebrand factor and ADAMTS13 axis.

Background: Thrombotic microangiopathy has been invoked as one of the most important mechanisms of damage in COVID-19 patients. Protease ADAMTS13 is a marker of microangiopathy responsible for controlling von Willebrand multimers size. Von Willebrand factor/ADAMTS13 ratio has been found impaired in COVID-19 patients outside pregnancy.

SARS-CoV-2 and Placenta: New Insights and Perspectives.

The study of SARS-CoV-2 positive pregnant women is of some importance for gynecologists, obstetricians, neonatologists and women themselves. In recent months, new works have tried to clarify what happens at the fetal-placental level in women positive for the virus, and different pathogenesis mechanisms have been proposed. Here, we present the results of a large series of placentas of Coronavirus disease (COVID) positive women, in a reference center for COVID-positive pregnancies, on which we conducted histological, immunohistochemical and electron microscopy investigations.

Comparison of endometrial polyp recurrence in fertile women after office hysteroscopic endometrial polypectomy using two widely spread techniques.

Aim: To compare the recurrence of benign endometrial polyps after office hysteroscopic polypectomy performed with a bipolar electrode (BE) or a small diameter hysteroscopic tissue removal system (HTRs).

Methods: From July 2018 to December 2019 we evaluated the charts of 114 asymptomatic fertile women who underwent office hysteroscopic polypectomy, 1 year before, for a single large benign endometrial polyp (size between 10 and 20 mm) using a 4 mm continuous flow hysteroscope with a BE or a 5 mm HTRs. Patients, divided into two groups according to surgical procedure, each performed exclusively by one expert gynecologist, were scheduled for a 12-month postoperative transvaginal sonography to evaluate the recurrence of endometrial polyps.

Resectoscopic Metroplasty with Uterine Septum Excision: A Histologic Analysis of the Uterine Septum.

Study Objective: To evaluate the histology of the uterine septum after its complete hysteroscopic excision.

Design: Case series.

Setting: Second Gynecological and Obstetric Unit and Pathological Anatomy Department of the University of Bari, Italy.

Human Endometrial Microbiota at Term of Normal Pregnancies.

The endometrium is a challenging site for metagenomic analysis due to difficulties in obtaining uncontaminated samples and the limited abundance of the bacterial population. Indeed, solid correlations between endometrial physio-pathologic conditions and bacteria compositions have not yet been firmly established. Nevertheless, the study of the endometrial microbiota is of great interest due to the close correlations between microbiota profiles, women's health, and successful pregnancies.

Office treatment of large endometrial polyps using truclear 5C: Feasibility and acceptability.

Aim: This retrospective multicenter study was carried out to evaluate feasibility, effectiveness and patient acceptability of a small diameter hysteroscopic tissue removal system in the treatment of large endometrial polyps (≥20 mm), usually not removed in an office setting.

Methods: Hundred and forty-six women with a single greater than 10-mm diameter polyp considered for polypectomy between April 2016 and August 2017. Sixty-five of these patients had a polyp size greater than 20 mm.

Office myomectomy.

Small myomas have a high potential to grow and either to become symptomatic or to cause complications in women of reproductive age. Furthermore, although the risk of malignancy is rare, even the most experienced operator cannot replace the histological analysis to exclude malignancy or premalignant lesions. Such small symptomatic and asymptomatic totally or partially intracavitary myomas may be treated effectively and safety in office setting.

Challenging the cervix: strategies to overcome the anatomic impediments to hysteroscopy: analysis of 31,052 office hysteroscopies.

Objective: To report our experience on 10,156 cases of cervical stenosis (CS) diagnosed at office hysteroscopy.

Design: Retrospective study.

Setting: Ambulatory clinics of diagnostic and operative hysteroscopy of two university teaching hospitals (Naples and Bari).

Hysteroscopic Patterns in Women on Treatment With Ulipristal Acetate 5 mg/day: A Preliminary Study.

Study Objective: To describe the hysteroscopic findings in women on treatment with ulipristal acetate (UPA) and to define the most common hysteroscopic patterns related to the treatment and compare them with the histologic findings.

Design: Preliminary study.

Setting: OB-GYN and Gynecology Oncology Clinic, Military Medical Institute, Ministry of Defense, Warsaw, Poland, and Obstetrics and Gynecology Department, University of Bari, Italy.

Ultrasonographic and hysteroscopic outcomes of uterine scar healing after cesarean section: comparison of two types of single-layer suture.

Aim:  A common anatomical consequence of low-segment cesarean section is the presence of a pouch on the anterior uterine wall that can be detected by sonography or hysteroscopy. Different suturing techniques have been compared (single vs double layer) and showed no substantial differences. This prospective longitudinal study was aimed at evaluating the outcome of the cesarean scar, comparing two different types of single-layer sutures by transvaginal ultrasound and hysteroscopy.

Fertility-enhancing hysteroscopic surgery.

Uterine abnormalities, including congenital pathologies, polyps, submucous leiomyomata, intrauterine adhesions, and chronic endometritis, have been reported in 21 to 47% of patients undergoing in vitro fertilization cycles. The position of hysteroscopy in current fertility practice is under debate. Although there are many randomized controlled trials on technical feasibility and patient compliance demonstrating that the procedure is well tolerated and effective in the treatment of intrauterine pathologies, there is no consensus on the effectiveness of hysteroscopic surgery in improving the prognosis of subfertile women.

Diagnosis of colorectal endometriosis: contribution of contrast enhanced MR-colonography.

Objective: To investigate the contribution of contrast-enhanced MR-colonography (CE-MR-C) for the diagnosis of intestinal endometriosis.

Methods: One hundred and four women with suspected endometriosis were prospectively enrolled. All patients were subjected to MRI consisting of two phases: pelvic high-resolution MRI (HR-MRI) followed by CE-MR-C after colonic distension using a 1.

A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study.

Objective: To assess the safety and the effectiveness of a novel hysteroscopic technique for the Office Preparation of Partially Intramural Myomas (OPPIuM), to facilitate the subsequent, already scheduled, resectoscopic myomectomy.

Design: Pilot study.

Setting: University of Bari, Naples and Foggia.

Hysteroscopic removal of gauze packing inadvertently sutured to the uterine cavity: report of 2 cases.

We report on 2 cases of successful hysteroscopic removal of uterovaginal packing, inserted during cesarean sections after uterine hemorrhage resistant to medical therapy. The packing, in both cases, could not be removed vaginally with sponge forceps because the packing had been sutured to the uterine cavity. A hysteroscopic approach enabled identification and cutting with 5F scissors of the stitches fixing the packing to the uterine walls, allowing straightforward removal in an outpatient setting and avoiding a repeated laparotomy.

Office hysteroscopy in an in vitro fertilization program.

Objective: In the present paper we evaluate the incidence of intrauterine pathologies in a population undergoing in vitro fertilization (IVF) treatment. Moreover, we compare the IVF outcome between patients with normal and abnormal uterine findings to determine if office hysteroscopy (OH) is of any clinical significance.

Methods: The hysteroscopic findings in 866 consecutive patients were analyzed.

Fibrotic tissue in the endometrioma capsule: surgical and physiopathologic considerations from histologic findings.

Ovarian tissue inadvertently excised along with endometriomas was associated with the presence of pericystic fibrosis and serum levels of CA-125, representing the only clinical parameter for predicting follicle loss before surgery. A consecutive series of 91 ovarian endometriotic cysts were studied, and an inverse relationship between serum CA-125 and the thickness of the fibrotic tissue of the endometrioma capsule was demonstrated.

Estimation of birth weight by two-dimensional ultrasonography: a critical appraisal of its accuracy.

Objective: To assess the accuracy and characterize two-dimensional ultrasonographic formulas for the estimation of birth weight according to the type of fetal biometric parameters these formulas rely on to make fetal weight predictions.

Methods: A prospective recruitment of 589 pregnant women was carried out for this cross-sectional study. Different biometric parameters were taken ultrasonographically to estimate birth weight using 35 different formulas.

The destiny of myomas: should we treat small submucous myomas in women of reproductive age?

Objective: To carry out a thorough analysis aimed at demonstrating that a "wait-and-see" approach is no longer acceptable in women of reproductive age with small submucous myomas, even if they are asymptomatic.

Design: Review article.

Setting: University hospitals.

Endometrial vaporization of the cervical stump employing an office hysteroscope and bipolar technology.

We report the successful treatment of a 40-year-old woman with ongoing cyclical vaginal bleeding lasting 10 days after laparoscopic subtotal hysterectomy. Hysteroscopic vaporization of the endometrial stripe in the cervical stump was performed in an office setting, using a 5-mm Bettocchi double-channel operative hysteroscope armed with a bipolar electrode.

Office hysteroscopic metroplasty: three "diagnostic criteria" to differentiate between septate and bicornuate uteri.

Study Objective: To evaluate the benefits of adopting 3 simple "diagnostic criteria" in the differential diagnosis between septate and bicornuate uteri, and the relative treatment by hysteroscopy in an office setting.

Design: Prospective clinical study (Canadian Task Force classification III).

Setting: University-affiliated hospital.

Correlation between serum levels of CA 125 and follicular loss after laparoscopic cystectomy in women with ovarian endometrioma.

Study Objective: To preoperatively predict follicular loss after laparoscopic cystectomy of ovarian endometriomas.

Design: Case-control study. (Canadian Task Force classification II-2).