Publications by authors named "Paolo I Cavoretto"

Background: Previous studies demonstrated that placental dysfunction leads to intrapartum fetal distress, particularly when an abnormal pattern of angiogenic markers is demonstrated at 36 weeks of gestation. Prediction of intrapartum fetal compromise is particularly important in patients undergoing induction of labor due to different indications for delivery, as this can be a useful in optimizing the method and timing of the induction.

Objective: To examine whether the risk of preeclampsia assessed by the Fetal Medicine Foundation (FMF) algorithm (derived from a combination of maternal risk factors, mean arterial pressure, placental growth factor and soluble fms-like tyrosine kinase-1), associates with the risk of intrapartum fetal compromise requiring cesarean delivery, in a population of singleton pregnancies undergoing labor induction for various indications.

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Background: Previous evidence showed that placental dysfunction triggers spontaneous preterm or term births and intrapartum fetal compromise and often requires urgent delivery, thereby exposing both the fetus and the mother to significant risks. Predicting spontaneous labor onset and intrapartum fetal compromise could improve obstetrical management and outcomes, but this is currently difficult, particularly in low-risk populations.

Objective: The objective of this study was to examine whether placental dysfunction, as assessed at 36 weeks' gestation by the soluble fms-like tyrosine kinase-1 to placental growth factor ratio, is associated with the interval to spontaneous onset of labor and intrapartum fetal compromise that requires cesarean delivery in a routinely examined population.

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Objective: To provide available evidence comparing surgical outcomes of different vaginal hysterectomy (VH) techniques and devices.

Data Sources: PubMed, Embase, and ClinicalTrials.gov databases were searched from inception to December 1, 2023, using relevant keywords.

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Purpose To test the performance of a transformer-based model when manipulating pretraining weights, dataset size, and input size and comparing the best model with the reference standard and state-of-the-art models for a resting-state functional (rs-fMRI) fetal brain extraction task. Materials and Methods An internal retrospective dataset (172 fetuses, 519 images; collected 2018-2022) was used to investigate influence of dataset size, pretraining approaches, and image input size on Swin-U-Net transformer (UNETR) and UNETR models. The internal and external (131 fetuses, 561 images) datasets were used to cross-validate and to assess generalization capability of the best model versus state-of-the-art models on different scanner types and number of gestational weeks (GWs).

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Background: The rate of preterm birth of singletons conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is increased, being as high as 15% to 16% across Europe and the United States. However, the underlying etiology, phenotype, and mechanisms initiating preterm birth (PTB) are poorly understood.

Objective: To quantify the PTB risk and examine supposed etiology in IVF/ICSI singleton pregnancies compared to naturally conceived.

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Preterm birth (PTB) is a complex syndrome traditionally defined by a single parameter, namely, gestational age at birth (ie, ˂37 weeks). This approach has limitations for clinical usefulness and may explain the lack of progress in identifying cause-specific effective interventions. The authors offer a framework for a functional taxonomy of PTB based on (1) conceptual principles established a priori; (2) known etiologic factors; (3) specific, prospectively identified obstetric and neonatal clinical phenotypes; and (4) postnatal follow-up of growth and development up to 2 years of age.

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Background: Altered neurodevelopment is a major clinical sequela of Preterm Birth (PTB) being currently unexplored in-utero.

Aims: To study the link between fetal brain functional (FbF) connectivity and preterm birth, using resting-state functional magnetic resonance imaging (rs-fMRI).

Study Design: Prospective single-centre cohort study.

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Article Synopsis
  • In early 2023, a study demonstrated that vaccinating pregnant women effectively reduces the chances of severe COVID-19 complications and maternal health issues.
  • The INTERCOVID-2022 study, conducted across 40 hospitals in 18 countries, analyzed how COVID-19 during pregnancy affects newborns and the benefits of maternal vaccination during the Omicron variant period.
  • Results showed that newborns from mothers who received a booster vaccine had significantly lower risks of contracting COVID-19 and experiencing preterm birth compared to those from unvaccinated mothers.
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Background: Despite the rising rates of opportunistic salpingectomy at the time of surgery for non-malignant conditions, salpingectomy is not widely adopted during vaginal hysterectomy (VH) and has not been extensively investigated.

Objectives: The aim of the primary study was to determine the feasibility of bilateral opportunistic salpingectomy at the time of VH. Secondary aims included surgical outcomes, factors associated with patient selection, and the prevalence of incidental tubal malignancies.

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Background: First-trimester screening for preeclampsia using a combination of maternal risk factors and mean arterial pressure, uterine artery pulsatility index, and placental growth factor, as proposed by the Fetal Medicine Foundation, provides effective prediction of preterm preeclampsia. Placental dysfunction is a potential precursor of spontaneous birth.

Objective: The objective of this study was to examine if the estimated risk of preeclampsia is associated with the gestational age at onset of spontaneous delivery in the absence of preeclampsia.

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SARS-CoV-2 infection poses a significant risk increase for adverse pregnancy outcomes both from maternal and fetal sides. A recent publication in BMC Pregnancy and Childbirth presented a machine learning algorithm to predict this risk. This commentary will discuss potential implications and applications of this study for future global health policies.

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Article Synopsis
  • The study looked at how progesterone levels on the day of ovulation affect the birthweight of babies born from frozen embryos.
  • Researchers collected data from 368 patients who had babies through a method called ART (Assisted Reproductive Technology) after their eggs were stimulated.
  • They found that higher progesterone levels were linked to lower birthweights for the babies, while taller mothers and those with more previous births had babies with higher birthweights.
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A link between maternal anxiety during pregnancy and adverse socio-emotional outcomes in childhood has been consistently sustained on the very early neurodevelopmental alteration of structural pathways between fetal limbic and cortical brain regions. In this study, we provide follow-up evidence for a feed-forward model linking (i) maternal anxiety, (ii) fetal functional neurodevelopment, (iii) neonatal functional network organization with (iv) socio-emotional neurobehavioral development in early childhood. Namely, we investigate a sample of 16 mother-fetus dyads and show how a maternal state-trait anxiety profile with pregnancy-specific worries can significantly influence functional synchronization patterns between regions of the fetal limbic system (i.

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To review the current evidence on the risk of gestational diabetes mellitus (GDM) in women with endometriosis, taking into account relevant confounders such as the higher frequency of Assisted Reproductive Technologies (ART) conceptions. Database searches on PubMed, Medline, Embase and Scopus through June 2022, using combinations of relevant keywords. A total of 18 studies, involving N = 4,600,885 women, were included.

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Background: In 2021, we showed an increased risk associated with COVID-19 in pregnancy. Since then, the SARS-CoV-2 virus has undergone genetic mutations. We aimed to examine the effects on maternal and perinatal outcomes of COVID-19 during pregnancy, and evaluate vaccine effectiveness, when omicron (B.

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Background: Preimplantation genetic testing (PGT) of embryos developed in vitro requires a biopsy for obtaining cellular samples for the analysis. Signs of cell injury have been described in association with this procedure. Thus, the consequences of the biopsy on obstetric and neonatal outcomes have been the subject of some quantitative analyses, although the reliability of data pooling may be limited by important issues in the various reports.

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The prenatal assessment of congenital heart defects (CHD) and related fetal and maternal management is very challenging and delicate [...

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