Publications by authors named "Raffaello Alfonso"

The Twin Reversed Arterial Perfusion (TRAP) Sequence is an extremely rare complication of monochorionic twin pregnancies, with one severely malformed twin (the "acardiac") lacking autonomous placental blood supply and being perfused by the co-twin (the "pump"), through arterio-arterial (and sometimes also veno-venous) vascular anastomoses located on the placental surface. The prognosis is poor: mortality is 100% in the acardiac twin because of its severe malformations and about 50-55% in the pump twin, mainly due to heart failure and prematurity. So, the goal of perinatal management of the TRAP twin pregnancy is to deliver a healthy and near-term pump twin without heart failure or fetal hydrops.

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Article Synopsis
  • Uterine arteriovenous malformations (AVMs) are a rare, high-risk cause of uterine bleeding that can be difficult to diagnose through ultrasound.
  • Two cases during the postpartum period showed episodes of bright red blood loss linked to AVMs, which were confirmed via imaging techniques like transvaginal ultrasound and angiography.
  • There are currently no established guidelines for managing AVMs, but the cases discussed opted for a conservative treatment approach to preserve the patients' fertility, aiming to contribute to the limited existing literature on the topic.
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To determine antenatal factors that may predict successful vaginal birth after Caesarean section (VBAC), to develop a relevant antenatal scoring system and a nomogram for prediction of vaginal birth after caesarean delivery. A non recurring indication for previous Caesarean section (CS), such as breech presentation or foetal distress, is associated with a much higher successful VBAC rate than recurrent indications, such as cephalopelvic disproportion (CPD). Prior vaginal deliveries are excellent prognostic indicators of successful VBAC, especially if the vaginal delivery follows the prior CS.

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Study Question: What is the prevalence of chronic endometritis (CE) in women with repeated unexplained implantation failure (RIF) at IVF, and how does antibiotic treatment affect the reproductive outcome?

Summary Answer: Chronic endometritis, associated with infection with common bacteria or mycoplasma, is common in women complaining of RIF and antibiotic treatment significantly improves the reproductive outcome at a subsequent IVF cycle.

What Is Known Already: We have reported that CE is a frequent finding in women with repeated pregnancy loss and a significantly higher rate of successful pregnancies was achieved after adequate antibiotic treatment. Moreover, CE was identified in 30.

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In a 3-year prospective study, 30 postmenopausal women received transdermal E2 gel and every-other-day vaginal P in capsules. At study completion, endometrial thickness was significantly reduced as compared with baseline (2.7 +/- 0.

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The blood supply to the uterus originates mainly from the uterine artery. However, the uterine and ovarian arteries form anastomoses bilaterally. Controversy exists about the direction of the flow in the anastomoses and thus the origin of the arterial supply to the tube and tubal part of the uterus.

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Background: The blood supply to the uterus is provided by the uterine and ovarian arteries, which form anastomoses. Yet the flow direction through this anastomoses and the primary source of blood supply to the tubes and uterine cornua remains unknown. To clarify this issue, we studied the spatial propagation of temperature changes following cooling of the upper vaginal area.

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