Publications by authors named "Tommaso Difonzo"

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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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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Malacoplakia is an uncommon disease characterized by chronic and granulomatous inflammation, which rarely involves the female genital tract. We describe the ecographic and histological evolution of the first case of a patient developing endometrial malacoplakia as a complication after a cesarean section. The patient, a 43-year-old woman, presented with pelvic pain one month after delivering by cesarean section and the initial suspicion was of retention of placental rests.

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Article Synopsis
  • Hysteroscopy is the best method for diagnosing and treating issues inside the uterus, with new technology allowing for a combined approach called “see and treat.”
  • Diode laser technology is becoming a key technique in this field, and a systematic review was conducted on original studies using this method, focusing on the treatment of 474 patients.
  • The results showed low complication rates (2.7% intraoperative and 0.6% postoperative), indicating that diode laser hysteroscopy is both safe and effective, but more extensive studies are needed for stronger evidence.
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