1,721,011 research outputs found
Ultrasound screening in second and third trimester of pregnancy: an update.
No full textActa Biomed. 2007 Dec;78(3):229-32.
Ultrasound screening in second and third trimester of pregnancy: an update.
Verrotti C, Caforio E, Gramellini D, Nardelli GB.
SourceDepartment of Obstetrics, Gynecology, and Neonatology, Section of Gynecology and Obstetrics, University of Parma. [email protected]
Abstract
Ultrasound screening of structural fetal malformations is mainly based on the use of ultrasounds during the second trimester of pregnancy. The diagnostic sensibility of ultrasounds varies in the different multicentric studies reported in literature and is correlated to different factors: gestation period, type of malformation, number of ultrasounds performed, operator experience, etc. Third trimester ultrasounds may identify late-onset malformations and offer adequate information for postnatal assistanc
Association between fetal doppler velocimetry abnormalities and confined placental trisomy 22
No full textJ Matern Fetal Neonatal Med. 2009 Jul;22(7):629-32.
Association between fetal Doppler velocimetry abnormalities and confined placental trisomy 22: A case report.
Piantelli G, Patrelli TS, Anfuso S, Neri TM, Gramellini D, Nardelli GB.
SourceDepartment of Obstetrics, Gynecology and Neonatology, University of Parma, Italy.
Abstract
The occurrence of trisomy 22 confined to the placenta is rare. We report on a patient who presented with fetal abnormal Doppler velocimetry (elevated umbilical artery pulsatility index), but serial ultrasound examinations revealed a spontaneous recovery throughout pregnancy. A healthy baby was normally delivered at 40 week
Uterine tumors resembling ovarian sex cord tumors: a case report of conservative management in young women.
No full textInt J Gynecol Cancer. 2009 May;19(4):808-10.
Uterine tumors resembling ovarian sex cord tumors: a case report of conservative management in young women.
Berretta R, Patrelli TS, Fadda GM, Merisio C, Gramellini D, Nardelli GB.
SourceDepartment of Obstetrics and Gynecology, University of Parma, Parma, Italy. [email protected]
Abstract
Uterine tumors resembling ovarian sex cord tumors (UTROSCT) are distinguished into two separate groups: endometrial stromal tumors with sex cord-like elements (Group I), which have an unfavorable prognosis; and UTROSCT proper (group II), with more than 40% sex cord-like differentiation and less endometrial component, which are biologically less aggressive than the tumors of the other group. We report the case of a young woman with UTROSCT treated by minimally invasive hysteroscopic surgery. This is one of the few cases reported in the literature that have been managed conservatively
Intrapancreatic rupture of a splenic artery aneurysm during pregnancy – a rare case report with fetal and maternal survival
No full textJ Matern Fetal Neonatal Med. 2009 Apr;22(4):362-4.
Intrapancreatic rupture of a splenic artery aneurysm during pregnancy - a rare case report with fetal and maternal survival.
Patrelli TS, Anfuso S, Verrotti C, Fadda GM, Gramellini D, Nardelli GB.
SourceDepartment of Obstetrics, Gynecology and Neonatology, OB/GYN Unit, Parma General Hospital, University of Parma, Via Gramsci, Parma 14 43100, Italy. [email protected]
Abstract
Rupture of a splenic artery aneurysm (SAA) during pregnancy is a rare and severe condition. A 35-year-old woman at 34 weeks' gestation came to our observation for acute abdominal pain. After being diagnosed with intra-pancreatic SAA rupture, she was delivered of a live fetus by cesarean section. This is a rare case with both fetal and maternal survival
Incidence of port-site metastases after laparoscopic pure management of borderline ovarian tumors : a series of 22 patients
No full textEur J Gynaecol Oncol. 2009;30(3):300-2.
Incidence of port-site metastasis after laparoscopic management of borderline ovarian tumors: a series of 22 patients.
Berretta R, Rolla M, Patrelli TS, Gramellini D, Fadda GM, Nardelli GB.
SourceDepartment of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. [email protected]
Abstract
PURPOSE: The aim of this work was to evaluate the incidence of port-site metastasis in patients undergoing laparoscopy for borderline ovarian carcinoma (BOT).
METHODS: Twenty-two patients who underwent laparoscopy from 2004 to 2008 for BOT were evaluated retrospectively.
RESULTS: In 15 patients an ultraconservative procedure with enucleation of the annexal neoplasia was carried out, while in five (23%) unilateral salpingo-oophorectomy was performed and in two cases (9%) bilateral salpingo-oophorectomy was done.
CONCLUSION: The literature data report few cases of port-site metastasis in BOT patients. Residual cutaneous metastases have been reported to occur within 12 months from the first surgery, generally in association with serous histology. In our analysis, we found 17 out of 22 cases of serous BOT, three mucinous and two endometriod. In no case was cutaneous metastasis revealed after an average of 30 months of follow-up
Mid-trimester amniocentesis and antibiotic prophylaxis.
No full textPrenat Diagn. 2007 Oct;27(10):956-9.
Mid-trimester amniocentesis and antibiotic prophylaxis.
Gramellini D, Fieni S, Casilla G, Raboni S, Nardelli GB.
SourceDepartment of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. [email protected]
Abstract
OBJECTIVES AND METHODS: Assuming that the rate of fetal loss after amniocentesis may be reduced in patients receiving antibiotic prophylaxis, we conducted a retrospective study on untreated versus treated patients receiving prophylactic antibiotics (amoxicillin/clavulanic-acid or azithromycin) and evaluated the fetal loss rate within the 22nd week of gestation, also with respect to the risk of spontaneous abortion, both preexisting and related to mid-trimester amniocentesis.
RESULTS: Spontaneous abortion occurred in 22 cases out of 1744 (1.26%). The incidence of spontaneous abortion was 1.3% among patients treated with antibiotic prophylaxis and 1.2% among untreated patients. Between patients with risk factors that predated amniocentesis, the spontaneous fetal loss rate was 9.2% in untreated patients versus 2.3% in patients treated (p = 0.10). In patients with procedure-related risk factors at amniocentesis, the spontaneous abortion rate was, respectively, 2.2 and 1.2% (p = 0.72).
CONCLUSION: Our data demonstrate that antibiotic prophylaxis does not reduce the risk of spontaneous abortion within the 22nd week of gestation. Compared with untreated patients, patients treated with amoxicillin showed the lower fetal loss rate (1.16 vs 0.31%), but the difference was not statistically significant (odds ratio (OR) = 3.68, p = 0.32). The same was true for patients with preexisting risks (OR = 4.25, p = 0.10)
Diagnostic accuracy of IOTA ultrasound morphology in the hands of less experienced sonographers
No full textAust N Z J Obstet Gynaecol. 2008 Apr;48(2):195-201.
Diagnostic accuracy of IOTA ultrasound morphology in the hands of less experienced sonographers.
Gramellini D, Fieni S, Sanapo L, Casilla G, Verrotti C, Nardelli GB.
SourceDepartment of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. [email protected]
Abstract
AIM: The purpose of our study was to evaluate the ability of the International Ovarian Tumor Analysis (IOTA) classification and its impact on the identification of benign and malignant adnexal masses by less experienced sonographers.
METHODS: One hundred and five patients undergoing elective surgical treatment for single adnexal masses at the University of Parma were enrolled. After the final diagnosis, we had the ultrasound recordings reviewed retrospectively by a group of three residents, and the features of each adnexal mass were evaluated according to the morphological score reported by the IOTA Group.
RESULTS: Based solely on the qualitative classification of the IOTA Group unilocular cysts were associated with a high, significant probability of a benign lesion (odds ratio (OR) = 12.6 (95% CI, 1.61-99.10), P < 0.001). This probability remained high also with multilocular cysts (OR = 7.9 (95% CI, 1.00-62.38), P < 0.05). By contrast, multilocular-solid cysts were significantly associated with the probability of malignancy (OR = 6.4 (95% CI, 1.81-22.70), P < 0.001), as were solid masses (OR = 5.5 (95% CI, 1.48-20.92), P < 0.05). None of the five ultrasound categories of lesions could be significantly correlated with borderline masses.
CONCLUSIONS: A simple qualitative classification based solely on the recognition of five different ultrasound categories may be enough to guide the physician to an accurate identification of the nature of the mass. Our findings confirm the diagnostic reliability of the IOTA Group classification by less experienced sonographers. This system is especially helpful because it is capable of discriminating between ovarian masses without further tests and clinical examinations
Pelvic lymphadenectomy in endometrial cancer: our current experience.
No full textEur J Gynaecol Oncol. 2009;30(5):536-8.
Pelvic lymphadenectomy in endometrial cancer: our current experience.
Patrelli TS, Berretta R, Rolla M, Vandi F, Capobianco G, Gramellini D, Bacchi Modena A, Nardelli GB.
SourceDepartment of Gynecology, Obstetrics and Neonatology, University of Parma, Italy. [email protected]
Abstract
OBJECTIVE: Lymph node involvement is the single most important factor in the prognosis of endometrial cancer, because it is predictive of locoregional and distant metastases. The purpose of our study was to determine whether lymphadenectomy is useful in the surgical staging of endometrial cancer and if it may help establish a more accurate prognosis and reduce the need for postoperative therapy in patients without surgical complications.
STUDY DESIGN: We conducted a retrospective study on 55 patients with diagnosis of endometrial cancer.
RESULTS: Surgical staging of patients undergoing pelvic lymphadenectomy (47/55) showed that 59.6% of cases (n = 28) had Stage I cancer (IA in 4, IB in 16, IC in 8), 17.02% (n = 8) Stage II (IIA in 3, IIB in 5), 21.2% (n = 10) Stage III (IIIB in 5, IIIC in 5), and 2.1% (n = 1) Stage IVA. In the remaining eight patients with a very high anesthesiologic risk (ASA 4), surgical staging was incomplete because they underwent only node palpation.
CONCLUSION: In conclusion, as we wait for the sentinel lymph node technique to demonstrate satisfactory results and be standardized also for endometrial cancer, we believe that surgical lymph node dissection plays a crucial role in debulking this type of cancer. When performed by a good surgical oncology team, it does not entail a significantly increased operative risk
Lack of normalization of middle cerebral artery flow velocity prior to fetal death before 30th week of gestation: a report of three cases
No full textIn recent years, the investigation of flow velocity in the
middle cerebral artery (MCA) has become critical to the
clinical management of fetal growth restriction (FGR).
The increase in end-diastolic flow velocity, leading to a
reduction of the pulsatility index (PI), is a consequence
of compensatory cerebral vasodilatation (brain-sparing
effect) secondary to fetal hypoxia. According to some
authors1–3, cerebral flow velocity may reveal important
prognostic signs of imminent fetal death in the presence
of a loss of compensatory vasodilatation. This feature
is described only sporadically in cases followed up until
intrauterine death, providing evidence that it is a late
sign and therefore may represent a poor index in FGR
management.
We report our experience of three pregnancies
complicated by severe FGR followed by fetal death
between the 25th and the 29th weeks of gestation
Role of D-dimer testing in severe pelvic inflammatory disease: a new usable marker to assess the need for fertility-impairing surgery?
No full textFertil Steril. 2010 Nov;94(6):2372-5. Epub 2010 May 14.
Role of D-dimer testing in severe pelvic inflammatory disease: a new usable marker to assess the need for fertility-impairing surgery?
Franchi L, Patrelli TS, Berretta R, Rolla M, Gizzo S, Gramellini D, Bacchi Modena A, Nardelli GB.
SourceDepartment of Maternal and Child Health, OB/GYN Unit, University of Parma, Parma, Italy.
Abstract
Pelvic inflammatory disease (PID), like many other inflammatory diseases, can be characterized by an inflammation-induced activation of the coagulation cascade, resulting in the production of D-dimers. In this study it is demonstrated how high levels of D-dimers, assayed at the time of hospitalization, are encountered in patients diagnosed with PID and how the levels of this parameter are significantly higher in patients, which due to the severity of the disease, needed surgical treatment. Therefore the d-dimer is shown to be an important parameter to be considered in the therapeutic counseling of severe forms of PI
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