Uterine artery Doppler in predicting pregnancy outcome in women with connective tissue disorders

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Marfan’s syndrome and pregnancy: a good maternal and fetal outcome

This case report highlights the important role of a multidisciplinary team’s task in the care of pregnant women with Marfan’s syndrome (MFS), a systemic disorder of connective tissue that is transmitted as an autosomal dominant trait. Case: a 42 year-old italian pregnant woman with Marfan’s syndrome and degenerative heart disease (aneurysmatic dilatation of the aortic root, mitral regurgitation and prosthetic mitralic valve) was clinically assessed jointly by an obstetrician and a cardiologist, ‘the obstetric team specialised in management of high risk pregnancy’, every 2-3 weeks from the 21th week of gestation. The first ambulatory monitoring echocardiogra- phy revelead aneurysmatic dilatation of the aortic root (41 mm), good function of the previously replaced mitral valve, cardiac ejection fraction 51% and telediastolic volume 116 ml. The echocardio-graphies showed no changes up to 32 weeks gestation. At the 34th week of gestation she had a slight decrease in cardiac ejection fraction and minimal increase of left ventricular diastolic volume. Therefore she underwent elective cesarean section under general anesthesia at 35 weeks’gestation. The post-partum course was uneventfull for the patient and the baby. Conclusion: pregnant women with heart disease benefit from an appropriate antenatal management, which may result in a favourable outcome

Characteristics of Gender-Based Violence Determined from Emergency Room Visits

Gender-based violence is recognized as a public health problem worldwide. Nevertheless, in Italy, there are no official epidemiological studies about it. We therefore thought that it was important to conduct a study to describe and quantify the problem in Ferrara. This is one of the first systematic studies to be performed by a regional health service authority. The sample examined was taken from patients presenting to the emergency departments of the Sant’Anna University Hospital in the period from January 1, 2008, to December 31, 2013. The final sample comprised 1,359 patients. Data were collected and analyzed using the following software: (1) SAP, acronym for Systems, Applications and Products in data processing, a management software developed by SAP AG; (2) SAS, acronym for ‘‘statistical analysis system,’’ a set of integrated software products enabling work on the database and specific operations such as data input, search, and management; and (3) Excel. The total number of women patients exposed to violence was 1,359, constituting an average of 225 per year. Sixty-one percent of victims of violence and/or abuse were of Italian nationality, followed by women from Central and Eastern Europe, Nigeria, and Morocco. Percentages related to nationalities refer to the three-year period 2010–2013 since before then this indicator was not available. Therefore, the total number of patients was 897. Where violence was perpetrated by an intimate partner, in 98% of the cases the perpetrator was the husband/live-in partner, and in the remaining 2% of cases a boyfriend. Since most women in our sample came within the central age group, that is, aged between 26 and 45, women appear to be most exposed to violence and/or abuse in these years when the stabilization of intimate relationships usually takes place. Patients who experienced violence and/or abuse were mostly of Italian nationality. In our sample, husbands/live-in intimate partners are the main abusers

Analysis of cytotoxic activity of peripheral blood natural killer cells in women with recurrent miscarriage

Around 50% of recurrent spontaneous abortions (RSA) remain unexplained. Immunological etiology has been proposed, supported by evidence of lower count of natural killer (NK) cells in peripheral blood of RSA women compared to women with normal delivery history. However, studies concerning the cytotoxic activity of NK cells in women with RSA are still controversial. We performed an observational case-control study assaying peripheral blood NK (pNK) cells cytotoxic activity in non-pregnant RSA women compared to non-pregnant women with normal delivery history. Twelve RSA and nine control women were recruited and blood samples were drawn during the luteal phase of ovarian cycle. pNK cells were incubated with target CFSE-labeled K562 cells and cytotoxicity was measured by cytofluorimetry. In non-pregnant RSA women pNK cytotoxic activity was not significantly altered compared to control women. In luteal phase of ovarian cycle the level of cytotoxic activity of pNK cells is not a marker for predicting RSA, and clinicians should not use pNK activity as a systematic recurrent pregnancy loss examination

The use of uterine artery doppler as a predictive tool for adverse gestational outcomes in pregnant patients with autoimmune and thrombophilic disease

Objectives: To verify whether Doppler velocimetry on the uterine arteries can be used to single out abnormal hemodynamic adjustments in the uteroplacental district and to prognose adverse gestational outcomes in pregnant women with autoimmune and trombophilic disease

Procreative sex in infertile couples: the decay of pleasure?

Background. Infertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment. Materials and methods. In this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL) to enquire about personality features and the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N=30, recently diagnosed infertile couples) Group B (N=30, infertile couples already undergoing Intrauterine Insemination) and Group C (N=52, fertile control group). Results. Infertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm) than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls. Conclusions. Even if at the very first stages of infertility treatment no personality disturbances can be detected, the couples’ sexual life is already impaired with different sexual disorders according togender

Procreative sex in infertile couples: the decay of pleasure?

Background: Infertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment.Materials and methods: In this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL) to enquire about personality features and the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N = 30, recently diagnosed infertile couples) Group B (N = 30, infertile couples already undergoing Intrauterine Insemination) and Group C (N = 52, fertile control group).Results: Infertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm) than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls.Conclusions: Even if at the very first stages of infertility treatment no personality disturbances can be detected, the couples' sexual life is already impaired with different sexual disorders according to gender. © 2012 Marci et al.; licensee BioMed Central Ltd

Investigation on Silent Bacterial Infections in Specimens from Pregnant Women Affected by Spontaneous Miscarriage.

Miscarriage is one of the main complications occurring in pregnancy. The association between adverse pregnancy outcomes and silent bacterial infections has been poorly investigated. Ureaplasma parvum and urealiticum, Mycoplasma genitalium and hominis and Chlamydia trachomatis DNA sequences have been investigated by polymerase chain reaction (PCR) methods in chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from females with spontaneous abortion (SA, n = 100) and females who underwent voluntary interruption of pregnancy (VI, n=100). U. parvum DNA was detected in 14% and 15% of SA and VI, respectively, with a mean of bacterial DNA load of 1.3 × 10−1 copy/cell in SA and 2.8 × 10−3 copy/cell in VI; U. urealiticum DNA was detected in 3% and 2% of SA and VI specimens, respectively, with a mean DNA load of 3.3 × 10−3 copy/cell in SA and 1.6 × 10−3 copy/cell in VI; M. hominis DNA was detected in 5% of SA specimens with a DNA load of 1.3 × 10−4 copy/cell and in 6% of VI specimens with a DNA load of 1.4×10−4 copy/cell; C. trachomatis DNA was detected in 3% of SA specimens with a DNA load of 1.5 × 10−4 copy/cell and in 4% of VI specimens with a mean DNA load of 1.4 × 10−4 copy/cell. In PBMCs from the SA and VI groups, Ureaplasma spp, Mycoplasma spp and C. trachomatis DNAs were detected with a prevalence of 1%–3%. Bacteria were investigated, for the first time, by quantitative real‐time PCR (qPCR) in chorionic villi tissues and PBMCs from women affected by SA and VI. These data may help to understand the role and our knowledge of the silent infections in SA