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  1. Article: Integrating reinforcement learning and serious games to support people with rare genetic diseases and neurodevelopmental disorders: outcomes on parents and caregivers.

    Stasolla, Fabrizio / Akbar, Khalida / Passaro, Anna / Dragone, Mirella / Di Gioia, Mariacarla / Zullo, Antonio

    Frontiers in psychology

    2024  Volume 15, Page(s) 1372769

    Language English
    Publishing date 2024-04-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2024.1372769
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  2. Article ; Online: Evidence-based labor management: postpartum care after vaginal delivery (part 6).

    Zullo, Fabrizio / Di Mascio, Daniele / Berghella, Vincenzo

    American journal of obstetrics & gynecology MFM

    2023  Volume 5, Issue 7, Page(s) 100977

    Abstract: In the setting of postpartum care after vaginal delivery, rooming-in is associated with a higher rate of exclusive breastfeeding rate at hospital discharge, but there is insufficient evidence to support or refute rooming-in to increase breastfeeding at 6 ...

    Abstract In the setting of postpartum care after vaginal delivery, rooming-in is associated with a higher rate of exclusive breastfeeding rate at hospital discharge, but there is insufficient evidence to support or refute rooming-in to increase breastfeeding at 6 months. Education and support for breastfeeding are valuable interventions to promote initiation of breastfeeding whether it is offered by a healthcare professional, nonhealthcare professional, or peer. A combined intervention, a professional provider-led intervention, having a protocol available for the provider training program, and implementation during both the prenatal and postnatal periods increased the rate of exclusive breastfeeding for 6 months. There is no single effective treatment for breast engorgement. Breast massage, continuing breastfeeding, and pain relief are recommended by national guidelines. Nonsteroidal anti-inflammatory drugs and acetaminophen are better than placebo for relief of pain caused by uterine cramping and perineal trauma; acetaminophen is effective in breastfeeding individuals who underwent episiotomy; and local cooling pain relievers have been shown to reduce perineal pain for 24 to 72 hours, compared with no treatment. There is insufficient evidence to assess the safety and efficacy of postpartum routine universal thromboprophylaxis after vaginal delivery. Anti-D immune globulin administration is recommended in Rhesus-negative individuals who have given birth to a Rhesus-positive infant. There is very low-quality evidence that a universal complete blood count is useful in reducing the risk of receiving blood products. In the absence of any postpartum complication, there is insufficient evidence to recommend a routine postpartum ultrasound. Measles, mumps, and rubella combination; varicella; human papillomavirus; and tetanus, diphtheria, and pertussis vaccines should be administered in nonimmune individuals in the postpartum period. Smallpox and yellow fever vaccines should be avoided. Individuals undergoing postplacental placement are more likely to use an intrauterine device at 6 months than those advised to follow-up for placement during outpatient postpartum care. An implant is safe and effective for immediate postpartum contraception. There is insufficient evidence to support or refute the routine administration of micronutrient supplements in breastfeeding women. Placentophagia does not provide any benefits and exposes mothers and offspring to infectious risks. Therefore, it should be discouraged. Because of the low level of evidence, there is insufficient data to assess the efficacy of home visits in the postpartum period. There is insufficient evidence to recommend when to resume daily activities, and individuals should be counseled to return to prepregnancy level of activity or exercise when comfortable. Sexual activity, housework exercise, driving, climbing stairs, and lifting weights should be resumed as soon as postpartum individuals want. A behavioral educational intervention reduces depression symptoms and increases breastfeeding duration. Physical activity after delivery is protective against postpartum mood disorders. There is no strong evidence that supports early discharge after vaginal delivery compared with standard discharge (ie, ≥48 hours).
    MeSH term(s) Pregnancy ; Infant ; Female ; Humans ; Acetaminophen ; Postnatal Care/methods ; Anticoagulants ; Venous Thromboembolism ; Delivery, Obstetric/adverse effects ; Pain ; Vaccines
    Chemical Substances Acetaminophen (362O9ITL9D) ; Anticoagulants ; Vaccines
    Language English
    Publishing date 2023-04-22
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2023.100977
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  3. Article: Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy.

    Stasolla, Fabrizio / Passaro, Anna / Di Gioia, Mariacarla / Curcio, Enza / Zullo, Antonio

    Frontiers in psychology

    2023  Volume 14, Page(s) 1273117

    Language English
    Publishing date 2023-12-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2023.1273117
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Coronavirus disease 2019 vaccine in pregnant women: not so far! The importance of counseling and the need for evidence-based data.

    Saccone, Gabriele / Zullo, Fabrizio / Di Mascio, Daniele

    American journal of obstetrics & gynecology MFM

    2021  Volume 3, Issue 3, Page(s) 100324

    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Counseling ; Female ; Humans ; Pregnancy ; Pregnant Women ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Letter ; Comment
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2021.100324
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Coronavirus disease 2019 antibody testing in pregnancy.

    Zullo, Fabrizio / Di Mascio, Daniele / Saccone, Gabriele

    American journal of obstetrics & gynecology MFM

    2020  Volume 2, Issue 3, Page(s) 100142

    MeSH term(s) Ambulatory Care Facilities/organization & administration ; Ambulatory Care Facilities/trends ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Serological Testing/methods ; Female ; Humans ; Immunoglobulin G/analysis ; Immunoglobulin M/analysis ; Infection Control/methods ; Italy/epidemiology ; Obstetrics and Gynecology Department, Hospital/organization & administration ; Obstetrics and Gynecology Department, Hospital/trends ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Pregnancy Complications, Infectious/virology ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification
    Chemical Substances Immunoglobulin G ; Immunoglobulin M
    Keywords covid19
    Language English
    Publishing date 2020-05-18
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2020.100142
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: COVID-19 Antibody Testing in Pregnancy

    Zullo, Fabrizio / Di Mascio, Daniele / Saccone, Gabriele

    2020  

    Keywords covid19
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Counseling in fetal medicine: Congenital cytomegalovirus infection.

    D'Alberti, Elena / Rizzo, Giuseppe / Khalil, Asma / Mappa, Ilenia / Pietrolucci, Maria Elena / Capannolo, Giulia / Alameddine, Sara / Sorrenti, Sara / Zullo, Fabrizio / Giancotti, Antonella / Di Mascio, Daniele / D'Antonio, Francesco

    European journal of obstetrics, gynecology, and reproductive biology

    2024  Volume 295, Page(s) 8–17

    Abstract: Although the clinical work-up of CMV in pregnancy has gradually become more accurate, counseling for CMV is still challenging. Despite the potential feasibility of universal prenatal serological screening, its introduction in prenatal diagnosis continues ...

    Abstract Although the clinical work-up of CMV in pregnancy has gradually become more accurate, counseling for CMV is still challenging. Despite the potential feasibility of universal prenatal serological screening, its introduction in prenatal diagnosis continues to raise concerns related to its real cost-effectiveness. Contextually, anticipating the confirmation of fetal infection earlier in pregnancy is one of the most pressing issues to reduce the parental psychological burden. Amniocentesis is still the gold standard and recent data have demonstrated that it could be performed before 20 weeks of gestation, provided that at least 8 weeks have elapsed from the presumed date of maternal seroconversion. New approaches, such as chorionic villus sampling (CVS) and virome DNA, even if not yet validated as confirmation of fetal infection, have been studied alternatively to amniocentesis to reduce the time-interval from maternal seroconversion and the amniocentesis results. Risk stratification for sensorineural hearing loss (SNHL) and long-term sequelae should be provided according to the prognostic predictors. Nevertheless, in the era of valacyclovir, maternal high-dose therapy, mainly for first trimester infections, can reduce the risk of vertical transmission and increase the likelihood of asymptomatic newborns, but it is still unclear whether valacyclovir continues to exert a beneficial effect on fetuses with positive amniocentesis. This review provides updated evidence-based key counseling points with GRADE recommendations.
    MeSH term(s) Pregnancy ; Female ; Infant, Newborn ; Humans ; Perinatology ; Valacyclovir ; Ultrasonography, Prenatal ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/complications ; Amniocentesis ; Pregnancy Complications, Infectious ; Infectious Disease Transmission, Vertical/prevention & control ; Counseling
    Chemical Substances Valacyclovir (MZ1IW7Q79D)
    Language English
    Publishing date 2024-02-01
    Publishing country Ireland
    Document type Journal Article ; Review
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2024.01.037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 837: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Outcome of prelabor rupture of membranes before or at the limit of viability: systematic review and meta-analysis.

    Sorrenti, Sara / Mascio, Daniele DI / Khalil, Asma / D'Antonio, Francesco / Rizzo, Giuseppe / Zullo, Fabrizio / D'Alberti, Elena / D'Ambrosio, Valentina / Mappa, Ilenia / Muzii, Ludovico / Giancotti, Antonella

    American journal of obstetrics & gynecology MFM

    2024  , Page(s) 101370

    Abstract: Background: Counselling of pregnancies complicated by pre- and periviable PROM to reach a shared decision-making is challenging and the current, limited evidence hampers the robustness of the information provided.: Objective: To elucidate the rate of ...

    Abstract Background: Counselling of pregnancies complicated by pre- and periviable PROM to reach a shared decision-making is challenging and the current, limited evidence hampers the robustness of the information provided.
    Objective: To elucidate the rate of obstetric and neonatal outcomes following expectant management for premature rupture of membranes (PROM) occurred before or at the limit of viability.
    Study design: Medline, Embase, Cinahl and Web of Science databases were searched electronically up to September 2023. We included both prospective and retrospective studies of singleton pregnancies with PROM before and at the limit of viability (i.e., occurring between 14/0 and 24/6 weeks of gestation). Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. We used meta-analyses of proportions to combine data and reported pooled proportions. In view of the clinical heterogeneity, a random-effect model was used to compute the pooled data analyses. The study was registered with the PROSPERO database (CRD42022368029).
    Results: The pooled proportion of termination of pregnancy (TOP) was 32.3%. After the exclusion of cases of TOP, the rate of spontaneous miscarriage or fetal demise was 20.1%, whereas the live birth rate was 65.9% of the ongoing pregnancies. The mean gestational age at delivery among the liveborn cases was 27.26 weeks and the mean latency between PROM and delivery was 39.40 days in liveborn cases. The pooled proportion of cesarean delivery was 47.9% of the liveborn cases. Oligohydramnios occurred in 47.1% of cases. Chorioamnionitis occurred in 33.4% of cases; endometritis in 7%, placental abruption in 9.2%, postpartum hemorrhage in 5.3%. Hysterectomy was necessary in 1.2% of cases. Maternal sepsis occurred in 1.5% of cases while no maternal deaths were reported in the included studies. When focusing on neonatal outcomes, the mean birthweight was 1022.85 grams in liveborn cases. The admission to NICU rate was 86.3%, RDS complicated 66.5%; pulmonary hypoplasia or dysplasia was diagnosed in 24.0% of cases and persistent pulmonary hypertension in 40.9%. Other neonatal complications included necrotizing enterocolitis in 11.1%, ROP in 27.1%, IVH in 17.5% of the surviving neonates. Neonatal sepsis complicated 30.2% of cases and the overall neonatal mortality was 23.9%. The long-term follow-up at 2-to-4 years was normal in 74.1% of the available cases.
    Conclusions: PROM before or at the limit of viability is associated with a high burden of both obstetric and neonatal complications, with an impaired long-term follow-up at 2-to-4 years in almost 30% of cases, and thus representing a clinical challenge for both counselling and management. These data are useful when first approaching such patients to offer the most comprehensive possible scenario on short- and long-term outcomes of this condition and to help parents for a shared decision-making.
    Language English
    Publishing date 2024-04-20
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2024.101370
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Removal versus retention of cervical cerclage with preterm prelabor rupture of membranes: Systematic review and meta-analysis.

    Zullo, Fabrizio / Di Mascio, Daniele / Chauhan, Suneet P / Chrysostomou, Spyridakis / Suff, Natalie / Pecorini, Francesco / D'Ambrosio, Valentina / Sorrenti, Sara / D'Alberti, Elena / Galoppi, Paola / Muzii, Ludovico / Giancotti, Antonella / Brunelli, Roberto

    European journal of obstetrics, gynecology, and reproductive biology

    2023  Volume 288, Page(s) 83–89

    Abstract: Objective: To evaluate maternal and perinatal outcomes of removal versus retention of cervical cerclage after premature preterm rupture of membranes (pPROM).: Study design: Medline, Embase and Cochrane databases were searched electronically on ... ...

    Abstract Objective: To evaluate maternal and perinatal outcomes of removal versus retention of cervical cerclage after premature preterm rupture of membranes (pPROM).
    Study design: Medline, Embase and Cochrane databases were searched electronically on February 2023 utilizing combinations of the relevant medical subject heading (MeSH) terms, keywords, and word variants that were considered suitable for the topic. Either prospective or retrospective trials were considered suitable for the inclusion. The coprimary outcome of this study were pregnancy latency >7 days from pPROM and pregnancy latency >48 h from pPROM. Random effect head to-head meta-analyses were performed to directly compare each outcome, expressing the results as summary odds ratio (OR) for dichotomous outcomes and as mean difference (MD) for continuous outcomes, plus relative 95% confidence interval (CI). Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale.
    Results: Six studies involving a total of 377 women (169 in the "removal" and 208 in the "retention" group) were included. The rate of pregnancy prolongation >48 h was significantly lower in the removal compared to retention group (OR 0.15, 95% CI 0.07-0.31; p < 0.0001), as well as the rate of pregnancy prolongation >7 days (OR 0.30 95% CI 0.11-0.83; p = 0.02) and pregnancy latency expressed in days (MD -2.84 days, 95% CI -5.40 to -0.29; p = 0.03). The rate of chorioamnionitis was significantly lower in the removal compared to the retention group (OR 0.57 95% CI 0.34-0.96p = 0.03) as was the rate of Apgar score < 7 at 5 min (OR 0.22 95% CI 0.08-0.56; p = 0.002). There was no difference between removal and retention groups for all the other maternal and perinatal outcomes.
    Conclusions: The decision whether to remove or retain cerclage in case of pPROM should balance the prematurity-related risks with that of infectious complications, thus highlighting the need for tailored management based on gestational age at occurrence of pPROM.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Female ; Humans ; Cerclage, Cervical ; Retrospective Studies ; Prospective Studies ; Fetal Membranes, Premature Rupture/epidemiology ; Pregnancy Outcome ; Premature Birth/etiology ; Premature Birth/prevention & control
    Language English
    Publishing date 2023-07-20
    Publishing country Ireland
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2023.07.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 837: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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