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  1. Article ; Online: Multiple Pregnancy and the Risk of Postpartum Hemorrhage

    Giulia di Marco / Elisa Bevilacqua / Elvira Passananti / Caterina Neri / Chiara Airoldi / Alessia Maccarrone / Vittoria Ciavarro / Antonio Lanzone / Alessandra Familiari

    Diagnostics, Vol 13, Iss 446, p

    Retrospective Analysis in a Tertiary Level Center of Care

    2023  Volume 446

    Abstract: The aim of our study was to identify characteristics associated with postpartum hemorrhage (PPH defined as blood loss >1000 mL) in twin pregnancies in order to select patients at higher risk to be treated. This retrospective study includes multiple ... ...

    Abstract The aim of our study was to identify characteristics associated with postpartum hemorrhage (PPH defined as blood loss >1000 mL) in twin pregnancies in order to select patients at higher risk to be treated. This retrospective study includes multiple pregnancies between 2015 and 2020. The possible association between pregnancy characteristics and the primary endpoint (occurrence of PPH) was conducted using chi-square or Fisher exact test and Wilcoxon test. Then, univariate logistic models were performed considering as outcome the PPH, and the odds ratios with 95% CI were estimated. Finally, a multivariate logistic model was implemented, including all significant covariates. Seven hundred seven twin pregnancies giving birth beyond 32 weeks were included and of those, 120 (16.97%) had a PPH. The univariate analysis showed that factors significantly associated with PPH were: Preterm delivery, episiotomy, neonatal weight, and mode of delivery. The multivariate analysis showed that the most important factors were episiotomy and neonatal weight. The results show that the performance of episiotomy and the neonatal weight are the factors that most impact the risk of PPH in twin pregnancies. The correct identification of factors associated with PPH in twins could ideally allow to modify the clinical management and positively affect the rate of complications.
    Keywords multiple pregnancy ; twins ; postpartum hemorrhage ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The complex relationship between infertility and female genital tract cancer: A review.

    Alessandra, Familiari / Vitalba, Gallitelli / Antonella, Biscione / Giulia, Di Marco / Carmine, Conte / Marco, D'Indinosante / Rachel, Schwab / Giacomo, Corrado / Anna, Fagotti / Valerio, Gallotta / Giovanni, Scambia

    Urologia

    2021  Volume 89, Issue 3, Page(s) 444–450

    Abstract: Introduction: The link between female infertility and gynecological cancer has always been a debated and challenging topic. Although cervical cancer has the worst impact on female fertility, as it is usually diagnosed in patients of reproductive age, ... ...

    Abstract Introduction: The link between female infertility and gynecological cancer has always been a debated and challenging topic. Although cervical cancer has the worst impact on female fertility, as it is usually diagnosed in patients of reproductive age, endometrial and ovarian cancer are also diagnosed and treated often in relatively younger patients in which fertility preservation is a relevant issue. The aim of this review is to highlight the correlation between therapy for female infertility and the developing cancer's risk and to describe the fertility sparing treatments in gynecological oncology.
    Material and methods: A systematic review of the literature through the main scientific search engines (PubMed and Google Scholar) was performed. We selected the most relevant articles based on the largest case series and the latest updates. All selected documents have been listed in the references.
    Results: Fifty-six relevant articles published between 1996 and 2019 were identified.Results from the available evidence report no significant increased risk of endometrial, cervical, and ovarian cancer in patients having infertility treatments.In young patients diagnosed with gynecological cancer, preservation of fertility is a personalized choice depending on several factors (type, stage, age and desire to conceive, safety of the treatment, and feasibility of fertility sparing surgery). For ovarian cancer FIGO stage IA G1, IA G2 (grade), and IC G1; for endometrial adenocarcinoma grade 1 with no lymphovascular space invasion (LVSI) or myometrial invasion and for early-stage cervical cancer (FIGO stage 2018: IA1-IB1), fertility sparing treatment is possible. The role of fertility sparing treatment with the increase of personalization of therapies therapy is always a theme of discussion and research.
    Conclusion: At present data regarding the risk of gynecological cancers after infertility treatments are reassuring. Careful evaluation of female fertility-sparing options in young women interested by ovarian, endometrial, or cervical tumors should be carried out involving a multidisciplinary team and ensuring safety and efficacy.
    MeSH term(s) Female ; Fertility Preservation/adverse effects ; Fertility Preservation/methods ; Genital Neoplasms, Female/complications ; Genital Neoplasms, Female/pathology ; Genital Neoplasms, Female/therapy ; Genitalia, Female/pathology ; Humans ; Infertility, Female/etiology ; Infertility, Female/pathology ; Infertility, Female/therapy ; Neoplasm Staging ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Uterine Cervical Neoplasms/complications ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/therapy
    Language English
    Publishing date 2021-08-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 204043-8
    ISSN 1724-6075 ; 0376-0057 ; 0391-5603
    ISSN (online) 1724-6075
    ISSN 0376-0057 ; 0391-5603
    DOI 10.1177/03915603211036426
    Database MEDical Literature Analysis and Retrieval System OnLINE

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