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  1. Article ; Online: Consecutive chorioangiomas in the same pregnancy: A clinical case and review of literature.

    Germano, Chiara / Pilloni, Eleonora / Rolfo, Alessandro / Botta, Giovanni / Parpinel, Giulia / Cortese, Paolo / Cotrino, Ilenia / Attini, Rossella / Revelli, Alberto / Masturzo, Bianca

    Health science reports

    2022  Volume 5, Issue 3, Page(s) e566

    Abstract: Background and aims: Aetiopathogenesis of chorioangioma is already unknown. Among the risk factors, hypoxia, environmental and genetic factors are believed to induce the overexpression of angiogenic cytokines promoting vascular proliferation. We ... ...

    Abstract Background and aims: Aetiopathogenesis of chorioangioma is already unknown. Among the risk factors, hypoxia, environmental and genetic factors are believed to induce the overexpression of angiogenic cytokines promoting vascular proliferation. We reported a case of prenatally diagnosed 67 mm-wide placental chorioangioma, which occurred at 32 weeks of gestational age, infarcted, and followed by the onset of a second infarcted chorioangioma at 35 weeks of gestational age. Besides, we discussed the hypothesis of chorioangioma aetiopathogenesis and behavior through a literature summary.
    Methods: We carried out a literature search of chorioangioma cases without a time interval. Therefore, we carried out a literature summary on chorioangioma risk factors and etiology, by selecting articles within a time interval from 1995 to 2021.
    Results: This is the first case of two consecutive chorioangiomas in the same pregnancy published in the literature. We found a possible genetic predisposition in women developing chorioangioma while infarction may be related to the abnormal structure of tumor vessels. The onset of a second lesion could reflect hypoxic stimuli following infarction and involves hypoxia-induced factor-1alpha, vascular endothelial growth factor, transforming growth factor-beta, and soluble Fms-like tyrosine kinase-1 pathways. Chorangiosis can be coexistent and may reflect a mutual etiology in susceptible individuals.
    Conclusion: In a predisposed placenta, that previously generated a chorioangioma, infarction of the chorioangioma should not represent a sign for pregnancy termination, but a marker for closer monitoring to early detect the possible onset of a second chorioangioma and a higher risk of umbilical cord thrombosis.
    Language English
    Publishing date 2022-04-05
    Publishing country United States
    Document type Case Reports
    ISSN 2398-8835
    ISSN (online) 2398-8835
    DOI 10.1002/hsr2.566
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  2. Article ; Online: The ADNEX model to triage adnexal masses: An external validation study and comparison with the IOTA two-step strategy and subjective assessment by an experienced ultrasound operator.

    Viora, Elsa / Piovano, Elisa / Baima Poma, Cinzia / Cotrino, Ilenia / Castiglione, Anna / Cavallero, Camilla / Sciarrone, Andrea / Bastonero, Simona / Iskra, Lilliana / Zola, Paolo

    European journal of obstetrics, gynecology, and reproductive biology

    2020  Volume 247, Page(s) 207–211

    Abstract: Objectives: The ADNEX (Assessment of Different NEoplasias in the adneXa) model was developed using parameters collected by experienced (level III) ultrasound examiners. Our primary aim was to externally validate the ADNEX model. Then, the discriminatory ...

    Abstract Objectives: The ADNEX (Assessment of Different NEoplasias in the adneXa) model was developed using parameters collected by experienced (level III) ultrasound examiners. Our primary aim was to externally validate the ADNEX model. Then, the discriminatory performance of ADNEX was compared with the two-step strategy and subjective assessment by an experienced ultrasound operator.
    Methods: Between February 2013 and January 2017, all patients who were scheduled for surgery for an adnexal mass at the Sant'Anna Hospital in Turin were enrolled in this study. Preoperative transvaginal sonography was performed, and the two-step strategy was applied for triage of the adnexal mass. Two ultrasound examiners, IOTA certified, applied the ADNEX model to all the collected masses based on the ultrasound reports. Finally, an experienced operator assigned the subjective assessment based on recorded ultrasound images. The discrimination and calibration performance of ADNEX were evaluated. The AUC was calculated for the basic discrimination between benign and malignant tumours. In addition, AUCs were computed for each pair of tumour types using the conditional risk method.
    Results: A total of 577 patients were included in the analysis: the overall prevalence of malignancy was 25 %. With ADNEX, the AUC to differentiate between benign and malignant masses was 0.9111 (95 % CI 0. 8788-0.9389). At risk cut-offs of 1%, 10 % and 30 %, sensitivities were 100 %, 89.6 % and 79.2 %, respectively, and specificities were 2.8 %, 76.2 % and 89.6 %, respectively. Discrimination between benign and stage II-IV tumours was good (AUC 0.935). The model had the most difficulties discriminating between borderline and stage I tumours (AUC 0.666), and between stages II-IV invasive and secondary metastatic tumours (AUC 0.736). The polytomous discrimination index (PDI) was 0.61 for ADNEX, whereas PDI for random performance would be 0.25. ADNEX proved to be equally or more accurate than the subjective assessment or the two-step strategy in the discrimination between benign and malignant adnexal masses.
    Conclusions: the ADNEX model could probably be successfully applied when an expert examiner is not available and, therefore both a subjective assessment and the two-step strategy cannot be performed.
    MeSH term(s) Adnexal Diseases/diagnostic imaging ; Adult ; Aged ; Algorithms ; Decision Support Techniques ; Female ; Genital Neoplasms, Female/diagnostic imaging ; Humans ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Triage ; Ultrasonography/statistics & numerical data
    Language English
    Publishing date 2020-02-14
    Publishing country Ireland
    Document type Comparative Study ; Journal Article ; Validation Study
    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.2020.02.022
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    Zs.A 837: Show issues Location:
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  3. Article ; Online: Ultrasound and clinical characteristics of uterine smooth muscle tumors of uncertain malignant potential (STUMPs).

    Cotrino, Ilenia / Carosso, Andrea / Macchi, Chiara / Baima Poma, Cinzia / Cosma, Stefano / Ribotta, Marisa / Viora, Elsa / Sciarrone, Andrea / Borella, Fulvio / Zola, Paolo

    European journal of obstetrics, gynecology, and reproductive biology

    2020  Volume 251, Page(s) 167–172

    Abstract: Objective(s): Smooth muscle tumors of uncertain malignant potential are rare uterine neoplasms. Their identification through imaging is still limited due to the few available descriptions in the scientific literature. The objective of this paper is to ... ...

    Abstract Objective(s): Smooth muscle tumors of uncertain malignant potential are rare uterine neoplasms. Their identification through imaging is still limited due to the few available descriptions in the scientific literature. The objective of this paper is to provide clinical and ultrasound features that could support an early identification of these neoplasms.
    Study design: We retrospectively evaluated preoperative sonographic data of patients receiving a histopathological diagnosis of smooth muscle tumors of uncertain malignant potential between 2014 and 2019 at the S. Anna Hospital (Turin, Italy), a tertiary gynecological center. Tumors were characterized on the basis of ultrasound images using terms and definitions according to the morphological uterus sonographic assessment group.
    Results: A total of fourteen patients with smooth muscle tumors of uncertain malignant potential (20 lesions, including 18 pure and 2 with associated leiomyosarcoma) were identified. The median age was 47 years (range 28-77) and nine (64%) patients were of reproductive age. Six patients (43%) were asymptomatic, two (14%) presented with abdominal pain, two (14 %) with menorrhagia and four (29%) with both symptoms. Two (14%) patients developed local recurrences as uterine smooth muscle tumor of uncertain malignant potential and leiomyosarcoma, respectively. At ultrasound imaging, nine (69%) smooth muscle tumors of uncertain malignant potential were poorly or moderately vascularized and nine (82%) showed both circumferential and intra-lesional flows. Only three (15%) showed shadowing. The outlines were well-defined in seventeen cases (85%) and most (90%) showed isoechoic or mixed echogenicity with microcystic anechoic areas in fourteen (70%) of cases.
    Conclusion(s): Sonographic features of smooth muscle tumors of uncertain malignant potential may vary and a pathognomonic description has not been recognized. However, the identification of single or multiple lesions with specific ultrasound features should raise the suspicion of tumors of uncertain malignant potential. These features include isoechogenicity or mixed echogenicity, regular borders, presence of internal microcystic and anechoic areas, circumferential and intralesional vascularization ranging from minimal to high and absence of shadowing.
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Italy ; Leiomyosarcoma/diagnostic imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Smooth Muscle Tumor/diagnostic imaging ; Ultrasonography ; Uterine Neoplasms/diagnostic imaging ; Uterus/diagnostic imaging
    Language English
    Publishing date 2020-05-25
    Publishing country Ireland
    Document type Journal Article
    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.2020.05.040
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    Zs.A 837: Show issues Location:
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  4. Article ; Online: Iron supplementation and gestational diabetes in midpregnancy.

    Bo, Simona / Menato, Guido / Villois, Paola / Gambino, Roberto / Cassader, Maurizio / Cotrino, Ilenia / Cavallo-Perin, Paolo

    American journal of obstetrics and gynecology

    2009  Volume 201, Issue 2, Page(s) 158.e1–6

    Abstract: Objective: Iron supplementation in pregnancy seems beneficial for neonatal/maternal outcomes, but it was associated with diabetes and hypertension in the general population.: Study design: We investigated the association between iron supplementation ... ...

    Abstract Objective: Iron supplementation in pregnancy seems beneficial for neonatal/maternal outcomes, but it was associated with diabetes and hypertension in the general population.
    Study design: We investigated the association between iron supplementation during midpregnancy and metabolic/hypertensive abnormalities in 500 consecutive gestational diabetes mellitus (GDM) and 500 normoglycemic women.
    Results: Iron-supplement users (n = 212/1000) showed significantly higher values of prepregnancy body mass index (BMI), actual BMI, waist circumference, blood pressure, fasting glucose, Homeostasis-Model-Assessment-Insulin-Resistance, and lower high-density lipoprotein-cholesterol than nonusers. The prevalence of GDM (70.8% vs 44.4%), hypertension (25.9% vs 9.8%), metabolic syndrome (25.9% vs 10.4%) was significantly higher in the former with a 2- to 3-fold-increased risk at multiple regression analyses. Most glucose values of the oral glucose tolerance test were significantly higher in iron supplemented women, both in GDM and normoglycemic individuals.
    Conclusion: Iron supplementation is associated with glucose impairment and hypertension in midpregnancy; its potential harmful effects might be carefully debated regarding its effectiveness.
    MeSH term(s) Adult ; Age Distribution ; Blood Glucose/metabolism ; Body Mass Index ; Diabetes, Gestational/epidemiology ; Diabetes, Gestational/metabolism ; Female ; Homeostasis/drug effects ; Humans ; Hypertension, Pregnancy-Induced/epidemiology ; Hypertension, Pregnancy-Induced/metabolism ; Iron/adverse effects ; Logistic Models ; Metabolic Syndrome/epidemiology ; Metabolic Syndrome/metabolism ; Pregnancy ; Pregnancy Trimester, Second ; Prevalence ; Risk Factors
    Chemical Substances Blood Glucose ; Iron (E1UOL152H7)
    Language English
    Publishing date 2009-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2009.04.049
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  5. Article ; Online: Mild gestational hyperglycemia and the metabolic syndrome in later life.

    Bo, Simona / Menato, Guido / Botto, Chiara / Cotrino, Ilenia / Bardelli, Chiara / Gambino, Roberto / Cassader, Maurizio / Durazzo, Marilena / Signorile, Anna / Massobrio, Marco / Pagano, Gianfranco

    Metabolic syndrome and related disorders

    2006  Volume 4, Issue 2, Page(s) 113–121

    Abstract: Background: Diabetes and obesity, components of the metabolic syndrome, are common longterm complications in women with previous gestational diabetes (pGDM). Long-term follow-up of women with mild gestational hyperglycemia is lacking.: Methods: Fifty ...

    Abstract Background: Diabetes and obesity, components of the metabolic syndrome, are common longterm complications in women with previous gestational diabetes (pGDM). Long-term follow-up of women with mild gestational hyperglycemia is lacking.
    Methods: Fifty women with previous positive oral glucose challenge test and negative oral glucose tolerance test (pOGCT+OGTT-), 161 with previous normal glucose tolerance (pNGT), and 182 pGDM were studied after 6.5 years from the index pregnancy.
    Results: Patients with pGDM showed a worse metabolic pattern than pNGT. Women with pOGCT+OGTT- had significantly higher levels of fasting glucose, homeostasis model assessment (HOMA), percentage of impaired fasting glucose, and low age and high-density lipoprotein (HDL)-cholesterol than pNGT subjects. Prevalence of the metabolic syndrome (MS) was, respectively, sixfold and twofold higher in pGDM and pOGCT+OGTT- than in pNGT. In a Cox proportional hazard model, after multiple adjustments, pGDM was significantly associated with subsequent hyperglycemia (hazard ratio [HR] = 4.2; 95% CI 1.6-11.1), low HDL-cholesterol (HR = 1.7, 1.1-2.8), hypertriglyceridemia (HR = 4.2, 1.2-14.9), hypertension (HR = 2.2, 1.3-3.6), MS (HR = 3.7, 1.3-10.8), while pOGCT+OGTT- was associated with subsequent hyperglycemia (HR = 4.3, 1.3-14.7), and low HDL-cholesterol (HR = 2.0, 1.0-3.8). The metabolic syndrome was present in 52.6% of obese pGDM, 50% of obese pOGCT+OGTT-, and 28.6% of obese pNGT women; the corresponding HRs were, respectively, HR = 2.20, 0.74-6.57 (pGDM), and HR = 3.56, 1.10-11.5 (pOGCT+OGTT-).
    Conclusions: Women who failed the OGCT, but not the OGTT, showed a subsequent worse metabolic pattern than pNGT subjects, independently of confounding factors. In the presence of obesity, the prevalence of the metabolic syndrome was similar to that of obese pGDM women, and almost twofold higher than in obese pNGT controls.
    Language English
    Publishing date 2006
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2151220-6
    ISSN 1557-8518 ; 1540-4196
    ISSN (online) 1557-8518
    ISSN 1540-4196
    DOI 10.1089/met.2006.4.113
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