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Article ; Online: Simulation in obstetrics: a new tool for education?

Mannella, Paolo / Pancetti, Federica / Chedraui, Peter

2024

Language	English
Publishing date	2024-04-24
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062815-5
ISSN	2724-6450
ISSN (online)	2724-6450
DOI	10.23736/S2724-606X.24.05505-2
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Article ; Online: Molecular and endocrine mechanisms involved in preterm birth.

Pisacreta, Elena / Mannella, Paolo

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

2022 Volume 38, Issue 5, Page(s) 368–378

Abstract: Preterm birth is a worldwide social problem. Incidence rates may vary from 5 to 18% of all deliveries, with important differences observed between developed and developing countries. Preterm birth has a negative impact on newborns and neonatal mortality ... ...

Abstract	Preterm birth is a worldwide social problem. Incidence rates may vary from 5 to 18% of all deliveries, with important differences observed between developed and developing countries. Preterm birth has a negative impact on newborns and neonatal mortality and morbidity are high. Despite improvements in modern neonatal care, we know little of the mechanisms that determine the onset and development of preterm birth. Infections seem to be one the most important triggers, determining the activation of protective mechanisms aimed at ending the pregnancy and safeguarding the health of the woman. However, threatened preterm birth often occurs even in women who do not have any ongoing infectious process. Of these, which are the majority, the causes and the activation mechanisms remain unknown or unclear; however, there are several molecular and endocrine mechanisms that finally lead to preterm birth. In this review, we seek to shed light and summarize the molecular and endocrine mechanisms underlying the development of preterm birth. Their understanding could help us to understand the dynamics of premature birth but, above all, to allow an early diagnosis and primary prevention of the problem.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Pregnancy ; Premature Birth/epidemiology ; Premature Birth/etiology
Language	English
Publishing date	2022-03-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	639237-4
ISSN	1473-0766 ; 0951-3590
ISSN (online)	1473-0766
ISSN	0951-3590
DOI	10.1080/09513590.2022.2053519
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Article ; Online: Risk and protective factors for pregnancy-related urinary incontinence until 1 year postpartum: A cohort study using patient-reported outcome measures in Italy.

Ferrari, Amerigo / Mannella, Paolo / Caputo, Alessia / Simoncini, Tommaso / Bonciani, Manila

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023 Volume 164, Issue 1, Page(s) 200–209

Abstract: Objective: To investigate the epidemiology of pregnancy-related urinary incontinence (UI) and the related risk factors, focusing also on women's characteristics related to maternity pathway utilization.: Methods: In this prospective cohort study, we ... ...

Abstract	Objective: To investigate the epidemiology of pregnancy-related urinary incontinence (UI) and the related risk factors, focusing also on women's characteristics related to maternity pathway utilization. Methods: In this prospective cohort study, we used patient-reported data obtained from the systematic survey on the maternity pathway that all pregnant women in Tuscany, Italy, can join. We selected 8410 women who completed-between March 2019 and November 2022-all five follow-up questionnaires from the first trimester until 12 months postpartum, each including a UI-specific patient-reported outcome measure. We performed panel regression models to explore the related risk factors. Results: Prevalence of UI was 4.4% at the first trimester, 23.7% at the third trimester, and 15.6%, 12.6%, and 12.4% at 3, 6, and 12 months postpartum. UI occurrence and severity were higher in older, overweight/obese, and unemployed women. High-risk pregnancy and discomfort during pregnancy were risk factors. Receiving a cesarean section reduced the risk, while spontaneous tears, episiotomy, and high birth weight increased it. Women who experienced delays in pregnancy examinations because of long waiting times and women who had planned pregnancy had a higher risk, while performing during-pregnancy pelvic-floor-muscle training was protective. Conclusion: Besides confirming the classic risk and protective factors for UI, we also found novel determinants related to the proper maternity pathway utilization.
MeSH term(s)	Female ; Pregnancy ; Humans ; Aged ; Cesarean Section/adverse effects ; Cohort Studies ; Prospective Studies ; Protective Factors ; Postpartum Period ; Urinary Incontinence/epidemiology ; Urinary Incontinence/etiology ; Risk Factors ; Pregnancy, High-Risk ; Pelvic Floor
Language	English
Publishing date	2023-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.15003
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Article ; Online: Five actions for five people: emergency cesarean section protocol.

Mannella, Paolo / Pancetti, Federica / Giannini, Andrea / Russo, Eleonora / Montt-Guevara, Magdalena / Simoncini, Tommaso

BMC pregnancy and childbirth

2023 Volume 23, Issue 1, Page(s) 272

Abstract: Objective: The scope of this work is to evaluate an operative protocol for emergency C-section to improve teamwork and reduce surgical setup time.: Methods: Sixty-six health care operators working together in the delivery ward (gynecologists, ... ...

Abstract	Objective: The scope of this work is to evaluate an operative protocol for emergency C-section to improve teamwork and reduce surgical setup time. Methods: Sixty-six health care operators working together in the delivery ward (gynecologists, midwives, anesthesiologists) simulated an emergency scenario applying a "five actions for each operator" protocol. For each simulation, the decision to delivery interval was considered and the perception of each operator as a team worker was analyzed with specific tests. Results: The "five actions for five people" protocol significantly reduces the decision to delivery interval (p < 0.001) for emergency C-section. At the same time, a simple and codified scheme improves communication among team members, avoids overlapping roles. Indeed, all the operators become more aware of being helpful to the team (p < 0.001). Conclusion: The use of a standardized, simple, and immediately usable protocol improves the performance of the delivery room team in terms of the urgency and quality of the operator's participation in the event. Procedures of this type should be favored within emergency obstetric settings. Trial registration number: CEAVNO 19-01-23. Local ethical Committee (COMITATO ETICO REGIONALE PER LA SPERIMENTAZIONE CLINICA - Sezione autonoma Area Vasta Nord Ovest -CEAVNO) approved this study as simulation training study. All the operators participated voluntary during their working time.
MeSH term(s)	Humans ; Pregnancy ; Female ; Cesarean Section ; Midwifery ; Simulation Training ; Anesthesiologists ; Awareness ; Patient Care Team
Language	English
Publishing date	2023-04-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-023-05591-9
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Article ; Online: Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy.

Ferrari, Amerigo / Seghieri, Chiara / Giannini, Andrea / Mannella, Paolo / Simoncini, Tommaso / Vainieri, Milena

The European journal of health economics : HEPAC : health economics in prevention and care

2023 Volume 24, Issue 9, Page(s) 1575–1586

Abstract: Objective: The Italian healthcare jurisdiction promotes patient mobility, which is a major determinant of practice variation, thus being related to the equity of access to health services. We aimed to explore how travel times, waiting times, and other ... ...

Abstract	Objective: The Italian healthcare jurisdiction promotes patient mobility, which is a major determinant of practice variation, thus being related to the equity of access to health services. We aimed to explore how travel times, waiting times, and other efficiency- and quality-related hospital attributes influenced the hospital choice of women needing pelvic organ prolapse (POP) surgery in Tuscany, Italy. Methods: We obtained the study population from Hospital Discharge Records. We duplicated individual observations (n = 2533) for the number of Tuscan hospitals that provided more than 30 POP interventions from 2017 to 2019 (n = 22) and merged them with the hospitals' list. We generated the dichotomous variable "hospital choice" assuming the value one when hospitals where patients underwent surgery coincided with one of the 22 hospitals. We performed mixed logit models to explore between-hospital patient choice, gradually adding the women's features as interactions. Results: Patient choice was influenced by travel more than waiting times. A general preference for hospitals delivering higher volumes of interventions emerged. Interaction analyses showed that poorly educated women were less likely to choose distant hospitals and hospitals providing greater volumes of interventions compared to their counterpart. Women with multiple comorbidities more frequently chose hospitals with shorter average length of stay. Conclusion: Travel times were the main determinants of hospital choice. Other quality- and efficiency-related hospital attributes influenced hospital choice as well. However, the effect depended on the socioeconomic and clinical background of women. Managers and policymakers should consider these findings to understand how women behave in choosing providers and thus mitigate equity gaps.
MeSH term(s)	Humans ; Female ; Hospitals ; Pelvic Organ Prolapse/surgery ; Delivery of Health Care ; Health Services ; Logistic Models
Language	English
Publishing date	2023-01-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2045253-6
ISSN	1618-7601 ; 1618-7598
ISSN (online)	1618-7601
ISSN	1618-7598
DOI	10.1007/s10198-022-01563-6
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Article ; Online: Pregnancy vaccination predictive factors and uptake profiles among Italian women: A cross-sectional survey study on a large population.

Ferrari, Amerigo / Moretti, Giaele / Corazza, Ilaria / Mannella, Paolo / Simoncini, Tommaso / Bonciani, Manila

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023 Volume 162, Issue 1, Page(s) 105–115

Abstract: Objectives: To assess influenza and Tdap (tetanus, diphtheria, pertussis) vaccine coverage during pregnancy, explore key socioeconomic and maternity pathway-related predictors of vaccination, and detect specific patterns of vaccination uptake.: ... ...

Abstract	Objectives: To assess influenza and Tdap (tetanus, diphtheria, pertussis) vaccine coverage during pregnancy, explore key socioeconomic and maternity pathway-related predictors of vaccination, and detect specific patterns of vaccination uptake. Methods: The authors cross-sectionally analyzed self-reported data obtained from the systematic survey on the maternity pathways of Tuscany. They selected all pregnant women that completed from March 2019 to June 2022 the third-trimester questionnaire (n = 25 160), which included two dichotomous items on influenza and Tdap vaccination, as well as socioeconomic and pathway-related questions. Multilevel logistic models were performed to assess vaccination predictors and cluster analysis to identify vaccination patterns. Results: Vaccination coverage was higher for pertussis (56.5%) than for influenza (18.9%). The main predictors of vaccination were high socioeconomic status, attending private gynecologists, and receiving vaccine information. Three clusters were identified: cluster 1 included women receiving both Tdap and influenza vaccines; cluster 2 included women receiving no vaccinations; and cluster 3 included women receiving only the pertussis vaccine. Although women from cluster 3 were of middle to low education status, vaccine information was the main adherence determinant also in this group. Conclusions: Health workers and policymakers should focus on groups of pregnant women less prone to vaccination to promote vaccination information and encourage wider uptake and coverage.
MeSH term(s)	Female ; Pregnancy ; Humans ; Influenza, Human/prevention & control ; Cross-Sectional Studies ; Whooping Cough/prevention & control ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Influenza Vaccines ; Surveys and Questionnaires
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines ; Influenza Vaccines
Language	English
Publishing date	2023-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14797
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Article ; Online: Do prenatal depressive symptoms developed by hospitalized women with high-risk pregnancy persist to post-partum?

Smorti, Martina / Ponti, Lucia / Ghinassi, Simon / Mauri, Giulia / Pancetti, Federica / Mannella, Paolo

Psychiatry research

2023 Volume 325, Page(s) 115224

Abstract: This study aims to explore the level of depressive symptoms during pregnancy and after childbirth comparing women hospitalized due to high-risk pregnancy (clinical group) and women with low-risk pregnancy (control group). Seventy pregnant women (26 ... ...

Abstract	This study aims to explore the level of depressive symptoms during pregnancy and after childbirth comparing women hospitalized due to high-risk pregnancy (clinical group) and women with low-risk pregnancy (control group). Seventy pregnant women (26 clinical group and 44 control group) filled in the Edinburgh Postnatal Depression Scale both during pregnancy and three months after childbirth. Results showed that the clinical group reported significant higher levels of prenatal depression than the control group, while no differences were found on postnatal depression. Data highlighted that hospitalization could represents a significant stressor that can exacerbate depression in women with high-risk pregnancy.
MeSH term(s)	Humans ; Female ; Pregnancy ; Infant, Newborn ; Depression/diagnosis ; Depression, Postpartum ; Prenatal Diagnosis ; Pregnancy, High-Risk/psychology ; Pregnancy Complications/diagnosis ; Pregnancy Complications/psychology ; Postpartum Period ; Pregnant Women/psychology ; Parturition ; Longitudinal Studies ; Adult
Language	English
Publishing date	2023-04-24
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2023.115224
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Article ; Online: Influence of COVID-19 pandemic on self-reported urinary incontinence during pregnancy and postpartum: A prospective study.

Ferrari, Amerigo / Corazza, Ilaria / Mannella, Paolo / Simoncini, Tommaso / Bonciani, Manila

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022

Abstract: Objective: To explore how the COVID-19 pandemic influenced self-reported occurrence and severity of pregnancy-related urinary incontinence (UI) in the maternity pathways of Tuscany, Italy.: Methods: In this prospective pre-post cohort study, we ... ...

Abstract	Objective: To explore how the COVID-19 pandemic influenced self-reported occurrence and severity of pregnancy-related urinary incontinence (UI) in the maternity pathways of Tuscany, Italy. Methods: In this prospective pre-post cohort study, we selected a pre-pandemic (n = 1018) and a post-pandemic (n = 3911) cohorts of women that completed, from the first trimester until 3 months postpartum, three surveys including validated patient-reported outcome measures for UI. Data were obtained from systematic surveys on the maternity pathways of Tuscany from March 2019 to June 2021. We performed panel regression models to explore how UI risk differed between COVID-19 groups. Results: UI occurred less frequently and less severely in post-pandemic patients-especially stress/mixed UI in women never performing pelvic floor muscle training (PFMT)-whereas no difference emerged in women performing during-pregnancy PFMT. During COVID-19, obese women had higher risk of UI, whereas women undergoing operative delivery had lower risk. The post-pandemic group reported more severe UI symptoms at the third trimester, but less severe UI postpartum in women suffering from UI during pregnancy. Conclusions: During the COVID-19 pandemic, women reported fewer UI symptoms because they might have lacked chances to identify UI symptoms as a result of pandemic-related sedentarism and inactivity. The risk in women performing during-pregnancy PFMT was not increased, but just six of 26 health districts organized remote PFMT sessions, thus revealing limited resilience to the pandemic in Tuscany.
Language	English
Publishing date	2022-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14522
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Article ; Online: The use of a novel sensorized simulation platform for real-time labor progression assessment.

Mannella, Paolo / Tognarelli, Selene / Pancetti, Federica / Morchi, Laura / Menciassi, Arianna / Simoncini, Tommaso

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 161, Issue 2, Page(s) 499–508

Abstract: Objective: To prove the potentialities of an integrated and sensorized childbirth platform as an innovative simulator for education of inexperienced gynecological and obstetrical medical students.: Methods: A total of 152 inexperienced medical ... ...

Abstract	Objective: To prove the potentialities of an integrated and sensorized childbirth platform as an innovative simulator for education of inexperienced gynecological and obstetrical medical students. Methods: A total of 152 inexperienced medical students were recruited to a simulation program on labor progression evaluation. After an introductory lecture on basic concepts of labor and birth given by an expert gynecologist, three different gynecologic scenarios were simulated using both a traditional obstetric simulator and the innovative proposed platform, for a total of six tests for each student. A score was assigned for each performed scenario, based on its correctness. Self-assessment questionnaires were compiled before and after the simulation program for additional subjective assessment. Results: Median score of the simulations performed with our platform was significantly higher than that of the simulations performed with a traditional simulator, for all the three experimented scenarios (P < 0.001). Conclusions: The use of a sensorized platform for labor progression allowed for an accurate and faster diagnosis if compared with a traditional simulator even for inexperienced operators, supporting its use in clinical training, which could be realistically introduced into the clinical practice for medical student education.
MeSH term(s)	Pregnancy ; Humans ; Female ; Obstetrics/education ; Delivery, Obstetric/education ; Parturition ; Gynecology/education ; Computer Simulation ; Students, Medical ; Clinical Competence ; Simulation Training
Language	English
Publishing date	2022-11-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14528
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Article ; Online: Patient-reported outcome measures for pregnancy-related urinary and fecal incontinence: A prospective cohort study in a large Italian population.

Ferrari, Amerigo / Bonciani, Manila / Russo, Eleonora / Mannella, Paolo / Simoncini, Tommaso / Vainieri, Milena

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 159, Issue 2, Page(s) 435–443

Abstract: Objective: To investigate prevalence and risk factors of pregnancy-related urinary/fecal incontinence (UI/FI) in a large Italian population.: Methods: This is a prospective cohort study analyzing patient-reported outcome (PRO) measures obtained from ... ...

Abstract	Objective: To investigate prevalence and risk factors of pregnancy-related urinary/fecal incontinence (UI/FI) in a large Italian population. Methods: This is a prospective cohort study analyzing patient-reported outcome (PRO) measures obtained from the systematic longitudinal survey on the maternity pathway of Tuscany from March 2019 to April 2021. Four questionnaires were completed by 6023 women from the beginning of pregnancy until 6 months postpartum, each including two PRO measures-Wexner scale for FI and ICIQ-SF for UI-, and questions investigating sociodemographic/clinical factors. After assessing UI/FI prevalence at each time-point, we run panel regressions to explore the related risk factors. Results: Women reporting UI and FI were, respectively, 24.3% and 6.2% in the third trimester, and 12.6% and 4.2% 6 months postpartum. UI occurrence and severity were higher in highly educated, aged >30, and overweight/obese women. Spontaneous tears or episiotomy were risk factors for postpartum UI, while receiving cesarean-section and performing pelvic-floor-muscle-training during pregnancy were protective, mainly in specific groups. Finally, higher FI prevalence and severity emerged in overweight, aged >40, highly educated, non-Italian women and in those undergoing tears. Conclusion: We employed PRO measures to investigate the epidemiology of pregnancy-related UI/FI and detect the main risk groups. Pelvic-floor-muscle-training may be recommended in women with peculiar sociodemographic/clinical features.
MeSH term(s)	Fecal Incontinence/epidemiology ; Fecal Incontinence/etiology ; Female ; Humans ; Overweight/complications ; Patient Reported Outcome Measures ; Pregnancy ; Prospective Studies ; Urinary Incontinence/etiology
Language	English
Publishing date	2022-03-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14132
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