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  1. Article ; Online: Corrigendum to "Effects of SARS-Cov-2 mRNA vaccine on placental histopathology: Comparison of a population of uncomplicated COVID-19 positive pregnant women" [Placenta 149 (2024) 64-71].

    Tartaglia, Silvio / Di Ilio, Chiara / Romanzi, Federica / Moresi, Sascia / Nardi, Eleonora / Bevilacqua, Elisa / Arena, Vincenzo / Lanzone, Antonio

    Placenta

    2024  Volume 151, Page(s) 18

    Language English
    Publishing date 2024-04-17
    Publishing country Netherlands
    Document type Published Erratum
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/j.placenta.2024.04.004
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  2. Article ; Online: Effects of SARS-Cov-2 mRNA vaccine on placental histopathology: Comparison of a population of uncomplicated COVID-19 positive pregnant women.

    Tartaglia, Silvio / Di Ilio, Chiara / Romanzi, Federica / Moresi, Sascia / Nardi, Eleonora / Bevilacqua, Elisa / Arena, Vincenzo / Lanzone, Antonio

    Placenta

    2024  Volume 149, Page(s) 64–71

    Abstract: 1.: Introduction: This study investigates the impact of SARS-CoV-2 infection on placental histopathology in pregnant women, comparing outcomes between vaccinated and non-vaccinated individuals. Despite known adverse pregnancy outcomes linked to SARS- ... ...

    Abstract 1.
    Introduction: This study investigates the impact of SARS-CoV-2 infection on placental histopathology in pregnant women, comparing outcomes between vaccinated and non-vaccinated individuals. Despite known adverse pregnancy outcomes linked to SARS-CoV-2 infection, the specific effects on the placenta remain unclear. Although vaccination has demonstrated a substantial reduction in infection severity, its impact on placental health requires more insight. 2.
    Methods: Between March 2021 and July 2022, 387 COVID-19-positive women were admitted for delivery. Of these, 98 with non-severe symptoms were analyzed: 35 vaccinated during pregnancy, and 63 non-vaccinated. Two independent pathologists evaluated all placental specimens. 3.
    Results: The only differing obstetrical characteristic between groups was the mode of delivery (p 0.047), lacking clinical implications. Over 85% of placentas exhibited microscopic abnormalities, predominantly maternal vascular supply disorders (vaccinated 89.1%; unvaccinated 85.5%). Comparing vaccinated and unvaccinated groups revealed statistically significant differences, notably in increased focal perivillous fibrin deposits (IFPFD) [17.1% vs. 33.3% (p 0.04)] and avascular fibrotic villi (AFV) [0% vs. 11.1% (p 0.04)]. Binomial logistic regression confirmed the vaccine's protective role against IFPFD (aOR 0.36; 95%CI 013-0.99) and AVF (aOR 0.06, 95% CI 0.003-0.98). A sub-analysis in vaccinated women showed a positive correlation between the timing of the first dose and IFPFD presence (p 0.018). 4.
    Discussion: The lower incidence of maternal and fetal vascular malperfusion placental features in vaccinated women, coupled with the timing correlation, supports the vaccine's protective effect on placental tissue in COVID-19-infected pregnant patients. Notably, no side effects were reported post-vaccination, emphasizing the vaccine's safety and advocating for its secure administration in pregnant populations.
    MeSH term(s) Pregnancy ; Humans ; Female ; COVID-19 Vaccines ; COVID-19/prevention & control ; mRNA Vaccines ; SARS-CoV-2 ; Pregnant Women ; Placenta ; Pregnancy Complications, Infectious/prevention & control
    Chemical Substances COVID-19 Vaccines ; mRNA Vaccines
    Language English
    Publishing date 2024-03-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/j.placenta.2024.03.008
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  3. Article: Is the mental health of couples with twins more at risk? Results from an Italian cohort study.

    Bonanni, Giulia / Longo, Valentina Laurita / Airoldi, Chiara / Meli, Federica / Familiari, Alessandra / Romanzi, Federica / Pellegrino, Marcella / Visconti, Daniela / Serio, Annamaria / Lanzone, Antonio / Bevilacqua, Elisa

    Frontiers in psychiatry

    2024  Volume 15, Page(s) 1284090

    Abstract: Introduction: Our retrospective study aimed to investigate whether parents of twins encounter heightened psychological and emotional distress one year after childbirth, in comparison to parents of singletons within an Italian cohort.: Methods: ... ...

    Abstract Introduction: Our retrospective study aimed to investigate whether parents of twins encounter heightened psychological and emotional distress one year after childbirth, in comparison to parents of singletons within an Italian cohort.
    Methods: Exclusion criteria included multiparity, preterm birth, congenital anomalies, stillbirth, >2 fetus pregnancies, and pre-existing maternal mental health disorders. Out of the 300 couples (600 parents) invited to participate, 286 parents (158 mothers, 128 fathers) successfully completed a self-administered survey. We analyzed three scores separately for mothers and fathers, differentiating between singleton and twin pregnancies: the Edinburgh Postnatal Depression Scale (EPDS) score, the State and Trait Anxiety Inventory (STAI)-Y1 score, and the STAI-Y2 score.
    Results: Logistic models were used to assess the influence of age, BMI, marital status, education, and employment on the three binary scores (EPDS, STAI-Y1, and STAI-Y2), revealing no significant differences in absolute scores between parents of singletons and twins. Paired analysis revealed significantly higher EPDS (mean increase: 3.8, SD: 6.5), STAI-Y1 (mean increase: 5.4, SD: 12.5), and STAI-Y2 (mean increase: 4.5, SD: 12.4) scores for mothers (p < 0.0001). Approximately 10% of women and 8% of men reported suicidal thoughts.
    Discussion: Contrary to expectations, no substantial psychological differences emerged between parents of twins and singletons. Adjusting for confounders through univariate analysis maintained nonsignificant trends. Nevertheless, caution in interpretation is warranted due to strict inclusion criteria favoring twin pregnancies with better outcomes. Unintended bias could have resulted from routine psychological support offered to mothers of twins in our clinic. This presents an important framework for future research, including randomized controlled trials comparing parents of multiples with psychological support to those without.Finally, the elevated prevalence of depression symptoms and suicidal thoughts in our cohort underscores the importance of mental health during pregnancy and early parenting. We advocate for the screening of parents for postpartum depression and various psychological conditions, encompassing a spectrum of anxiety disorders. Those at elevated risk of mental distress should be proactively offered appropriate support.
    Language English
    Publishing date 2024-01-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2024.1284090
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  4. Article ; Online: Maternal and fetal outcomes after planned cesarean or vaginal delivery in twin pregnancy: a comparison between 2 third level birth centers.

    Bevilacqua, Elisa / Torcia, Eleonora / Meli, Federica / Josse, Juliette / Bonanni, Giulia / Olivier, Camille / Romanzi, Federica / Carlin, Andrew / Familiari, Alessandra / Jani, Jacques C / Lanzone, Antonio / Badr, Dominique A

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2024  Volume 37, Issue 1, Page(s) 2350676

    Abstract: Background: Twin pregnancy is associated with higher risks of adverse perinatal outcomes for both the mother and the babies. Among the many challenges in the follow-up of twin pregnancies, the mode of delivery is the last but not the least decision to ... ...

    Abstract Background: Twin pregnancy is associated with higher risks of adverse perinatal outcomes for both the mother and the babies. Among the many challenges in the follow-up of twin pregnancies, the mode of delivery is the last but not the least decision to be made, with the main influencing factors being amnionicity and fetal presentation. The aim of the study was to compare perinatal outcomes in two European centers using different protocols for twin birth in case of non-cephalic second twin; the Italian patients being delivered mainly by cesarean section with those in Belgium being routinely offered the choice of vaginal delivery (VD).
    Methods: This was a dual center international retrospective observational study. The population included 843 women with a twin pregnancy ≥ 32 weeks (dichorionic or monochorionic diamniotic pregnancies) and a known pregnancy outcome. The population was stratified according to chorionicity. Demographic and pregnancy data were reported per pregnancy, whereas neonatal outcomes were reported per fetus. We used multiple logistic regression models to adjust for possible confounding variables and to compute the adjusted odds ratio (adjOR) for each maternal or neonatal outcome.
    Results: The observed rate of cesarean delivery was significantly higher in the Italian cohort: 85% for dichorionic pregnancies and 94.4% for the monochorionic vs 45.2% and 54.4% respectively in the Belgian center (
    Conclusion: In this study, neither the presentation of the second twin nor the chorionicity affected maternal and severe neonatal outcomes, regardless of the mode of delivery in two tertiary care centers, but VD was associated to a poorer short-term neonatal outcome.
    MeSH term(s) Humans ; Female ; Pregnancy ; Pregnancy, Twin/statistics & numerical data ; Cesarean Section/statistics & numerical data ; Retrospective Studies ; Adult ; Infant, Newborn ; Italy/epidemiology ; Pregnancy Outcome/epidemiology ; Belgium/epidemiology ; Delivery, Obstetric/statistics & numerical data ; Delivery, Obstetric/methods ; Birthing Centers/statistics & numerical data
    Language English
    Publishing date 2024-05-09
    Publishing country England
    Document type Journal Article ; Observational Study ; Comparative Study ; Multicenter Study
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2024.2350676
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  5. Article: Case Report: Challenges of Non-Invasive Prenatal Testing (NIPT): A Case Report of Confined Placental Mosaicism and Clinical Considerations.

    Bonanni, Giulia / Trevisan, Valentina / Zollino, Marcella / De Santis, Marco / Romanzi, Federica / Lanzone, Antonio / Bevilacqua, Elisa

    Frontiers in genetics

    2022  Volume 13, Page(s) 881284

    Abstract: Since the introduction of cell-free (cf) DNA analysis, Non-Invasive Prenatal Testing (NIPT) underwent a deep revolution. Pregnancies at high risk for common fetal aneuploidies can now be easily identified through the analysis of chromosome-derived ... ...

    Abstract Since the introduction of cell-free (cf) DNA analysis, Non-Invasive Prenatal Testing (NIPT) underwent a deep revolution. Pregnancies at high risk for common fetal aneuploidies can now be easily identified through the analysis of chromosome-derived components found in maternal circulation, with the highest sensitivity and specificity currently available. Consequently, the last decade has witnessed a widespread growth in cfDNA-based NIPT use, enough to be often considered an alternative method to other screening modalities. Nevertheless, the use of NIPT in clinical practice is still not devoid of discordant results. Hereby, we report a case of confined placental mosaicism (CPM) in which a NIPT false-positive result for trisomy 13 required not only amniocentesis but also cordocentesis, to rule out the fetal aneuploidy, with the additional support of molecular cytogenetics on placental DNA at delivery. Relevant aspects allowing for precision genetic diagnosis and counselling, including the number of analysed metaphases on the different fetal cells compartments and a repeated multidisciplinary evaluation, are discussed.
    Language English
    Publishing date 2022-05-12
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2606823-0
    ISSN 1664-8021
    ISSN 1664-8021
    DOI 10.3389/fgene.2022.881284
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  6. Article ; Online: The impact of placental anastomoses and umbilical cord insertions' sites on monochorionic twin pregnancy outcomes: Evidence from color-dye injection studies.

    Bonanni, Giulia / Airoldi, Chiara / Romanzi, Federica / Passananti, Elvira / Torcia, Eleonora / Di Marco, Giulia / Felici, Francesca / Familiari, Alessandra / Meli, Federica / Visconti, Daniela / Lanzone, Antonio / Bevilacqua, Elisa

    Placenta

    2023  Volume 143, Page(s) 110–116

    Abstract: Introduction: Our knowledge of monochorionic pregnancies' complications is largely based on the extensive ongoing research on monochorionic placental structure. Previous studies on the concordance of umbilical cord insertions are limited. This study ... ...

    Abstract Introduction: Our knowledge of monochorionic pregnancies' complications is largely based on the extensive ongoing research on monochorionic placental structure. Previous studies on the concordance of umbilical cord insertions are limited. This study aimed to evaluate placental anastomoses and cord insertions as independent risk factors for neonatal adverse outcomes.
    Methods: This was a prospective study conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy from April 2021 to December 2022. Seventy-six women with a monochorionic pregnancy were enrolled at their first-trimester scan. After delivery, all placentas that were confirmed to be monochorionic were analyzed according to standard protocols, including those of complicated monochorionic twin pregnancies. The primary outcomes were a Composite Monochorionic Pregnancy Outcome (CMPO) and a Composite Neonatal Adverse Outcome (CNAO). The secondary outcome was the birth weight discordance between the neonates.
    Results: The CMPO occurred in 15.8 % pregnancies, and the CNAO occurred in 67.1 % pregnancies. The analysis confirmed a significant association between velamentous cord insertions and neonatal adverse events (p = 0.003). Also, a significant positive association (p = 0.0326) between twin birth weight discordance and discordance in twins umbilical cord insertions' sites was found. No significant association between the number and type of the anastomoses and both the CMPO or CNAO was detected.
    Discussion: Our data suggest that the routine sonographic assessment of umbilical cords' insertion sites during the first trimester could be helpful in predicting fetal and neonatal adverse events. We believe that this sonographic assessment should start to be implemented in our routine care of monochorionic pregnancies.
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Pregnancy ; Birth Weight ; Fetofetal Transfusion/etiology ; Placenta/diagnostic imaging ; Pregnancy Complications ; Pregnancy, Twin ; Prospective Studies ; Umbilical Cord/diagnostic imaging
    Language English
    Publishing date 2023-10-21
    Publishing country Netherlands
    Document type Journal Article ; Twin Study
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/j.placenta.2023.10.007
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  7. Article ; Online: A case of three rare uterine neoplasms in the same surgical specimen.

    Giuliani, Antonio / Romano, Lucia / Romanzi, Federica / Giubbolini, Giacomo / Coletti, Gino / Di Stefano, Nicoletta / Le'Clerc, Jean Nicolas / Schietroma, Mario / Carlei, Francesco / Di Stefano, Leonardo

    Annali italiani di chirurgia

    2020  Volume 9

    Abstract: Background: Uterine sarcomas are mesenchymal tumors; they are rare, representing less than 2-3% of all uterine malignancies. Among them, we can define four types: leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), Adenosarcoma and Carcinosarcoma. ... ...

    Abstract Background: Uterine sarcomas are mesenchymal tumors; they are rare, representing less than 2-3% of all uterine malignancies. Among them, we can define four types: leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), Adenosarcoma and Carcinosarcoma. This last type was recently reclassified by FIGO as a Mullerian type of the endometrial adenocarcinoma. Therefore, today only the first three types are histologically considered.
    Methods: In this paper, we reported a case of simultaneous presence of three different rare neoplasms in the same surgical specimen, resulting from a hysterectomy of a premenopausal woman. The woman presented to the ED with a six-months history of vaginal bleeding. Given the complexity of the clinical picture, we suggested hospitalization in our Department of Gynecology, to perform appropriate diagnostic tests. Because of the persistent hemorrhage and the absence of required fertility preservation, a laparotomic hysterectomy with bilateral annessiectomy was performed.
    Results: The postoperative histology of the specimen described the myoma at the fundus as a leiomyosarcoma. The myoma of the uterine anterior wall appeared as an endometrial stromal sarcoma of low-grade. Moreover, an intramural cavernous hemangioma of 3 cm in diameter was reported at the uterine corpus.
    Conclusion: All these described pathologies have no specific clinic characteristics; the most common symptom is abnormal uterine bleeding. To date, hysterectomy and bilateral salpingo-oophorectomy are the standards of care in the management of all early stage uterine sarcomas. To our knowledge, cases of LMS, ESS and cavernous haemangioma coexisting in the same patient have not been reported in literature to date. The pathogenesis of this combination remains to be elucidated. Key words: Cavernous hemangioma, Endometrial stromal sarcoma, Leiomyosarcoma, Uterine sarcomas.
    MeSH term(s) Adenosarcoma/pathology ; Adenosarcoma/surgery ; Carcinosarcoma/pathology ; Carcinosarcoma/surgery ; Female ; Humans ; Hysterectomy ; Leiomyosarcoma/pathology ; Leiomyosarcoma/surgery ; Middle Aged ; Neoplasms, Multiple Primary/pathology ; Neoplasms, Multiple Primary/surgery ; Uterine Neoplasms/pathology ; Uterine Neoplasms/surgery
    Language English
    Publishing date 2020-01-19
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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  8. Article: Acute Flaccid Paralysis by Enterovirus D68 Infection: First Italian Description in Adult Patient and Role of Electrophysiology.

    Ceccanti, Marco / Sbardella, Emilia / Letteri, Federica / De Michele, Manuela / Falcou, Anne / Romanzi, Federica / Onesti, Emanuela / Inghilleri, Maurizio

    Frontiers in neurology

    2017  Volume 8, Page(s) 638

    Abstract: A Peruvian woman was admitted to the Emergency Department, due to an acute flaccid paralysis (AFP) of the upper limbs that progressively involved also lower limbs and respiratory muscles. She previously suffered from non-Hodgkin's lymphoma and had to ... ...

    Abstract A Peruvian woman was admitted to the Emergency Department, due to an acute flaccid paralysis (AFP) of the upper limbs that progressively involved also lower limbs and respiratory muscles. She previously suffered from non-Hodgkin's lymphoma and had to undergo hematopoietic stem cell transplantation. A magnetic resonance imaging showed a T2 hyperintensity in the anterior and central region of the cervical segment with an elective involvement of gray matter. This finding, combined with other clinical, laboratory, and electrophysiological data, led to a diagnosis of AFP. Enterovirus D68 was isolated in the patient's cerebrospinal fluid, plasma, and throat swab. To our knowledge, this is the first Italian case of AFP by Enterovirus D68 infection in an adult. The diagnostic assessment and management of AFP by Enterovirus D68 are discussed.
    Language English
    Publishing date 2017-11-27
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2017.00638
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  9. Article ; Online: Hypovolemic shock after pelvic radiotherapy. A rare combination leading to a devastating complication.

    Giuliani, Antonio / Romanzi, Federica / Di Sibio, Alessandra / Calvisi, Giuseppe / Lombardi, Loreto / Marchese, Michele / Di Staso, Mario / Schietroma, Mario / Carlei, Francesco / Romano, Lucia

    Annali italiani di chirurgia

    2019  Volume 8

    Abstract: Background: Radiotherapy currently plays a key role in pelvic malignancies' management. Excellent outcomes have been reported on its association with chemotherapy for the treatment of the anal carcinoma. Despite that, the combined use of chemo- and ... ...

    Abstract Background: Radiotherapy currently plays a key role in pelvic malignancies' management. Excellent outcomes have been reported on its association with chemotherapy for the treatment of the anal carcinoma. Despite that, the combined use of chemo- and radiotherapy and the high doses administered seem to be strongly associated with early and late onset side effects.
    Methods: We reported a case of a 72 years old woman, affected by anal squamous cell carcinoma. She underwent chemotherapy, and then radiotherapy, with good results.
    Results: During a regular MR control, the patient developed anaphylactic reaction to Gadolinium, and after that a rectosigmoid ischemia with total necrosis of the posterior rectal wall was diagnosed and surgically treated with Hartmann procedure.
    Conclusion: In our case we faced with the rapid and severe degeneration of pelvic anatomy determined by the sum of vascular alterations following hypovolemic shock and pelvic tissues alteration after radiotherapy. It seems essential not to underestimate the exponential outcome of a similar unusual combination of events.
    Key words: Anal carcinoma, Hypovolemic shock, Pelvic radiotherapy, Rectal necrosis.
    MeSH term(s) Aged ; Anaphylaxis/chemically induced ; Anaphylaxis/complications ; Anus Neoplasms/therapy ; Carcinoma/drug therapy ; Carcinoma/radiotherapy ; Carcinoma, Squamous Cell/therapy ; Chemoradiotherapy/adverse effects ; Colon, Sigmoid/blood supply ; Colon, Sigmoid/diagnostic imaging ; Colon, Sigmoid/radiation effects ; Colon, Sigmoid/surgery ; Combined Modality Therapy ; Contrast Media/adverse effects ; Female ; Fluorouracil/administration & dosage ; Gadolinium/adverse effects ; Heart Arrest/etiology ; Humans ; Ischemia/etiology ; Ischemia/pathology ; Ischemia/surgery ; Mitomycin/administration & dosage ; Necrosis ; Proctectomy ; Radiation Injuries/etiology ; Rectovaginal Fistula/diagnostic imaging ; Rectovaginal Fistula/etiology ; Rectovaginal Fistula/surgery ; Rectum/blood supply ; Rectum/diagnostic imaging ; Rectum/radiation effects ; Rectum/surgery ; Shock/etiology ; Tomography, X-Ray Computed
    Chemical Substances Contrast Media ; Mitomycin (50SG953SK6) ; Gadolinium (AU0V1LM3JT) ; Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2019-06-26
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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