Sofia Sollazzi

Ospedale Santa Maria alle Scotte

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Felice Petraglia

University of Florence

Stefano Luisi

University of Siena

Massimo Gabbanini

Azienda Usl Toscana Centro

Francesco Calonaci

University of Siena

Valentina Ciani

University of Siena

Gabriele Centini

University of Siena

A Imperatore

Federico II University Hospital

Sandro Razzi

University of Siena

L. Rosignoli

Meyer Children's Hospital

Rosamaria Servillo

Ospedale Santa Maria alle Scotte

Cooperative Institutions

University of Siena

Ospedale Santa Maria alle Scotte

University of Florence

Ehime University

Ehime Medical Center

Aretaeio Hospital

University of Pisa

Universidade Federal de Minas Gerais

Beijing Obstetrics and Gynecology Hospital

Azienda Ospedaliero-Universitaria Careggi

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OP23.04: First trimester ultrasonography in detection of fetal anomalies

Ultrasound in Obstetrics and Gynecology (2010)

Sofia Sollazzi Gabriele Centini V. Ciani A Imperatore Rosamaria Servillo

To evaluate the diagnostic capacity of first trimester ultrasound scan analysis in detection of fetal anomalies. We enrolled in the study patients between May 2001 and December 2009 to undergo obstetric ultrasonography. Ultrasound equipment used were: HDI 3000 ATL, Voluson 730 Expert and Voluson E8. A total of 13.913 obstetric ultrasound scans analysis performed 199 fetal defects identified. Among the 3728 ultrasound scans were performed in first trimester 47 fetal anomalies were correctly diagnosed, thus displaying a detection rate (DR) of 1.26%. Among those: cystic hygroma (n = 8), nuchal edema (n = 8), omphalocele (n = 5), hydrops (n = 2), holoprosencephaly (n = 1), anasarca (n = 1), anencephaly (n = 2), omphalomesenteric duct remnant (n = 1), umbilical cord cyst (n = 3), heart defects (n = 2 ventricular septal defects, n = 1 crux cordis defect), megacystis (n = 5), bilateral corneal opacity (n = 1), spina bifida (n = 1), ectopia cordis (n = 1), multiple defects (n = 5), amniotic band syndrome associated to omphalocele and leg amputation, pentalogy of Cantrell, oloprosencephaly associated to central cleft lip and heart defect, oloprosencepahaly with omphalocele, cystic hygroma associated to bowel loops erniation and increased placenta thickness (n = 1). Following diagnosis of fetal structural anomalies, 27 women underwent invasive diagnostic procedure thus allowing identification of 6 trisomy 21, 2 trisomy 18 and 19 euploid fetuses. Among the 10185 ultrasound scans performed in second and third trimester, 152 between major and minor fetal defects were diagnosed (DR = 1.49%). A total of 23.6% of fetal defects were diagnosed during the first trimester. During first trimester of pregnancy major fetal structural defects and multiple anomalies are easier to diagnose compared to minor and single defects. As suggested by our data, ultrasound scan analysis performed in first trimester shows a similar DR compared to second and third trimester scans (DR = 1.26% vs. DR = 1.49%). Our data corroborates the possibility to consider in the future a reliable first trimester ‘anatomic’ ultrasound examination.

Omphalocele

Cystic hygroma

Anencephaly

Trisomy

Hydrops fetalis

Anasarca

Gastroschisis

Amniotic Band Syndrome

10.1002/uog.8139

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Surgical scar endometriosis after Cesarean section: A case report

Gynecological Endocrinology (2006)

Stefano Luisi Massimo Gabbanini Sofia Sollazzi Francesco Calonaci Sandro Razzi

Cutaneous endometriosis is a rare condition.A 37-year-old woman came to our observation 3 years after Cesarean section for a nodule under the scar that became spontaneously painful during menstrual bleeding. Transabdominal ultrasound examination, serum CA125 determination and histopathological analysis of the nodule were performed. Ultrasound revealed the presence of an oval-shaped hypoechogenic neoformation, while the serum CA125 level was slightly increased, and a diagnosis of endometriosis was confirmed by the histopathological analysis of a surgical specimen.This is an interesting case of surgical scar endometriosis, and the etiopathogenetic mechanism of this location may be explained by a dissemination of endometrial tissue during the Cesarean section.

Histopathological examination

Nodule (geology)

Surgical excision

Menstrual bleeding

10.1080/09513590600777578

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Oral Contraceptives after Myomectomy: A Short Term Trial

International Journal of Endocrinology (2009)

Stefano Luisi Valentina Ciani Massimo Gabbanini Sofia Sollazzi Michela Torricelli

Following myomectomy the rate of fertility is restored and pregnancy may be attempted with a good outcome. In the present study a 3 month treatment with OCs in a group of women after a myomectomy was evaluated. The drug compliance and side effects, the benefits of OC in order to reduce symptoms, to increase post-surgical hemoglobin levels and to avoid an early pregnancy after myomectomy were analyzed. A group of women (n = 55) each with myoma >/=5 cm was recruited: they presented menorrhagia, pelvic pain, dyspareunia and dysmenorrhae. After laparotomic myomectomy the women were divided into 3 groups. Group 1: women (n = 16) treated with pill A (15 mcg of ethynilestradiol + 60 mcg of gestodene); group 2: women (n = 23) treated with pill B (20 mcg of ethynilestradiol + 100 mcg of levonorgestrel); group 3: women (n = 16) treated with a placebo (oral calcium). After three months from myomectomy and treatment patients in each group reported a reduced menorrhagia, dismenorrhea and pelvic pain. Serum haemoglobin levels increased in all women (P < .05). No pregnancy occurred in any group and the compliance was good. A post surgery treatment by using oral contraceptives guarentees pregnancy prevention, associated with reduction of pain, and improvement of haematologic conditions.

Uterine myomectomy

10.1155/2009/476897

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Citations (2)