A. D'Ambra

University of Naples Federico II

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Mariavittoria Locci

University of Naples Federico II

G. Nazzaro

University of Naples Federico II

M. L. Pisaturo

Ospedale San Carlo

Giuseppe De Placido

University of Naples Federico II

A. Merenda

University of Naples Federico II

P. Laviscio

University of Naples Federico II

A. Stile

University of Naples Federico II

R. Poppiti

University of Naples Federico II

A. Nazzaro

Azienda Ospedaliera G.Rummo

M. Miranda

University of Naples Federico II

Cooperative Institutions

University of Naples Federico II

Federico II University Hospital

Institute for Experimental Endocrinology and Oncology

Weatherford College

University of Cyprus

University Medical Center Freiburg

University of the Aegean

Istituti di Ricovero e Cura a Carattere Scientifico

Stazione Zoologica Anton Dohrn

Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Introduction of BLOODchip ID-HPA for high throughput molecular biology typing in a immunohematology laboratory for the management of patients with platelet refractoriness, thrombocytopenia and FNAIT

Vox Sanguinis (2013)

A. D'Ambra Giorgio Fratellanza F Ferruzzi Marialessia Capuano N. Scarpato

Neonatal alloimmune thrombocytopenia

Source

Cite

Citations (0)

Cytogenetic and developmental toxicity of cerium and lanthanum to sea urchin embryos

Chemosphere (2010)

Rahime Oral Paco Bustamante Michel Warnau A. D'Ambra Marco Guida

Paracentrotus lividus

Developmental toxicity

Lanthanum

10.1016/j.chemosphere.2010.06.057

Cite

Citations (104)

329 Neonatal Alloimmune Thrombocytopenia: Laboratory Findings and Clinical Management in 38 Cases

Pediatric Research (2005)

A. Scarcella Giorgio Fratellanza N. Scarpato A Fratellanza P Gambardella

Neonatal alloimmune thrombocytopenia

10.1203/00006450-200508000-00358

Cite

Citations (0)

P06.04: Vesicocentesis vs vesicoamniotic shunt: our experience in obstructive urinary fetal malformation

Ultrasound in Obstetrics and Gynecology (2006)

G. Nazzaro Mariavittoria Locci P. Laviscio A. Merenda M. L. Pisaturo

Congenital lower obstructive uropathy is a heterogeneous condition affecting approximately 1 in 3000 pregnancies. High perinatal mortality (up to 45%) in untreated fetuses is the result of chronic and severe oligohydramnios associated with pulmurary hypoplasia. The key component is identifying those fetuses that have retained renal function and that could benefit from in utero treatment. Urine sampling by vesicocentesis offer prenatal parameters effective to evaluate the eventual good renal function in addition to ultrasound. Main intrauterine intervention for prenatal bladder drainage are vesicocentesis, vesicoamniotic shunt or open fetal bladder surgery. We report our experience in intrauterine intervention for treatment of fetal obstructive uropathy. In the period 1998–2005 14 fetuses with megacystis have referred to our Unit of Prenatal Diagnosis; mean week at gestational age 17 w. 11 fetuses underwent a diagnostic amnioinfusion for severe oligohydramnios. Karyotipe and renal function have been valuated in all cases. 10 fetuses have been undergoing serial vesicocentesis, mean 3. 4 fetuses have been treated with indwelling vesicoamniotics shunts. Pregnancy outcome were compared between vesicocentesis and vesicoamniotic shunts. Vesicocentisis Four fetuses showed aneuplydia. In 4 cases there was complete intrauterine remission of ultrasonographic findings. In 3 fetuses the serial vesicocentisis prevented renal impairment with a good postnatal outcome. Intrauterine death occured in 3 cases: 2 pregnancy was voluntarily interrupted, a fetus died at 24th week. Vesicoamniotic shunt: remission of pathology occurred in 2 cases; in 1 fetus there was a good postnatal outcome; a fetus died in utero after shunt-displacement at the 26th week. In our hands, less invasive procedures seems to be safer and more effective. Anyway, the optimal therapeutic approach needs early and precise diagnosis and accurate evaluation of the renal function.

Obstructive uropathy

Fetal Surgery

Amnioinfusion

10.1002/uog.3605

Cite

Citations (0)

P12.18: Spontaneous septostomy in twin‐to‐twin transfusion syndrome. A case report

Ultrasound in Obstetrics and Gynecology (2004)

G. Nazzaro A. Merenda Mariavittoria Locci A. Nazzaro P. Laviscio

The twin–twin transfusion syndrome (TTTS) is one of the most common complication of monochorionic twin gestations.The incidence of TTTS ranges from 4% to 35% of monochorionic twins. It results from unbalanced flow between two fetuses via placental vascular anastomosis, usually arterio-venous. Prognosis depends upon the gestational age at the time of diagnosis, severity of growth abnormality and severity of oligohydramnios-hydramnios sequence. Mortality is above 50% without treatment. Several therapeutic treatments have been proposed: serial amnioreductions, intertwin microseptostomy and fetoscopic laser photocoagulation of the anastomotic placental vessels. We report the sonographic findings of spontaneous septostomy in a twin pregnancy complicated by TTTS. D. A., a 35 year old Caucasian woman, gravida1, was referred to our prenatal diagnosis unit for the routinary second trimester US scan at 20 weeks. It was twin monochorionic pregnancy complicated by TTTS. We detected growth discordance among fetuses, hydramnios/oligohydramnios. Twin-to-twin anastomotic vessels with unidirectional flow from recipient to donor, on the fetal side of the placenta, were found by color Doppler. Further ultrasound examination, to assess fetal growth, showed a spontaneous septostomy with normalizing of hydramnios/oligohydramnios sequence at 24 w of gestation. Growth fetal discordance persisted (about four weeks between donor fetus and recipient fetus) until delivery at 35 w of gestation. Bidirectional arterial flow was found within the side of TTT anastomosis starting from the 24 w of gestation up to 35 w. Neonatal birth weights were 2300 g and 1200 g respectively. Neonatal and postnatal outcome was favourable in both fetuses. This is the first case in which spontaneous inversion of anastomotic flow and spontaneous septostomy have been reported. Considering that surgical treatment of TTTS are high risk manovres, ultrasound surveillance could be an alternative approach to this pathology.

Monochorionic twins

Twin Pregnancy

Twin-to-twin transfusion syndrome

10.1002/uog.1566

Cite

Citations (1)

[Congenital cytomegalovirus infection: current status and future perspectives].

PubMed (2013)

Ilaria Avarello A Cancemi A. D'Ambra

In recent years, infection with cytomegalovirus (CMV) was the subject of numerous studies, one side being the most frequent congenital infection in newborns and one that determines the increased incidence of sequelae distance (about one third of childhood deafness is due to CMV), and the other one of the most frequent and serious opportunistic infections in immunocompromised individuals. Of newborns with congenital infection, approximately 10% are symptomatic at birth. Of the remaining 90%, asymptomatic at birth, 10-15% will develop sequelae from a distance. Regarding the possibility of vertical transmission of the disease from mother to fetus, the debate is still open on the usefulness or not to set a screening during pregnancy in order to prevent or limit the damage caused fetal infection. Despite detailed knowledge about the epidemiology and pathogenesis of CMV disease in pregnant women, this infection remains largely unknown to most women. The opportunity of a serological screening is important, however, since more than 90% of primary CMV infection in pregnancy are asymptomatic and may remain asymptomatic in the fetus. The education on methods to prevent transmission of CMV, particularly among young women of childbearing age, must continue until an effective vaccine becomes available. In this article we summarize the current concepts regarding the epidemiology, pathogenesis, symptoms and prevention of CMV disease, with particular focus on strategies to improve awareness of the risk of CMV infection in women of childbearing age.

Cytomegalovirus

Source

Cite

Citations (1)

P05.01: Regional responses in middle cerebral artery in severely growth restricted fetuses: preliminary reports of postnatal follow up

Ultrasound in Obstetrics and Gynecology (2004)

G. Nazzaro Mariavittoria Locci A. Nazzaro A. Merenda M. L. Pisaturo

brain sparing effect is considered a physiologic mechanism in response to chronic hypoxia. Aim of this study was to asses changes in cerebral blood flow in the proxymal (M1) and in the distal tract (M2) of middle cerebral artery (M1) and distal part (M2) in severely growth restricted fetuses in relation to neonatal mortality and neurological morbidity at 2 years of age. Doppler study of umbilical artery and middle cerebral artery, in both tracts M1 and M2, was performed in a group of 15 IUGR fetuses starting from 28 week of gestation until delivery. Inclusion criteria were umbilical artery absent diastolic flow and brain sparing effect in both M1 and M2 in fetuses with intrauterine growth restriction at mid-gestation with abdominal circumference below the 5th centile. Doppler analysis was performed twice a week until the onset of reverse flow in U. A. Starting from reverse flow onset, Doppler was performed daily and within 2–5 hours before delivery. Infant outcome was evaluated using Griffiths mental scales and was considered favourable if normal neurological development at 2 years was assessed. Infant outcome was considered unfavourable in case of neonatal death or impaired neurological development at 2 years follow up. In 11 fetuses favourable outcome was observed 4 fetuses showed unfavorauble outcome. In fetuses with favourable outcome, brain sparing effect had been detected both in M1 and M2 before delivery. In 4 fetuses with unfavourable outcome the lost of sparing effect in M2 with high PI values had been observed 2–5 hours before delivery. Longitudinal evaluation of growth restricted fetuses showes that the loss of compensation with an increase in M2 resistance, should be considered a bad sign for impaired long term neurological development.

Umbilical artery

10.1002/uog.1407

Cite

Citations (0)

P40.05: Prenatal diagnosis of dacrocystocele: case report

Ultrasound in Obstetrics and Gynecology (2007)

R. Poppiti G. Nazzaro Giuseppe De Placido M. L. Pisaturo A. D'Ambra

Dacrocystocele is a rare condition caused by obstruction of the lacrimal duct; usually due to a combination of an imperforate Hasner's valve inferiorly and malfunction of Rosenmuller's valve superiorly. Rupture is normally spontaneous in utero or during the first month of life. There are only a few reports of prenatal diagnosis of bilateral congenital dacrocystocele. We report a case of prenatal detection of this rare anomaly. A 35-year-old gravida II, para I, was referred for an ultrasound investigation at 30 + 3 weeks' gestation. Normal anatomy had been demonstrated at the 21 weeks examination. The 30 weeks ultrasound examination revealed bilateral, well circumscribed, transonic cystic lesions measuring 68 mm and 74 mm, inferomedially to the fetal orbits without displacement of the globe, or evidence of intracranial or facial abnormalities with synchronous eyes movement. A repeat scan 1 week later revealed a spontaneous resolution of the right dacrocystocele and unchanged the left mass at 34 and 37 weeks. Three-dimensional ultrasound allowed to study in detail the anatomy of the fetal face on every ultrasound examination. The 3130 g female infant born by spontaneous delivery at 38 + 3 weeks, breathed spontaneously without respiratory complications. The diagnosis of dacrocystocele was confirmed and it was treated with massage and antibiotics; no further treatment was necessary to complete resolution. Prenatal diagnosis of congenital dacrocystocele is important because the cyst can have intranasal extension and if bilateral, may result in neonatal respiratory distress. Morever, the typical cystic appearance of dacrocystocele should be distingued by prenatal ultrasound scan from other periorbital mass, such as encephalocele, hemangioma, dermoid cyst, and glioma. 3D ultrasound has shown to be better able to describe this type of anomaly adding precision information for the final diagnosis.

10.1002/uog.4894

Cite

Citations (0)

P18.14: Prenatal utrasonographic findings of a fetal dorsal giant congenital nevus

Ultrasound in Obstetrics and Gynecology (2010)

Maximiliano Miranda G. Nazzaro Mariavittoria Locci M. L. Pisaturo A. D'Ambra

Giant congenital nevi occur in 1 in 20000 live births, and may be associated with by proliferative nodules. They are usually disfiguring and associated with complications of malignant melanoma, and neurocutaneous melanosis. Here we present a case of prenatal diagnosis of this pathology. A 39-year-old woman, gravida 2 para 1 was referred to our center for sonographic examination since the presence of an unknown mass on the fetal shoulder. The scan revealed a fetus of 29 + 6 weeks of gestation with normal amniotic fluid. An irregular cystic-solid mass of heterogeneous echogenicity (12 × 10 × 9 cm in size) was detected on the surface of the left shoulder covering the dorsal chest wall. The mass was mostly subcutaneous and did not appear to penetrate the skeleton. Color Doppler investigation showed an intense and chaotic low resistance vascularization (RI 0.48) in the mass. There was no other fetal anomaly. Three-dimensional surface rendering showed an irregular and nodular tumor surface. The mass was considered as a malignant tumor. The patient was monitored by ultrasound every 2 weeks and no increase in tumor size was detected up to 38 weeks. A 3.1 kg male infant was delivered via cesarean section at 38 weeks' gestation (1 and 5 minute Apgar scores were 9 and 9, respectively). The newborn had a large cutaneous lesion covering the dorsal chest. The lesion showed marked heterogeneity in colour, with dark-brown to black and erythematous violaceous areas. The whole lesion was soft with proliferative nodules and cauliflower appearance, some ulcerated areas were present. MRI of the thorax and abdomen confirmed the ultrasound findings. Multiple biopsies were taken for histological analysis of the lesion. Histological examination revealed that the mass was a giant melanocytic nevus. The MRI investigation of the brain showed no intracerebral lesions. There are several postnatal case reports, but to our knowledge, no sonographic description of the prenatal findings of this type lesion has been reported up to now.

10.1002/uog.8566

Cite

Citations (0)

OC120: 3D invert mode sonography versus 2D saline infusion sonohysterography in the diagnosis of endometrial anomalies

Ultrasound in Obstetrics and Gynecology (2006)

G. Nazzaro A. Stile P. Laviscio A. D'Ambra Giuseppe De Placido

In this study we compared the diagnostic accuracy of two sonographic techniques, three dimensional (3D) sonographic inversion rendering mode, a 3D software able to invert anechoic into echogenic voxels, and bidimensional (2D) saline sonohysterography (SIS), in the diagnosis of endometrial anomalies (polyps, submucous fibroids, uterine malformations). 20 patients with previous diagnosis of endometrial anomaly at the 2D transvaginal sonography were referred to our department. All patients were submitted to 3D invert mode sonography during the midlutheal phase. Following, patients were submitted to 2D SIS. Diagnostic hysteroscopy was performed in all patients. Ten endometrial polyps, five submucous fibroids, two partial uterine septa and three cases of arcuate uterus were easily recognized either by 3D sonography or 2D SIS. Diagnosis was hysteroscopically confirmed. Our study shows that the diagnostic accuracy of the 3D invert mode and of the 2D SIS in case endometrial anomalies overlap. Nevertheless, considering that 3D ultrasound does not require invasive tools and that it is well tolerated by the patients if compared to the 2D SIS, we believe that the former technique should be considered the first line technique to study these type of anomalies. The techniques will be extensively discussed.

Endometrial Polyp

Echogenicity

Uterine Fibroids

10.1002/uog.2980

Cite

Citations (0)