Biomedical subjects

B Roma

Publications and source records attributed to B Roma.

5 recordsLinked to original sources

PubMed2001

[Bleedings during the third term: which complications?].

BACKGROUND: The aim of this research was to study the maternal and prenatal complications which may occur in the abruptio placentae and in placenta praevia. METHODS: All the patients who were hospitalized in the Obstetrics and Gynaecology Department of the Policlinico Umberto I, from January 1993 to July 2000 have been studied. Moreover, a comparative study between the onset of complications of the two pathologies considered and the ones found in a control group was carried out. We found 62 cases of placenta previa and 48 cases of abruptio placentae. The total amount of childbirths was 6861, so the incidence of abruptio placentae was 0.007%, while the incidence of placenta previa was 0.009%. RESULTS: The results show that the most frequent maternal complication, in both pathologies, was haemorrhage. We did not find any statistically meaningful difference between the percentage of haemorrhage in the two pathologies ( p=0.0608), but we noted a higher percentage of haemorrhage compared to the control group. The number of hysterectomies was higher in patients with placenta previa compared to patients with abruptio placentae. The most frequent fetal complication was premature birth, significantly more frequent than in the control population (p=0.0210). CONCLUSIONS: As a matter of fact, we can affirm that, in all its clinical manifestations abruptio placentae is a more dangerous disease than the placenta previa, except in the complications of the discharge of the afterbirth and of the postpartum, where haemorrhage and uterus atony lead to a great number of hysterectomies.

Abruptio Placentae↗

PubMed1999

[Stark's method of cesarean section. Advantages compared to the traditional method].

BACKGROUND AND AIM: The increased incidence of caesarean section has led, over the past few years, to the revision of surgical methods in order to reduce fetus extraction time and the total costs of surgery, without detracting from cosmetic advantages. Stark devised a surgical technique for this purpose which aims to reduce operating trauma and duration of surgery and to ensure a faster recovery and greater well being. METHODS: We performed a retrospective study in all patients undergoing caesarean section using Stark's technique and we evaluated their postoperative progress based on body temperature and any complications involving the suture (infections, hematoma, adhesions, pain). The results were compared to those obtained by other authors using traditional caesarean section. RESULTS: It was found that patients undergoing traditional caesarean section showed an incidence of wound infection which was higher than that observed in the Stark group (8.75%). Likewise, in relation to the onset of hypothermia, only 3 cases (3.75%) were observed in this study. CONCLUSIONS: Reduced short- and long-term maternal morbidity was obtained using this technique, together with a lower incidence of febrile morbidity and wound infection, less pain and a decreased risk of visceral adhesion.

Cesarean Section↗

PubMed1998

[Modifications to the technic of cesarean section after Stark].

BACKGROUND: As the operating births (caesarean section) increase, many surgical equipes have been compelled to revise operating techniques in order to reduce fetus extraction times and the whole expense of operation without renouncing, at the same time to beauty advantages. With Stark technique, that we have modified, we have obtained all these aims, improving at the same time patients' postoperative course as well succeeding to extract the fetus in about five minutes. In the '70 Cohen explained the utility of a transiliac incision allowing the access to abdominal cavity with rectus muscles unsticking in an area in which these muscles should present a less adhesiveness. METHODS: Since 1988 Stark has used Cohen's technique changing however uterus closing times, peritoneal membranes and abdominal walls. Our technique is different since we performed the incision according to Pfannestiel. RESULTS: The times are considerably reduced to 4.8 minutes for fetus extraction and in postoperative time the complications are drastically reduced too (infection, pain, hematoma, adhesions). CONCLUSIONS: Therefore we can surely say that this kind of technique can be used with success in all gynaecological surgery, in extrauterine pregnancies and adnexial tumefactions (not malignant). Personal opinion is that spinal anesthesia is the best analgesic technique.

Antibiotic Prophylaxis↗

PubMedDate not supplied

[Antiphospholipid syndrome in obstetrics].

BACKGROUND: The purpose of this study was to verify the frequency of antiphospholipid syndrome in pregnancy associated with fetal wastage and maternal hypertension. The antiphospholipid antibody syndrome is a clinical syndrome of venous and arterial thrombotic events, recurrent pregnancy loss, and thrombocytopenia associated with two autoantibodies: the lupus anticoagulant (LAC) and anticardiolipin antibody (ACA). METHODS: A group of 83 pregnant patients with recurrent fetal loss or with maternal hypertension for the presence of autoantibodies has been studied. None of the patients had systemic lupus erythematosus or any other autoimmune disease such as sclerodermia, myasthenia, autoimmune thrombocytopenic purpura. The patients have been divided into two groups: a) 45 women with fetal wastage history; b) 38 women with maternal hypertension. RESULTS: The prevalence of autoantibodies in the first group reaches 31.1% (14/45 patients). Two of these 14 patients (14.3%) had fetal loss (one with treatment and one without). 12 of this 14 patients (85.7%) had a normal delivery and all with treatment. Two treatment scheme were used in this study: one with aspirin and another with aspirin and prednisone. In the group of 45 patients there were 34 normal deliveries: 27 (79.5%) pregnancies were treated with aspirin and 7 (20.6%) were treated with aspirin and prednisone. There were 11 fetal loss and 9 (81.1%) in patients without treatment and 2 (18.2%) in treated pregnancies. The prevalence of autoantibodies in the second group reaches 21%. CONCLUSIONS: In conclusions, it can be suggested that treatment strategies for the prevention of fetal loss in the antiphospholipid syndrome are warranted because treatment appears to alter fetal outcome favorably.

Abortion, Habitual↗

PubMedDate not supplied

[Management of female genital HPV infections by the LEEP method (Loop Electrosurgical Excisional Procedure)].

METHOD: Two different groups of women have been selected: group A (120 patients), affected by genital warts and ectropion, treated only with destructive therapy by means of LEEP (Loop Electrosurgical Excisional Procedure) with spheric electrod, while group B (20 patients), of which two affected by CIN I and resistant to other treatments for a period longer than 12 months, and 18 patients with a histologic diagnosis of CIN II, CINIII/HPV, treated with conization by LEEP method. After therapy, a follow-up has been carried out, with colposcopic, cytologic, histologic control, scheduled 1-3-6-12 months after therapy. RESULTS: The results proved positive, since recovery in the two groups (A and B), after treatment, has been 100% with no complications, verified by follow-up after 12 months. CONCLUSIONS: The introduction of LEEP, represents a simple alternative, fast, painless practical, at a minimum cost to the patient and the community, devoid of complications, without general anaesthesia in the treatment of CIN as well as of genital warts, substituting in this last case the loop with a sphere electrode. Moreover, it does not affect the function, as well as the anatomy of the organ, a primary factor is young patients desiring children. This technique permits to obtain at the end of the operation one or more tissue fragments to be used for histological examinations, with free margins from necrotic border, assuring the integrity of the tissue, and thus leading a correct diagnosis.

Adult↗