PubMed Health⌕ Search

Biomedical subjects

G Grismondi

Publications and source records attributed to G Grismondi.

4 recordsLinked to original sources
PubMed2001

EXIT procedure in a twin gestation and review of the literature.

Prenatal diagnosis can show masses of the fetal neck, mouth, and face that can potentially cause respiratory distress at birth. To prevent such an emergency, the EXIT (ex utero intrapartum technique) is performed: it is the intrapartum intubation of the fetus at term while still connected to the placenta. The EXIT procedure was first performed in a case of cervical teratoma. Up to now a total of 34 cases are described, mostly cervical teratomas (13 cases), lymphangiomas (7), epignathus (3); babies' outcome has been successful in 25 of them, with one death related to the procedure. Among the reported cases we are aware of only one where EXIT was performed in a twin gestation, in which the normal twin was delivered first. In our case the normal fetus was posterior to the twin with cervical malformation, requiring us to work on the latter while the former was still in the uterus. After having safely secured the airway in twin A, twin B was prompt delivered with excellent general conditions. Our limited experience enlarges the possibility to perform this prenatal procedure even in "nonstandard" conditions, such as a twin gestation, and may prove useful to those who are going to deal with such issues.

Adult↗
PubMed2001

[The EX-utero Intrapartum Technique (EXIT) procedure in Italy].

Aim of the study was to present the first two Italian cases of C-section performed with the EXIT procedure (EX-utero Intrapartum Technique). Deliveries were performed at the Division of Obstetrics and Gynecology of the Hospital of Padua in cooperation with the Pediatric Surgery Department, both tertiary care centers. The first case was a twin with a huge neck mass (cystic hygroma) and the second a fetus with an oropharyngeal mass (epignathus). Airway patency could have been compromised at birth in both of them. EXIT procedure consists in securing the airway of the fetus partially delivered and still connected with the placenta. This technique leaves an intact feto-placental circulation and guarantees a normal fetal oxygenation while fetal airway patency is secured. Both the fetuses were successfully intubated and the C-section ended up in a short period of time without maternal and fetal complications. The EXIT technique, performed for the first time in 1989 and now in many centers abroad, can be considered a safe procedure as long as a multidisciplinary approach is carried out. The EXIT procedure is indicated whenever fetal airways can be compromised at birth, that is when oropharyngeal masses, laryngeal atresia, cystic hygroma and goiter are encountered during prenatal ultrasound.

Adult↗
PubMedDate not supplied

Postpartum hostility and prolactin.

In a previous study ten women with hyperprolactinemia and amenorrhea had significantly higher Symptom Questionnaire scores for depression, hostility and anxiety than patients with amenorrhea only and a matched nonpatient employees group. The hyperprolactinemic patients and employees were compared with ten women on their seventh day after childbirth who had been matched for sociodemographic variables and had similar prolactin levels. Hostility was significantly higher in postpartum patients than employees and did not differ significantly from that of women with hyperprolactinemic amenorrhea. Postpartum hyperprolactinemic women did not differ significantly from the employees for anxiety and depression, which was significantly lower than in the amenorrheic patients. In several mammals aggression occurs concurrently with lactation. The studies in humans suggest an association of high prolactin levels with hostility.

Adult↗