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Biomedical subjects

G Ventolini

Publications and source records attributed to G Ventolini.

6 recordsLinked to original sources

Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness.

OBJECTIVE: To compare the neonatal outcome of infants delivered before 39 weeks' gestation following documentation of fetal lung maturity before and after the lamellar body count (LBC) threshold was increased from 30,000 to 50,000 LB/ul. We discuss the algorithm employed for testing fetal lung maturity, the cost of testing and potential savings. MATERIAL AND METHODS: We studied the outcome of infants delivered electively before 39 weeks' gestation after fetal lung maturity was documented by amniotic fluid analysis. We compared the outcome of neonates born before and after the LBC threshold was increased. RESULTS: Our cohort included 527 neonates who were divided into two groups: 264 who underwent fetal lung maturity studies before the change in LBC threshold and 263 who underwent testing after the change. In the first group, 158 neonates met the criteria of LBC >30,000 LB/ul and were delivered without further testing. The second group included 154 neonates who were mature by LBC >50,000 LB/ul and were delivered. Seven of the neonates born in the first group required admission to the neonatal intensive care unit (NICU), whereas in the second group only two neonates required admission (P = 0.02). Additionally, 16 neonates in the first group required respiratory assistance compared with six in the second group (P = 0.04). The overall neonatal complication rate was significantly higher in the first group (P = 0.001). CONCLUSION: Changing the LBC threshold resulted in a significant decrease in neonatal morbidity. Employing the algorithm, we described for testing fetal lung maturity is cost effective, and more importantly, represents sound evidence-based medical management.

Algorithms↗

Gender-related differences in fetal heart rate during first trimester.

OBJECTIVE: Many expecting parents wish to ascertain fetal gender early in pregnancy. Our goal was to determine whether fetal heart rate (FHR) of males and females during the first trimester is significantly different. MATERIALS AND METHODS: From November 1997 to February 2003 we enrolled pregnant women with singleton gestations who underwent obstetric sonography at less than 14 weeks of gestational age. Indications for the sonographic study included first-trimester bleeding, uncertain gestational dating, poor obstetrical history, and aneuploidy screening by nuchal translucency. The sonographic studies were performed by a single sonographer and reviewed by the first author. The FHR was determined by m-mode. All subjects underwent second-trimester sonography at 18.0-24.0 weeks' gestation by the same team, and fetal gender was recorded. Multiple gestations, miscarriages and pregnancies with uncertain fetal gender were excluded. Sonographically assigned fetal gender was confirmed at delivery. RESULTS: Of the 966 first-trimester studies performed, 477 met the inclusion criteria. Of these, 244 (51%) were female and 233 (49%) were males. There were no statistical differences in mean maternal age, gravidity, parity, and mean gestational age at the time of the first study (9.0 +/- 2.3 weeks for female fetuses and 9.0 +/- 2.3 weeks for males, p = 0.7). The average female FHR was 151.7 +/- 22.7 bpm and male FHR was154.9 +/- 22.8 bpm (p = 0.13). DISCUSSION: Contrary to beliefs commonly held by many pregnant women and their families, there are no significant differences between male and female FHR during the first trimester.

Female↗

Hysteroscopy in the evaluation of patients with recurrent pregnancy loss: a cohort study in a primary care population.

BACKGROUND: The purpose of this study was to determine the prevalence of structural uterine defects (SUD) in patients with recurrent pregnancy loss (RPL) attending a large family medicine practice and to determine the effectiveness of the therapeutic intervention. METHODS: This prospective cohort study from October 1995 to October 1998 included 23 patients aged 23 to 35 years (mean, 28.1) with an otherwise unexplained history of three or more 1st- or 2nd-trimester miscarriages and no live births. None of the couples were tobacco or alcohol users, all of them and had normal cytogenetic examinations and testing. Their jobs were unrelated to chemical handling. All patients had a complete history taken and underwent physical examination and hysteroscopy with directed biopsy. They had normal values for complete blood count, sedimentation rate, urinalysis and culture (gonorrhea, Chlamydia, syphilis, hepatitis B, HIV), lupus anticoagulant, anticardiolipin antibodies, spermiogram, progesterone, and pelvic ultrasound. RESULTS: Fourteen patients (60.9%) had a normal hysteroscopy (with biopsies). Nine patients (39.1 %) had SUD, as follows: Five patients (21.8%) had intrauterine adhesions, two patients (8.7%) had a septated uterus, one patient (4.3%) had submucosal myoma, and one patient (4.3%) had multiple factors. After appropriate therapy of the SUD, seven patients (77.8%) achieved successful pregnancy and two patients (22.2%) had recurrent miscarriage. In the normal hysteroscopy group, eight patients (57.1%) had recurrent miscarriages, two patients (14.3%) had infertility, and four patients (28.6%) achieved successful pregnancy with no further therapy. CONCLUSIONS: The prevalence of SUD in our studied population was 39.1 %. After appropriate treatment, the rate of live-birth pregnancies in these patients was 77.8%. Because SUD are the most treatable cause of RPL, these patients should be identified early after other potential causes of RPL are eliminated.

Abortion, Habitual↗

A controlled clinical study on the efficacy of benzydamine in the topical treatment of non-specific cervicitis and vaginitis.

The authors report the results achieved in a controlled clinical study carried out for evaluating the efficacy of some topical preparations in the treatment of the so-called non-specific cervicovaginitis. The best results have been observed in 55 patients treated with a 0.1% benzydamine solution, whose efficacy was found to be significantly greater than that of povidone-iodine vaginal suppositories or a 0.2% aluminium acetate solution that were used in an additional 45 patients suffering from non-specific vulvovaginitis and exocervicitis, according to a fully randomized experimental study protocol. The results obtained in the non-selected population of the present study confirm the usefulness of benzydamine vaginal douches in the therapy of non-specific inflammations involving the lower female genital apparatus.

Acetates↗