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Biomedical subjects

R Corosu

Publications and source records attributed to R Corosu.

16 recordsLinked to original sources
PubMed2006

[Inherited thrombophilia in pregnancy: a systematic review].

The purpose of this study was to conduct a systematic review of the literature of studies that examined the association between inherited thrombophilias and adverse pregnancy outcomes. We have evaluated developments in this area published since 1998. The published studies differ widely in design, mostly in patients and controls selection and in data analytic approach. Despite the growing evidence in the literature, there are still gaps in our knowledge of thrombophilia in pregnancy, specially regarding less prevalent thrombophilic defects, such as deficiencies in antithrombin, protein C, and S. Several studies on the association on factor V Leiden showed that it may play a role not only in second trimester losses, but also in pre-eclampsia, intrauterine growth-retardation, and placental abruption. Studies on the prothrombin gene mutation yielded conflicting results. Further large prospective studies are needed to asses the relative clinical and cost effectiveness of anticoagulant therapies in the prevention of pregnancy adverse outcomes.

Female↗
PubMed2006

Pregnancy in immigrant women.

OBJECTIVE: We wanted to study how foreign women face pregnancy and childbirth in a society quite different from their own. METHODS: In 2004 we studied 328 pregnant women at the Department of Gynaecology at the "General Hospital Umberto I" in Rome. Information on patients' personal lives and experiences was collected. RESULTS: Women were classified into six (6) groups based on nationality, race, religion and culture. CONCLUSIONS: Arabian women had the most natural childbirths. African women had a longer duration of gestation. Women from Eastern Europe underwent frequent tests and examinations, but had the highest chance of having preterm births. Chinese women did not usually undergo many examinations and were able to tolerate pain during childbirth quite well.

Africa↗
PubMed2006

Postoperative analgesia after cesarean section by continued administration of levobupivacaine with the On-Q Painbuster system over the fascia vs ketorolac + morphine i.v.

OBJECTIVE: This study aimed to detect if continuous local infusion of levobupivacaine with the On-Q Painbuster system provided postoperative analgesia of similar quality to morphine + ketorolac i.v. in patients undergoing cesarean section. MATERIALS AND METHODS: Using a randomized prospective double-blind study, 20 women undergoing cesarean section with a standardized spinal technique were randomly assigned into two groups to receive either 10 mg morphine + 120 mg ketorolac + saline solution up to 96 ml with an elastomeric pump i.v. (group A) or local infusion of levobupivacaine 0.2% with the On-Q PAINBUSTER system (group B). Both groups were administered ketorolac i.v. in bolus in case of pain. RESULTS: The two groups differed in their VAS scores with group A experiencing significantly less pain than group B; the consumption of analgesics was significantly lower in group A than in group B. CONCLUSIONS: The i.v. system with morphine and ketorolac is more effective than levobupivacaine subcutaneous infusion in reducing postoperative pain associated with cesarean section.

Analgesics, Opioid↗
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↗
PubMed2001

[CIN: multicentric study of therapeutic strategies].

BACKGROUND: Cervical Intraepithelial Neoplasia (CIN) is a dysplastic lesion that precedes cervical cancer. The diagnosis is made by colposcopic, cytologic and bioptic exams. Therapy may be physical, pharmacological or surgical. METHODS: We prepared a model of interview (consisting of 9 questions) for 33 colposcopic centers in the Lazio region. Our aim was to evaluate their therapeutic strategies for CIN and cervical condylomata. We referred to SIGO 1999 guidelines for CIN therapy and to European guidelines for cervical condylomata therapy. RESULTS: The centers used drugs more for HPV infections (57%) than for dysplasia (33%). Drug therapy was used more in the past (66.67%). Actually they prefer treating CIN I with electrocoagulation diathermy (DTC), CIN II with loop electrosurgical excision procedures (LEEP) or Laser, CIN III with cold knife conization or LEEP, cervical condylomata with laser or DTC. CONCLUSIONS: The results show that the centers prefer physical therapy. Therapeutic strategies comply with SIGO 1999 guidelines for therapy of CIN and with European guidelines for cervical condylomata partially.

Conization↗
PubMed1999

[Evaluation of the cardiotocographic specificity in antepartum diagnosis].

BACKGROUND: In last years, pregnancies and deliveries carefully monitorized, have led to perinatal mortality decrease. The more common diagnostic method used to point out fetal distress is cardiotocography, which is carried out as a routine screening during pregnancy and labor. The importance of cardiotocography, the limitations of this of measurement of fetal heart rate (FHR) are highlighted: no decrease in neurologic sequelae, positive and/or negative falses, dependence in interpretation on clinicians' experience. Our search aimed at checking the specificity of electronic fetal monitoring of fetal hearth rate at antepartum diagnosis moment. METHODS: 53 pregnant women in the third trimester of gestation period have been studied and the pregnancies results have been compared with specific women CTG trace and results of other diagnostic method (Ultrasound, Velocimetry). RESULTS: Analysing our data we find out that diagnostic methods of fetal distress, at present, are not significative. CONCLUSIONS: To sum up, it is possible to confirm that cardiotocography has a low specificity in fetal distress diagnosis, although it remains the most reliable method. In any case a global evaluation is necessary to monitorize pregnancy by means of clinical screening ordinary used.

Cardiotocography↗
PubMed1999

[Incidence of thromboembolic complications in cesarean sections and heparin prophylaxis].

BACKGROUND AND AIM: Venous thromboembolism is a rare but severe complication of pregnancy and puerperium: it is the most frequent cause of death and maternal morbidity. Pregnancy leads to hemodynamic, hormonal and hematological changes which make hypercoagulability a secondary condition. In particular, surgical birth via an abdominal route is burdened with a higher risk of thromboembolic disease compared to spontaneous birth. The aim of this study was to highlight the increased incidence of deep venous thrombosis and pulmonary embolism after caesarean section. METHODS: All the pregnant women (no = 879) admitted to the institute from January 1997 to May 1998 were monitored: their clinical conditions were followed both during the last period of pregnancy and after birth in order to identify the onset of pre- and post-partum thromboembolic episodes. RESULTS: Among the women examined, 9 cases (1.02%) of lung embolism were observed, one of which was fatal. All 9 women had undergone caesarean section and in all cases the thromboembolic episode occurred between the second and fourth day after birth. Prophylactic therapy was not administered in any of the above cases. CONCLUSIONS: It is important that anti-thrombotic prophylaxis with heparin should be administered. Although this presents a number of collateral effects (hemorrhage, platelet deficiency, osteoporosis), it protects the woman from the risk of thromboembolic episodes, above all if a caesarean section is performed or if the personal and/or family medical history is positive for this pathology.

Blood Coagulation Disorders↗
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↗
PubMed1999

[Clinical considerations on oligohydramnios].

BACKGROUND: Oligohydramnios represents a physiopathologic process, associated to a high rate of pregnancy complications and increased fetal morbidity and mortality. The purpose of this study is to determine whether amniotic fluid ultrasound evaluation is a useful parameter to identify pregnancies at risk for fetal distress. METHODS: 91 pregnant women with oligohydramnios were followed, and fetal conditions monitored with cardiotocography and ultrasounds. Delivery way and new-born conditions at birth were considered too. RESULTS: Cardiotocograms appeared abnormal in 61 cases (67%). Intrauterine growth restriction (IUGR) observed in 36 cases (39.56%). Cesarean section was performed in 60 cases (66%) for fetal distress, identified with cardiotocography. Also significant was the correlation with oligohydramnios, IUGR and cardiotocographic anomalies. From the results, it may be inferred that oligohydramnios is an index of affected fetal good health, because frequently is related with pregnancy anomalies and fetal health involvement. CONCLUSIONS: We can then affirm that the ultrasound evaluation of amniotic fluid represents a useful means to identify pregnancies at risk for fetal distress. In case of oligohydramnios, it is important to increase the surveillance on fetus, with the different means at our disposal (ultrasonography, velocimetry, cardiotocography).

Cardiotocography↗
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↗
PubMed1996

[Condition at birth of a group of neonates suffering from intrauterine growth retardation].

The authors monitored a group of pregnant patients who presented fetuses with intrauterine retarded growth syndrome. Only pregnant women who were monitored until the time of birth were included in the study. Patients were divided into three groups depending on the week of gestation in which birth occurred and two subgroups were identified within each group depending on the type of birth. Three perinatal deaths (5%) were recorded in the group of patients at risk, a percentage that is comparable to data reported in the literature, in spite of careful monitoring (flow metric and cardiographic). Cesarian section was resorted to in 86.4% of cases and 67.7% of neonates presented decisively "poor" conditions at birth.

Female↗
PubMed1994

[Use of alpha interferon in microcondylomatosis of the female genitalia].

The Authors report the results of their research into the use of the alpha-interferon in the microcondylomatosis of the female genital apparatus. The therapy was successful in 18% of cases. Considering oncological risk connected with the permanency of the HPV in the uterine portio, the Authors consider they must continue the study on new diagnostic and therapeutic protocols.

Condylomata Acuminata↗
PubMedDate not supplied

[Hystersoscopy: instrumentation and techniques].

This paper was presented at the 1st Update Course in Hysteroscopy and Microcolpohysteroscopy organised by LAMM and held at the 1st Institute of Obstetrics and Gynecology at Policlinico Umberto I in Rome. The paper is divided into three sections: the first section describes the technical instruments used during hysteroscopy (light source, means of distending the uterine cavity, optic systems); the second reports the technique used in hysteroscopic examination: in particular, the authors underline the importance where necessary (i.e. in young patients with stenosis of the cervical canal and in elderly patients with atrophy of the neck of the uterus or conglutination of the external uterine operning) of preceding dilatation of the cervical canal by the use of endovaginal prostaglandin derivatives in order to render it less traumatic. Moreover, the authors attempt to simplify the technique as much as possible so as to render it a routine or ambulatorial test; the third section describes complications of the hysteroscopic examination, in order of frequency, as well as methods of storing and disinfecting the instruments used in hysteroscopy.

Female↗
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↗