Minerva ginecologica (Minerva Ginecol )

Description

A Journal on Obstetrical and Gynecological Pathophysiology, Clinical Medicine and Therapy. Frequency: Bi-Monthly.

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  • 5-year impact
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  • Website
    Minerva Ginecologica website
  • Other titles
    Minerva ginecologica
  • ISSN
    0026-4784
  • OCLC
    1696021
  • Material type
    Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • Minerva ginecologica 12/2014;
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    ABSTRACT: The population of our planet continues to grow at an alarming rate. If the growth continues at the present rate, the estimated current world population of about seven billion is expected to double in the next forty years. Accumulated data from surveys by the United Nations Population Control Division suggest that a majority of today's young men in many countries are willing to have fewer children than their parents did. However, the contraceptive options available to them have not changed in several decades. In spite of the general agreement that men, like women, must take full responsibility of their fertility, the availability of safe, reversible and affordable contraceptives for men have lagged behind because of the complexity of the science of the male reproductive system. Thus, the contraceptive needs of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. In this article, we intend to discuss new hormonal and non--hormonal contraceptive approaches that are at various stages of research and development and may someday provide new contraceptives for men. In addition, we intend to discuss many details of three safe, effective, affordable and reversible vas--based approaches that are inching closer to being approved for use by millions of men in multiple countries. Finally, our intention is to discuss the male contraceptive pill that will soon be available to men only in Indonesia. The availability of these male contraceptives will allow both men and women to take full control of their fertility and participate in slowing down the growth of world population.
    Minerva ginecologica 12/2014;
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    ABSTRACT: The aim of the study is to assess the outcome of pregnancies achieved by OD IVF compared with those obtained by autologous IVF. This retrospective cohort study includes 136 consecutive patients who were referred to our centre between 2009 and 2011. According to the mode of conception, they were divided into two groups, whose pregnancy outcomes were analyzed by chi-square test for unpaired data. PIH, cesarean section, complications after delivery resulted more frequent in pregnancies from donor oocyte IVF. The other outcomes considered were non significantly different between the two groups. The risk of developing preeclampsia, cesarean section, and postpartum complications is higher in patients who conceived by donor oocyte IVF than in patients who underwent autologous IVF.
    Minerva ginecologica 12/2014;
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    ABSTRACT: To evaluate the association between endothelial dysfunction, evaluated through flow--mediated dilation (FMD) of the brachial artery, and preeclampsia. A case--control prospective cross--sectional study was conducted on 81 pregnant women of between 20 and 39 weeks and 5 days, among whom 40 had preeclampsia and 41 were controls. The right brachial artery was identified using color Doppler, between 2 and 5 cm above the cubital fold. The diameter of the brachial artery was measured by calculating the distance between the proximal and distal intima (D1) during diastoles. Ischemia was caused for five minutes and the artery measurement was repeated 60 seconds after ending the compression (D2), during diastoles. The FMD (%) was calculated through the equation: (D2 -- D1) / D1 × 100. The association between independent variables and the presence of preeclampsia was estimated through odds ratios (OR) and their 95% confidence intervals (95% CI). 75.0% of the pregnant women with preeclampsia and 26.8% of the normotensive women presented reduction in the diameter of the brachial artery (OR = 8.18; 95% CI: 2.74 - 25.04) (p = 0.000). A greater proportion of the pregnant women with preeclampsia (42.1% vs. 14.3%) had a history of a mother with hypertension during pregnancy (OR = 4.36; 95% CI: 0.89 - 23.51) (p = 0.045). We identified an association between endothelial dysfunction, evaluated through FMD of the brachial artery, and preeclampsia.
    Minerva ginecologica 12/2014;
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    ABSTRACT: Aim of the present study was to investigate type of contraception, if any, used by women with induced abortion.
    Minerva ginecologica 12/2014; 66(6):521-6.
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    ABSTRACT: The aim of this paper was to compare serum chemerin levels in nonobese and overweight/obese patients with polycystic ovary syndrome (PCOS) with lean controls.
    Minerva ginecologica 12/2014; 66(6):535-42.
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    ABSTRACT: Preterm birth (PTB) is usually defined as a delivery before 37 completed weeks or 259 days of gestation. World Health Organization estimates a worldwide incidence of PTB of 9.6%. Infants born preterm are at higher risks than infants born at term for mortality, and acute and chronic morbidity. Major causes of PTB are the following: spontaneous preterm labor with intact membranes (50%), labor induction or caesarean delivery for maternal or fetal indications (30%), and preterm premature rupture of membranes or PPROM (20%). The aim of this review is to analyze this medical condition, focusing on cellular and biochemical mechanisms, maternal risk factors and role of inflammation and infections in preterm premature rupture of membranes (PPROM) and PTB. Moreover we will discuss about the proper therapeutic strategies for its management. Although different methods have been introduced to predict the advent of preterm labour in asymptomatic women, possibilities for real primary prevention are rare. An early estimation of potential risk factors is pivotal in the secondary prevention of PTB. Finally most efforts so far have been tertiary interventions. These measures have reduced perinatal morbidity and mortality. Advances in primary and secondary care will be needed to prevent prematurity-related illness in infants and children.
    Minerva ginecologica 12/2014; 66(6):589-95.
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    ABSTRACT: The aim of this study was to develop a pharmacogenetic- (PGx) driven approach for a controlled ovarian hyperstimulation (COH) treatment protocol used for in vitro fertilization procedures. The enrolled patients were genotyped for a single nucleotide polymorphism (SNP) N680S, within the FSHR.
    Minerva ginecologica 12/2014; 66(6):543-9.
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    ABSTRACT: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies of the reproductive age in women. PCOS is an endocrine-metabolic disorder characterized by insulin resistance. Aim of the study was to evaluate the efficacy of natural substances such as inositol and glucomannan, and their combination in reducing glucose levels and improving insulin sensitivity in PCOS patients.
    Minerva ginecologica 12/2014; 66(6):527-533.
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    ABSTRACT: Colorectal infiltration by endometriotic implants accounts about 90% of all intestinal location and is difficult to be assessed preoperatively by means of history taking and clinical examination. During the last decade, a number of studies are trying to assess various minimally invasive procedures in order to establish a therapeutic plan that is efficacious and produces acceptable clinical outcomes, preventing the morbidity that results from open surgery. The study aims to review the efficacy of these procedures as therapeutic options of endometriosis infiltrating the bowel. Thirty five observational studies were finally included in the present review involving 3,490 women. Intraoperative complications were observed in 4.3% of women and postoperative complications in 7.8%. Quality of Life was statistically significantly improved, wherever recorded. Postoperative pain reduction and fertility scores were also improved among cases that received either segmental resection or less radical operations. The various techniques described seem to be efficacious, with acceptable intraoperative and postoperative complication rates. Laparoscopic disc shaving or disc resection in cases of minimal bowel involvement seem to be sufficient alternatives to segmental bowel resection, resulting in high rates of fertilization.
    Minerva ginecologica 11/2014;
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    ABSTRACT: A plethora of evidence has shown that circulating autoantibodies (a-Abs) are critically linked to pregnancy failure. In this study the possible association of serum immune reactivity (IR) against β2-Glycoprotein-I (β2GPI) and Anti Neutrophil Cytoplasmic (ANCA) auto-antibodies (a-Abs) in RM was examined. This is a case-control study which was carried out in Yazd research and clinical center for infertility, Yazd, Iran during January to December 2013 on 128 women with RM, matched with 65 women with no history of pregnancy wastage. The participant's sera were collected and serum Immune Reactivity (IR) was analyzed against β2GPI and ANCA a-Abs by ELI-P-Complex screening technology, the assay involved a standard enzyme-linked immunosorbent assay (ELISA. Serum IR of each sample was calculated in conditional units (CU). Elevated serum IR against β2GPI and decreased serum IR against ANCA a-Abs were detected in a total of 51.5% (n=66; m=-42 CU) and 24.2% (n=31; m=-42 CU) patients, respectively. In rare control subjects, serum IR against β2GPI (3%) and ANCA (1.5%) was observed. The elevated serum IR of β2GPI was not correlated with the decreased serum IR against ANCA (r=-0.23, p<0.05). Moreover, β2GPI IR was associated with first trimester miscarriages (p=0.03) and the number of previous miscarriages (p=0.04). The present study indicates that the risk of RM may be high in women with the prominent serum IR deviations against β2GPI and ANCA a- Abs. According to the findings and ELI-P-Complex technology principles, it is suggested that the vigorous monitoring of these two a-Abs pre and during pregnancy may be useful to avoid negative outcomes such as miscarriage.
    Minerva ginecologica 11/2014;
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    ABSTRACT: To assess the pre and perinatal risk factors for cerebral palsy in premature infants, comparing them with full-term infants. This was a prospective cross-sectional cohort study on 48 infants between four and eight months of life, of whom 20 were born prematurely (< 37 weeks of gestational age) and 28 at full term (37 to 42 weeks). A questionnaire was used, which investigated maternal reproductive, obstetric and neonatal factors, along with an evaluation scale for neurosensory-motor development of infants at risk of neuromotor alterations. For the statistical analysis, the Student's t, chi-square, Fisher's exact and Cramer's V tests were used. All the newborns that were small for their gestational age (35%) were in the premature group (p = 0.001). Hyperbilirubinemia (p = 0.000), anemia (p = 0.009), respiratory distress syndrome (p = 0.000) and periventricular hemorrhage (p = 0.025) were more frequent in the premature newborn group. Phototherapy and blood transfusion were more frequent among the premature infants: 70.0% vs. 25.0% (p = 0.002) and 20.0% vs. 0.0% (p = 0.025), respectively. Among the premature infants, 50.0% presented neuromotor development alterations, against only 14.3% of the full-term infants. Prematurity is an important risk factor for the development of neurosensory-motor alterations that are suggestive of cerebral palsy.
    Minerva ginecologica 11/2014;
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    ABSTRACT: Electronic fetal monitoring (EFM) has been introduced in the obstetrics practice as a test to identify the first signs of fetal deterioration, allowing a prompt intervention to reduce neonatal morbidity and mortality. However, results from clinical trials fail to demonstrate a clear benefit with the use of EFM. No decrease in the incidence of cerebral palsy due to intrapartum asphyxia has been achieved and a significant increase in the rate of operative deliveries and in medico--legal litigations has been observed instead. Despite the lack of evidence supporting its safety and effectiveness, this method is routinely used in the clinical practice and periodical updated guidelines to standardize the method of interpretation and proper actions are proposed. However limitations still exist and the unavoidable consequences are the increasing rate of caesarean delivery, partly due to a defensive attitude in medical choices, and medico--legal litigations for presumed inappropriate evaluation in case of perinatal adverse event. While Obstetrics Societies are trying to "fight" the rise in caesarean section rates, intrapartum EFM tracings are taken in the court proceedings as one of the main evidences in case of adverse event. The aim of this review is to discuss the limitations of guidelines dealing with intrapartum EFM and the pathophysiological basis to assess the suspicious tracings which represent the most observed and critical issue of EFM interpretation.
    Minerva ginecologica 11/2014;
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    ABSTRACT: To evaluate advantages and disadvantages of the sacrospinous ligament fixation (SSF) technique using the Capio suture--capturing device in a group of menopausal women affected by vaginal vault prolapse.
    Minerva ginecologica 11/2014;
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    ABSTRACT: Early dating of pregnancy by ultrasound measurements is necessary to establish the adequate fetal growth. Customized or individualized estimation of fetal growth is probably a better option than population based curves to identify fetuses at a higher risk of perinatal complications. Biological maternal markers and placental evaluation might contribute in the identification of fetuses at risk of abnormal growth. There is no specific Doppler pattern of deterioration; however, in early growth restriction it is mainly expressed in the umbilical artery, and in late growth restriction (>34 weeks) in the middle cerebral artery. Abnormal biophysical profile and/or non--stress test can be considered as acute signs of fetal decompensation. Magnetic resonance imaging can provide information of fetuses at risk of abnormal neurodevelopment. Neonatal body composition in low birthweight newborns can be used to identify children at risk of metabolic complications. Gestational age at delivery is the most important parameter associated with perinatal morbidity and morbidity; however, waiting until the ductus venosus is severely abnormal might reduce the possibilities of survival of preterm fetuses with abnormal growth.
    Minerva ginecologica 10/2014;
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    ABSTRACT: Although various laboratory tests have been studied with an intended use in the diagnosis of pelvic inflammatory disease (PID) and the assessment of treatment response, the neutrophil/lymphocyte ratio (NLR) has not been investigated in PID. We aimed to explore the value of blood NLR in diagnosis of PID and assessment of the treatment response.
    Minerva ginecologica 10/2014;
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    ABSTRACT: This review uses the most up--to--date literature to help guide obstetrical providers through the diagnosis and management of perinatal lung malformations. These lesions, which include congenital pulmonary airway malformation [CPAM, formerly congenital cystic adenomatoid malformation (CCAM)] and bronchopulmonary sequestration (BPS), are relatively rare but are becoming increasingly common because of the improved resolution and enhanced sensitivity of fetal ultrasound. Serial assessment throughout pregnancy remains the norm rather than the exception. Perinatal management strategies can differ based on the sonographic characteristics and dynamic growth patterns of lung masses. Fetal magnetic resonance imaging and other diagnostic testing can sometimes be helpful in providing additional prognostic information. Over the last decade, the importance of echocardiography and utility of maternal steroids have been recognized in cases of nonimmune hydrops. Fetal surgery is now rarely performed. Decisions regarding whether delivery of these fetuses should occur in a tertiary care center with pediatric surgery coverage versus delivery at a local community hospital are now highly relevant in most prenatal counseling discussions with families. Large lung malformations may require urgent surgical removal in the early postnatal period because of respiratory distress. Other complications, such as recurrent pneumonia, pneumothorax, and cancer, are indications for lung resection on an elective basis. In the vast majority of cases, the overall prognosis remains excellent.
    Minerva ginecologica 10/2014;
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    ABSTRACT: The study of preterm labor and prematurity, as with any medical science, has undergone a major transformation in its approach from an inevitable part of obstetrics with few answers to one in which science has led to knowledge and clinical intervention. Despite these advancements, understanding of preterm labor and prevention of prematurity is still limited. In the current review, we begin the discussion with fetal viability, first from a historical perspective and then from the understanding of this issue from a prospective of various professional organizations. We then present the scope of the problem of preterm birth from various countries including the discrepancy between the US and Europe. We continue with updates on extreme prematurity and outcomes with two longitudinal studies from the past 2 years. We further review available interventions for prematurity and discuss the use of antenatal corticosteroids. First, we examine their use in the context of professional recommendations and then examine the trajectory of their continued use in the late preterm period. We focus on a European--based trial with preliminary results and an ongoing American counterpart. The current knowledge of molecular mechanisms behind preterm labor is presented with a focus on the multiple etiologies of preterm labor, both known and presumed, with updates in the basic science realm. Furthermore, up--to--date studies on prediction of preterm birth and prematurity-related morbidity are presented.
    Minerva ginecologica 10/2014;
  • Minerva ginecologica 10/2014;
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    ABSTRACT: Endometriosis affects from 10 to 15% of women of childbearing age and 20% of these women have deep infiltrating endometriosis (DIE). The goal of this review was to assess the impact of various locations of DIE on spontaneous fertility and the benefit of surgery and Medically Assisted Reproduction (MAR) (in vitro fertilization and intrauterine insemination) on fertility outcomes.
    Minerva ginecologica 10/2014;