Andrea Tinelli

Veris delli Ponti Hospital · Department of Obstetrics and Gynecology

Objective: Preeclampsia is a highly morbid disease of placental origin, life-threatening condition for both a pregnant woman and her fetus. Cadherin 6 and 11 are adhesion molecules that play an important role in trophoblastic development and placentation. In our study, we investigated the change in serum cadherin 6 and 11 levels in pregnant women...

We evaluated factors influencing long-term health-related quality of life (HRQoL) after excisional treatments of low- and high grade squamous intraepithelial cervical lesions (SIL) in three groups of women (n = 160): nulliparas interested in reproduction (A), parous women interested in reproduction (B) and women without pregnancy desire (C). The HR...

Objective Pregnants and puerperas show different perceptions of their body image and appearance, so authors investigated their perceptions related to pregnancy and puerperium, evaluating their views on cosmetic surgery, by a cross-sectional study. Materials and Methods 5-item questionnaires were administrated to women at first pregnancy and puerper...

We investigated the serum anti-Mullerian hormone (AMH), oestrogen and progesterone levels in spontaneously conceiving pregnant women, diagnosed for hyperemesis gravidarum (HG), in the first trimester. Pregnant women admitted at Hospital between 5 and 12 gestational weeks and treated for HG were compared, in this prospective case-control study, to a...

Introduction It is not known whether appendectomy for acute appendicitis (AA) increases the Cesarean section (CS) rate and whether CS increases the likelihood of AA and appendectomy in the early puerperium. In this study, delivery type and delivery outcomes and appendectomy during pregnancy and puerperium were analyzed. Methods This cross-sectiona...

The objective of this study was to assess the value of serum leptin, adiponectin, apelin, and ghrelin as biomarkers for the prediction and diagnosis of intra-hepatic cholestasis (ICP). This prospective study included pregnant women in the third trimester of pregnancy: 63 with ICP, 48 and 15 of whom had mild and severe disease, respectively, and 32...

Objectives: To evaluate intrauterine adhesion formation after laparoscopic and laparotomic myomectomy. Design: Prospective, multicenter, observational study (ClinicalTrials.gov ID: NCT04030273). Methods: We included patients after laparotomic and laparoscopic myomectomy. All patients underwent post-surgical diagnostic hysteroscopy, after three...

Gynecological cancer management remains challenging and a better understanding of molecular mechanisms that lead to carcinogenesis and development of these diseases is needed to improve the therapeutic approaches. The Na ⁺ /H ⁺ exchanger regulatory factor 1 (NHERF1) is a scaffold protein that contains modular protein-interaction domains able to int...

Background: Uterine fibroids (UFs) are the most common female benign tumors linked to significant morbidity. There are large literature data connecting UFs with infertility and adverse pregnancy outcome. In this research, authors reviewed literature on UFs, analyzing their relationship with infertility, influence of different therapeutic approaches...

Anatomically, the uterine corpus, isthmus and cervix are components of the same organ, but functionally they have different roles during pregnancy and labor. The uterine cervix is mainly composed of connective tissue and extracellular matrix to allow cervical ripening and dilatation to occur with the onset of labour. The cervical innervation and th...

Nowadays it is quite common to encounter pregnants over 35 years with uterine fibroids (UFs), requiring cesarean section (CS). Large UFs may cause severe complications during delivery, as bleeding and hemorrhage, during vaginal or cesarean delivery. Frequently, the caesarean myomectomy (CM) is recommended, but generally obstetricians are reluctant...

Introduction the aim of this study was to determine whether maternal serum IL-6 and postnatal melatonin levels change with the mode of delivery. Materials and Methods a prospective controlled study was performed on pregnant women (17–43 years) over 37 weeks of pregnancy. Patients were divided into three groups according to the route of delivery: Gr...

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021....

The possible correlation between nausea and vomiting during pregnancy (NVP) with obsessive-compulsive disorder (OCD) and alexithymia were examined in this cross-sectional study. A cohort of pregnant women at the first trimester of pregnancy experiencing NVP were divided into three groups, according to severity (mild, moderate and severe) with the P...

AIM OF THE STUDY to investigate whether antenatal corticosteroid therapy (ACST) could impact neurological condition, as assessed through muscular tone, of prematurely born infants. METHODS all 82 patients at risk of preterm delivery treated and delivered over 12 months were divided into two equal groups regarding the use of ACST. The investigated...

Objective: To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. Methods: Demographic information, surgical history, symptoms, and postoperative outcome of maternal and neonates after UR were collected in a large database. The statis...

Scientists from multiple basic disciplines and an international group of physician-scientists from the field of obstetrics and gynecology presented recent studies and discussed new and evolving theories of uterine fibroid etiology, growth and development at The Basic Science of the Uterine Fibroids meeting, sponsored by the Campion Fund and the Nat...

Background: Novel coronavirus disease 2019 (COVID-19) outbreak negatively impacted on the mental wellbeing of infertile couples, because of the World Health Organization's recommendation to stop all fertility treatments. This study aims to investigate the level of depression and hopelessness during the COVID-19 outbreak, in women with primary and s...

Adenoid cystic carcinoma of the Bartholin gland (BG-ACC) is a rare form of vulvar cancer. Literature reported approximately 350 cases of BG-ACC since 1864. Literature data and case reports suggested an aggressive nature with protracted clinical symptoms and a tendency for local recurrence despite adequate surgical excision with or without adjuvant...

Objective: To evaluate whether placental protein-13 (PP-13) measured in the serum of pregnant women could predict abnormal invasive placentation (AIP) detected by color Doppler ultrasound (US) and magnetic resonance imaging scan in addition to the routine US scan during the third trimester. Materials and methods: The prospective case-control stu...

Objective: On May 13, 2020, the Italian government Pharmaceutical Agency (AIFA) stopped ulipristal acetate (UPA) treatments for uterine fibroids (UFs), so patients shifted to other natural treatments. The authors tested the patients' compliance with UF natural treatments. Methods: Thirty patients of reproductive age (30-45 years) affected by UFs...

Objectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective...

Authors evaluated the impact of laparoscopic intracapsular myomectomy (LIM) in women 40 years of age and over with desire of future fertility compared with medical management of symptomatic fibroids, by a prospective cohort study in University affiliated Hospitals. This study includes a cohort of women 40 years of age and older with symptomatic int...

Sexually transmitted diseases (STDs) among adolescents and young people represent a significant public health problem that generates a pressing requirement of effective evidence-based education to promote primary and secondary prevention. The objective of the study is to evaluate how knowledge, information needs, and risk perception about HIV and S...

Uterine fibroids (UFs) are the most common benign gynecological tumors. It was estimated that fifty percent of women presenting with UFs has symptomatology that negatively influences their quality of life. Pharmacological and/or surgical treatments are frequently required, depending on the woman’s desire to preserve fertility, with a high impact on...

Intrauterine adhesions (IUAs) caused by endometrial injury have a serious impact on women’s fertility and morbility and involves a wide range of patients. Although the first case of IUAs was published in 1984 by Heinrich Fritsch, a full description of Asherman syndrome was done by Joseph Asherman. IUAs lead to a lot of complications in women, as th...

Uterine myomas or fibroids are the most common benign female tumors of the reproductive organs, associated with significant morbidity and quality of life impairment. Several epidemiological risk factors for their occurrence have been identified so far, including nutrition and dietary habits. In this investigation, authors reviewed, as a narrative r...

Even if in as seen in many delivery a moderate degrees of asynclitism is present very often, asynclitism is a clinical condition that may create mechanical dystocia during both the first and second stage of labor. Its recognition is of paramount importance to help the clinician in the management of labor and in his/her decision of route of delivery...

For several years the use of ultrasound in labor has been widespread, showing this as an effective, accurate, and reproducible tool for the assessment of the fetal head position, station, and attitude. Literature affirmed that traditional transvaginal digital examination is highly inaccurate and subjective. However, transvaginal examination cannot...

Dystocia is the leading cause of caesarean section in nulliparas. In 1998, Gregory et al. reported that the main indication for performing a caesarean section is dystocia [1].

The occiput posterior position is reported to be the most common of all malpositions, and it may present as either straight (OP), left (LOP), or right (ROP). Diagnosis of OP position can be made at different times: during the third trimester, prior to the onset of labor, during the first stage of labor, while the fetus is transiting in the birth ca...

Myomas are the most common neoplasms of the female reproductive organs, causing significant health problems. Overall myoma incidence during pregnancy is expected to rise in the future, due to association of myoma formation and women’s age and global trend of delayed childbearing.

Uterine fibroids, myomas or leiomyomas, are the most common benign genital tumors, with high rate in general populations [1]. In women aged 19–82 years, almost 25% had fibroids, and 20–30% of reproductive age women show fibroids (Fig. 15.1), with a continuous incidence increasing in pregnancy and a first trimester of pregnancy prevalence in about 1...

Intrauterine adhesions (IUAs) can occur after mechanical or infectious injury to the endometrium. Normal endometrial repair occurs without scar formation; however, in some women, these normal repair mechanisms are aberrant, resulting in IUA formation. The exact alteration in repair mechanisms is not well understood; however, it likely involves hypo...

Background: Uterine fibroids (UFs) are the most common female benign tumors linked to significant morbidity. There are large literature data connecting UFs with infertility and adverse pregnancy outcome. In this research, authors reviewed literature on UFs, analyzing their relationship with infertility, influence of different therapeutic approaches...

Hemorrhagic corpus luteum (HCL) is an ovarian cyst formed after ovulation and caused by spontaneous bleeding into a corpus luteum (CL) cyst. When HCL rupture happens, a hemoperitoneum results. Clinical symptoms are mainly due to peritoneal irritation by the blood effusion. The differential diagnosis is extensive and standard management is not defin...

Uterine fibroids or leiomyomas are the most common benign female genital tumors, although this pathology can also manifest itself outside the uterus, as in the case we present, with a retroperitoneal development. In this article, authors showed a rare case of 81-year-old women, with a right pelvic mass and lower abdominal discomfort. Basing on a pr...

Objective Midregional pro-adrenomedullin (MR-proADM) and matrix metalloproteinase-2 (MMP-2) are such proteins, that decreased levels are demonstrated in defective placental functions, as preeclampsia. The aim of the study is to compare maternal serum MR-proADM and MMP-2 levels across pregnancies with intrauterine growth restriction (IUGR), small fo...

This retrospective cohort study focused on colposcopic accuracy for the diagnosis of cervical premalignant lesions using cytology and histology, as well as HPV data not included in current cervical screening practices in Kazakhstan. Colposcopy performance was assessed using the modified Reid index in women aged 18–63 years. In total, 1,129 colposco...

Scientists from multiple basic disciplines and an international group of physician-scientists from the field of obstetrics and gynecology presented recent studies and discussed new and evolving theories of uterine fibroid etiology, growth and development at The Basic Science of the Uterine Fibroids meeting, sponsored by the Campion Fund and the Nat...

Introduction The need for the presence of the pediatrician during cesarean section is often questioned, although he is a member of the obstetrical interdisciplinary team. The pediatrician has to be informed in advance about any expected obstetrical problems and about the indications for planned or emergency Cesarean Sections. No one can predict if...

Background: Cesarean myomectomy (CM) is, for many gynecologists, a discussed surgical procedure characterized by fibroid's removal during cesarean section (CS) followed by possible complications. For a long time, it has been common and shared thinking that myoma should not be surgically treated in pregnant women at the time of birth through CS in o...

Cited in @WHO report An awesome #Teamwork by 35 #scientists from 15 #countries #Australia #Austria #Brazil #Ecuador #Germany #Guatemala #Iran #Israel #Italy #Philippines #Poland #Portugal #Spain #Turkey & #USA #Openaccess article “COVID-19: Pandemic surgery guidance” has been cited in @WHO report https://bit.ly/3mtd6ri Check out interview ht...

High-risk Human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on h...

Based on high quality surgery and scientific data, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues circumstances related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, the authors used the B...

Based on high quality surgery and scientific data, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues circumstances related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, the authors used the B...

Abstract Despite the high quality of science and surgery, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, surgeons and scientists used...

Despite the high quality of science and surgery, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, surgeons and scientists used the Briti...

Premature ovarian failure (POF), which may be undetectable for a long time, is associated with impaired fertility. The mechanisms involved in the pathogenesis of POF as well as the concomitant treatments are still unclear. Although many data exist, mainly produced by the study of transgenic animal under various experimental conditions, they remain...

Study Objective To evaluate surgical outcomes of intracapsular single-layer myomectomy in terms of efficacy and safety as well as examine potential alterations based on kind of surgical approach. Methods A prospective observational study was performed between January 2010 and December 2018. Women in reproductive age, affected by intramural or subs...

Objective: This multi-center study aims to determine the efficiency and safety of endometrial myomectomy (EM) for the removal of uterine fibroids during cesarean section (CS). Methods: Retrospective review of 360 women diagnosed for fibroids during pregnancy. They all delivered by CS between 2014 and 2019. The study groups included 118 women who on...

HPV is still the most common sexually transmitted infection, leading to the onset of many disorders while causing an increase in direct and indirect health costs. High Risk (HR) HPV is the primary cause of invasive cervical cancer and contributes significantly to the development of anogenital and oropharyngeal cancers. The introduction of universal...

Following the FDA safety communication of 2014 increasing attention has been to the treatment of uterine fibroids, due to the suspicion of a potential leiomyosarcoma (ULM). FDA banned the use of power morcellation in US, since this technique is likely to spread malignant cells from an unsuspected ULM. We criticized the medical legal consequences of...

In recent years, the development of Assisted Reproductive Technique, the egg and embryo donation changed substantially the role of the uterus in recent years. It provided a higher chance for a pregnancy even in women over 45 years or post-menopause. In fact, the number of aged patients and in peri/post-menopause in pregnancy is nowadays increasing,...

Uterine UFs (UFs), or leiomyomas, represent the most frequent pelvic tumor in reproductive-aged women. Although of benign origin, UFs decrease fertility and cause significant reproductive dysfunctions. Compared to normal myometrium, UFs are characterized by a clinical and molecular heterogeneity as demonstrated by the presence of multiple genetic a...

Endometriosis is a gynecological disease characterized by the presence of endometrial glandular and stromal cells existing in the extra-uterine environment. Estimates show that endometriosis affects 10–15% of all women of reproductive age. Approximately, 25–50% of infertile women may be affected by endometriosis and 30–50% patients with endometrios...

Uterine fibroids affect almost one in two patients, causing many pelvic problems and requiring pharmacologic and surgical treatment. For many years, the importance of the fibroid was emphasized as uterine pathology, without focusing on the complex myometrial biology peripheral to fibroid. Moreover, the traditional surgical technique in fibroid remo...

This book provides a wealth of detailed hysteroscopic images, illustrating the various gynecological pathologies that can be directly diagnosed by hysteroscopy. Providing comprehensive coverage, the book examines each pathology on the basis of concrete images, offering readers support with the diagnostic evaluation. This is especially important wh...

Abstract: This article describes a Protocol for a study to determine a scope of Human Papillomavirus (HPV) infection and evaluate cervical cancer prevention measures in the western Kazakhstan. Introduction — ICO (Institut Catala d’Oncologia) working group in 2015 informed that cervical cancer in Kazakhstan ranked as the 1st most frequent cancer amo...

Minimally invasive techniques for myomectomy are based on the rationale of preserving the myometrial integrity, in order to spare muscular and fibro-neurovascular myometrial fibers and ensure complete and bloodless myoma removal. Post-operative myometrial vascularization is crucial in injured muscle regeneration. The post-surgical myometrial healin...

Peptides and neurotransmitters strongly influence the uterine physiology, contractility and healing, ripening, pain and complications during labor and delivery, starting and promoting changes in the lower uterine segment (LUS) during pregnancy and labor. Neuropeptides are signaling peptides produced by neural, endocrine and/or immune cells: all of...

Uterine myomas or fibroids represent the most common pathology in female genital tract. There are marked differences by race in both prevalence and incidence. Pathogenesis of fibroids is still unclear. Several risk factors have been identified, ranging from genetic predisposition to variable lifestyles, with recurrence in positive family history fo...

Purpose: Since every obstetric surgical procedure requires gaining informed consent from patient, we have set out to evaluate whether such requirement also applies to episiotomy. Material and methods: To that end, we have conducted a thorough search of relevant scientific literature on multidisciplinary databases (Scopus, PubMed, PubMed, Central, R...

Objective: to detect the HPV types distribution both in general female population and in women with first diagnosed cervical cancer, including viral load in both groups. Methods: Qualitative detection and quantification of HPV was performed by PCR-Real time method based on the Russian equipment and test systems (“DNA-Technology” LLC, Russia). The D...