Eliana Fuggetta

Placental transfer of persistent organic pollutants: a preliminary study on mother-newborn pairs.

The aim of this study was to characterize the placental transfer of some environmental pollutants, and to explore the possibility of quantitatively predicting in utero exposure to these contaminants from concentrations assessed in maternal blood. Levels of toxic substances such as pesticides (p,p’-DDE, β-HCH, and HCB), polychlorinated biphenyls (PCBs), perfluorooctane sulfonate (PFOS), and perfluorooctanoic acid (PFOA) were determined in serum samples of 38 pregnant women living in Rome and in samples of cord blood from their respective newborns. The study was carried out in the years 2008–2009. PCB mean concentrations in maternal serum and cord serum ranged from 0.058 to 0.30, and from 0.018 to 0.064 ng/g·fw respectively. Arithmetic means of PFOS and PFOA concentrations in mothers and newborns were 3.2 and 1.4 ng/g·fw, and 2.9 and 1.6 ng/g·fw. A strong correlation was observed between concentrations in the maternal and the foetal compartment for PFOS (Spearman r = 0.74, p < 0.001), PFOA (Spearman r = 0.70, p < 0.001), PCB 153 (Spearman r = 0.60, p < 0.001), HCB (Spearman r = 0.68, p < 0.001), PCB 180 (Spearman r = 0.55, p = 0.0012), and p,p’-DDE (Spearman r = 0.53, p = 0.0099). A weak correlation (p < 0.1) was observed for PCBs 118 and 138.

Rupture of Ovarian Pregnancy in a Woman with Low Beta-hCG Levels

Background. Ovarian pregnancy is a rare form of ectopic pregnancy. It is often difficult to distinguish from tubal pregnancy, and diagnosis and management are frequently a challenge. Case. A 33-year-old nulligravida woman presented with light vaginal bleeding and bilateral lower quadrants abdominal pain. Beta-human chorionic gonadotropin (beta-hCG) level (592 mUI/mL) and clinical and ultrasound (US) findings were suspicious for tubal pregnancy. On the third day, despite beta-hCG decrease (364 mUI/mL), she complained of severe pain in the lower abdomen, and physical examination revealed abdominal rebound tenderness. US showed a large amount of fluid in the abdominal cavity. Because of the unstable clinical condition, emergency laparoscopy and resection of left ovarian ectopic pregnancy were performed. Histology confirmed ovarian gestation. Conclusion. This case shows that ectopic pregnancy rupture may occur despite low levels of beta-hCG. Hemoperitoneum is not contraindication to laparoscopy.

Sonohysterosalpingography: Comparison of foam and saline solution

To compare sonohysterosalpingography (sono‐HSG) with foam instillation (HyFoSy) versus saline solution (HyCoSy) in the evaluation of tubal patency.

Endometriosis: 10 keys points for MRI

Endometriosis is a chronic disease and a clinical problem in women of fertile age, with a high impact on quality of life, work productivity and health care management. Two imaging modalities are employed in the diagnosis and evaluation of extent of disease: ultrasound examination with endovaginal approach and magnetic resonance imaging (MRI). MRI, thanks to its high contrast and resolution characteristics, offers a high level of accuracy in the study of endometriosis and adenomyosis. We illustrate here 10 key MRI points for the detection and diagnosis of endometriosis.

Efficacy of long-term gonadotropin-releasing hormone analogue therapy to prevent recurrent catamenial penumothorax: a case report

Koon Chan Department of Obstetrics, St Mary’s Hospital, Hathersage Road, menses and was admitted to the same department where sh underwent chemical pleurodesis with 5 g of sterile talc a sclerosing agent. One year later, however, during menstruation she had othe episodes of pneumothorax. This condition severely affected he quality of life and working ability. A chest CT scan, performe immediately after a catamenial pneumothorax episode, reveale little apical subpleural air rime on the right side and a focal groun glass opacity of 24 mm with calcifications, suggestive of endome triosis, in the lateral segment of the right medium lobe, an absence of lymphadenopathy (Fig. 1). The diagnosis of catamenia y f ’. d d l g c n x t n f l y

Organochlorine pesticides exposure & preterm birth

occurs before 37 wk gestational age. In USA, the preterm delivery rate is 12-13 per cent; in Europe and other developed countries, reported rates are generally 5-9 per cent 1. PTB accounts for 75 per cent of perinatal mortality and it is the leading direct cause of prenatal and neonatal death, resulting in 3.1 million newborn deaths annually. Half of preterm infants have longterm morbidity such as severe childhood neurological disability2. Preterm birth is a major contributor of infant mortality in India and constitutes 31 per cent of neonatal deaths3.

Frequently misdiagnosed extrapelvic endometriosis lesions: case reports and review of the literature

Extrapelvic endometriosis is a rare condition defined as the presence of endometriotic stroma and glands outside the pelvis and elsewhere in the body. The cervix, vagina, vulva, intestinal tract, urinary tract, diaphragm, abdominal wall, inguinal canal, thoracic cage and lungs, extremities and even the central and peripheral nervous system can be involved. Because extrapelvic endometriosis is located in unusual sites, it is often confused with other pathologic conditions. This can lead to a difficult and challenging diagnosis and management. In the presence of recurrent, cyclical and catamenial symptoms, extragenital endometriotic lesions should be suspected. The aim of our paper is to report 9 cases of rare locations of extrapelvic endometriosis and to provide a literature review.