Federico Prefumo

Effect of fetal gender on first‐trimester ductus venosus blood flow

Recent reports have suggested that nuchal translucency (NT) measurements in the first trimester may be influenced by fetal gender. Since both NT and central venous blood flow are considered to be related to fetal cardiac function, we investigated gender‐related differences in first‐trimester ductus venosus Doppler indices.

Analysis of p53 and c-erbB-2 expression in ovarian endometrioid carcinomas arising in endometriosis

We assessed the immunohistochemical expression of p53 and c-erbB-2 oncoproteins in 13 ovarian endometrioid adenocarcinomas arising from endometriosis (group 1) and compared the findings with 15 otherwise similar cases without associated endometriosis (group 2). Tumors in group 1 showed a higher expression of both p53 and c-erbB-2 (p=0.015 and p=0.048, respectively). The expression of the two proteins was also significantly associated in group 1 (p=0.013) but not in group 2 (p=0.63) tumors. The different pattern of expression of p53 and c-erbB-2 in the two groups suggests that different molecular pathways may be involved in their pathogenesis.

Prenatal diagnosis of Meckel-Gruber syndrome in a pregnancy obtained with ICSI.

The association of occipital encephalocele, cleft palate, postaxial polydactyly, polycystic kidneys, and hepatic cysts is well known as Meckel–Gruber syndrome (MGS). Nowadays, the diagnosis of MGS is usually performed prenatally by ultrasound findings. MGS was previously described following in vitro fertilization. We report a case of MGS diagnosed at 17 weeks in a pregnancy obtained with intra-cytoplasmic sperm injection (ICSI).

Placental morphology in pregnancies associated with pregravid obesity.

Abstract Objective: Pre-gravid obesity is associated with increased morbidity and mortality for both mother and offspring. We aimed to investigate the changes in placental structure and to characterize the placental inflammatory status in obese women. Methods: Placentas from 10 women with pregravid body mass index ≥ 30 kg/m2 were analyzed histopathologically and compared with those from 10 normal weight women. The effect of pregravid obesity on placental structure was investigated by examining placental maturity, angiogenesis, inflammatory response, and vascular abnormalities. Hematoxylin and eosin stain, immunohistochemical analysis, and morphometric analysis were performed. Results: Immaturity of the villous tree was demonstrated more often in the pregravid obesity group (p = 0.005). The villous tree was mainly represented by villi of larger diameter (p = 0.001) and lower number (p = 0.023) compared with controls. By contrast, the number of capillaries per villus was increased in the obese group (p = 0.001), while the global number of capillaries per surface unit did not differ in the studied groups (p = 1). There was no difference between the pre-gravid obese group and controls in inflammatory status and vascular pathology. Conclusions: Pregravid obesity is associated with focal immaturity of the villous tree and angiogenetic abnormalities of the placenta.

The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study

Objective: The objective of this study was to longitudinally evaluate maternal echocardiographic findings in uncomplicated twin gestations according to chorionicity. Methods: Healthy women with twin pregnancy were assessed with transthoracic echocardiography across the first, second, and third trimesters. Cardiac findings were compared within each group and between monochorionic (MC) and dichorionic (DC) pregnancies. Results: Overall, 19 MC and 48 DC uncomplicated twin pregnancies were included. In the MC group, no significant maternal haemodynamic changes were documented across gestation, with the exception of a decrease in ejection fraction. Compared to DC pregnancies, in the MC set lower cardiac output (second and third trimester, p = 0.001 and p = 0.006, respectively) and higher total vascular resistance (first trimester, p = 0.032) were observed. Regarding the diastolic function in MC twins, significantly higher values were observed for mitral E/A ratio (third trimester, p = 0.014), septal mitral E1/A1 ratio (third trimester, p = 0.030), lateral mitral E1 (second and third trimester, p = 0.014 and p = 0.029, respectively), and E1/A1 ratio (third trimester, p = 0.006). Conclusions: Maternal cardiac adaptation in twin pregnancy seems to differ significantly according to chorionicity. In particular, in MC pregnancies the impairment of diastolic function is less pronounced, presumably due to the lower circulating volume.

Stepwise sequential screening for trisomy 21 in assisted reproduction pregnancies

We offered a modified stepwise sequential integrated screening for Down syndrome to 72 singleton and 16 twin pregnancies obtained with assisted reproductive techniques, observing no cases of trisomy 21 and obtaining a false positive rate of 10% in singleton and 7% in twin pregnancies. In our population, this approach for regulating access to invasive karyotyping can avoid a substantial number of unnecessary procedures, comparing favourably with current practice even in spontaneous pregnancies.