L. Rosignoli
University of Siena
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Publication
Featured researches published by L. Rosignoli.
American Journal of Obstetrics and Gynecology | 1994
G. Centini; L. Rosignoli; Filiberto Maria Severi
A cervical pregnancy diagnosed by transvaginal ultrasonography and successfully treated by aspiration and curettage is disucssed.
The Cleft Palate-Craniofacial Journal | 2009
Gabriele Tonni; G. Centini; Pieraldo Inaudi; L. Rosignoli; Chiara Ginanneschi; Claudio De Felice
A prenatal ultrasound diagnosis of epignathus in a dichorionic-diamniotic twin pregnancy is reported. A complex mass protruding from the fetal face was seen at week 19. Amniocentesis resulted in a 46,XX fetus with elevated alpha-fetoprotein (α-FP). An increase in tumor size and severe polyhydramnios ensued. Selective feticide performed at 22 weeks led to untreatable uterine contractions with iatrogenic abortion and early neonatal mortality of the healthy cotwin. Without development of polyhydramnios and tumor growth, weekly scan and transvaginal cervical assessment would have been carried out and cesarean section planned at around 32 weeks. Necroscopy and histology aided the ultrasound-based prenatal diagnosis.
Journal of Clinical Ultrasound | 2009
Gabriele Tonni; Gabriele Centini; L. Rosignoli; Cindy Argento; G. Centini
The aim of this study was to assess the effectiveness of 4D sonography (US) to guide amniocentesis when compared with standard 2D US, and to evaluate the impact this new method may have on needle placement, the number of needle insertions performed, and duration of the procedure.
Taiwanese Journal of Obstetrics & Gynecology | 2015
Gabriele Tonni; Enrico Periti; L. Rosignoli
OBJECTIVE To describe the value of hysteroscopic fetoscopy (virtuopsy) at the time of uterine suction in a case of early diagnosis of congenital anomalies in parents refusing conventional full autopsy examination. CASE REPORT First trimester ultrasound diagnosis of proboscis, median cleft lip and palate and limb deformities. Chorionic villus sampling demonstrated normal karyotype. Parents refused medical induction of termination of pregnancy with subsequent conventional autopsy. At this stage, hysteroscopic fetoscopy was consented and carried out under local anesthesia prior to uterine evacuation. CONCLUSION Hysteroscopic fetoscopy (virtuopsy) proved to be a valuable complementary diagnostic investigation and enhanced the parental bonding process concerning the fetal phenotype. Notwithstanding, the woman declared an acceptable compliance during the procedure. In selected cases, virtuopsy may be a valid option in confirming early prenatal ultrasound diagnosis in parents refusing conventional autopsy or when full postmortem examination may not be clinically indicated or warranted.
Journal of Diagnostic Medical Sonography | 2009
Gabriele Tonni; Alessandro Ventura; G. Centini; L. Rosignoli
Cleft lip and cleft palate are among the more common congenital abnormalities, representing the fourth most common birth defect in the United States, with an incidence of 1 in 700 live births. The study of fetal secondary palate has reached new potential due to new 3D applications— namely, tomographic sonography imaging and volume contrast imaging (VCI). The aim of this review is to describe the 3D sonographic setting for a systematic study of the fetal secondary palate during second-trimester pregnancy. Sonographers can easily achieve appropriate training in 3D scanning of the fetal face under expert tutoring. The sonographic study of the fetal secondary palate should become an integral part of the second-trimester scan. Technically, the axial and coronal sections are those that better display the 3D reconstruction, especially when the fetus is facing the transducer (profile section). The use of static VCI may enhance tomographic sonography imaging of the fetal secondary palate and should therefore be integrated in this target examination.
Journal of Maternal-fetal & Neonatal Medicine | 2016
Gabriele Tonni; L. Rosignoli; Ettore Cariati; Wellington P. Martins; A. H. Miyague; Rafael Frederico Bruns; Edward Araujo Júnior
Abstract Objective: To assess the visualization rate and transverse diameter of fetal thymus by two-dimensional ultrasound (2DUS) as well as the fetal thymus volume by three-dimensional ultrasound (3DUS) during the 2nd trimester echocardiography. Methods: A prospective cross-sectional study involving 100 normal fetuses between 18w0d and 23w6d was performed. The identification of fetal thymus and peri-thymic vessels was realized at level of three vessels and trachea (3VT). The transverse diameter was obtained placing a line cursor perpendicular to the line connecting the sternum and the spine. The fetal thymus volume was obtained by virtual organ computer-aided analysis (VOCAL) with 30° of rotation. We used the percentage of visualization rate of 2D structures and means and 95% confidence intervals (CI) for fetal thymus transverse diameter and volume. Results: The visualization rate of fetal thymus by 2DUS was of 100% in all gestational ages using the 3VT view. Addition of color Doppler ultrasound facilitates identification of the thy-box and enhanced the calculation of both fetal thymus transverse diameter and volume. The mean fetal thymus transverse diameter by 2DUS ranged from 11 mm at 18 weeks to 19 mm at 23 weeks of gestation. The mean fetal thymus volume by 3DUS ranged from 1.25 cm3 at 18 weeks to 2.61 cm3 at 23 weeks of gestation. Conclusion: We demonstrated a high visualization rate of fetal thymus and peri-thymic vessels by 2DUS during the 2nd trimester echocardiography. The measurements of transverse diameter by 2DUS and the volume by 3DUS also showed a high success rate.
Journal of Clinical Ultrasound | 2013
Gabriele Tonni; Mario Lituania; L. Rosignoli
The prenatal detection in the second trimester of pregnancy of a fetus with craniosynostosis, wide metopic suture, and wormian bone associated with bowing of the long bones, unilateral short femur, and focal fibula deficiency is reported. These ultrasonographic findings when not supported by a diagnostic molecular biology result represent a prenatal dilemma in term of both parents counseling and management of potential overlapping skeletal diseases.
Ultrasound in Obstetrics & Gynecology | 2007
A. Kenanidis; G. Centini; L. Rosignoli; R. Scarinci; Mariangela Longini; Serafina Perrone; Felice Petraglia; Giuseppe Buonocore
included sensitivities, false-positive rates and receiver–operating characteristic (ROC) curves. Results: Of 576 pregnancies studied from 1995 to 2006, 145 (25.2%) were affected. At 12–13 weeks’ gestation, fetal cardiomegaly predicted the affected pregnancies significantly better than placentomegaly (area under ROC curve, 0.949 vs. 0.687, P < 0.05). The sensitivity for prediction of the affected pregnancies was 90.6% for fetal cardiomegaly (CTR ≥ 0.5), 69.8% for placentomegaly (PT > 18 mm) and 65.1% for combined testing. The corresponding false-positive rate was 6.8%, 50.3% and 2.8% respectively. At 14–15 weeks’ gestation, the sensitivity for prediction of affected pregnancies was 93.8% for fetal cardiomegaly, 93.8% for placentomegaly and 87.5% for combined testing. The corresponding false-positive rate was 16.7%, 76.9% and 17.7% respectively. MCAPSV was not predictive in early second trimester. However, at 18–19 weeks’ gestation, MCAPSV (at a cut-off 1.5 multiples of the median) predicted affected pregnancies significantly better than fetal cardiomegaly (area under ROC curve, 0.959 vs. 0.788, P < 0.05). The sensitivity for the prediction of affected pregnancies was 100.0% for fetal cardiomegaly and 57.1% for high MCAPSV while the corresponding false-positive rate was 46.2% and 0% respectively. Conclusions: The best ultrasonographic predictor of affected pregnancies at 12–13 weeks’ and 18–19 weeks’ gestation was fetal CTR and MCAPSV respectively.
Ultrasound in Obstetrics & Gynecology | 2004
G. Centini; A. Kenanidis; L. Rosignoli; R. Scarinci; Mariangela Longini; Barbara Marzocchi; Donatella Tanganelli; Piero Vezzosi; Serafina Perrone; Giuseppe Buonocore; Felice Petraglia
notch and clinical risk factors were present in 41.9% and 11% of women respectively. There were statistically significant differences between Doppler indices from pregnancies with or without subsequent PE or associated complications: mean PI 1.75 vs 2.04 (P = 0.002, t-Student test) and mean RI 0.75 vs 0.79 (P = 0.000, t-Student test). A multivariate logistic regression produced a two parameter model (including the mean PI and the presence of clinical risk factors) with the best sensitivity (46.27%) and specificity (80.99%) for the prediction of PE and its associated complications. Conclusion: There are differences in uterine Doppler blood flow indices at 11–14 weeks in pregnancies with or without subsequent PE and /or associated complications. The combination of mean PI with the presence of clinical risk factors at this gestational age show the best sensitivity and specificity for the prediction of PE and its associated complications in our population.
Ultrasound in Obstetrics & Gynecology | 2004
G. Centini; L. Rosignoli; Elisa Faldini; G. Tonni; D. Azzoni; G. B. LaSala
Objective: Postnatal intracranial hemorrhage (ICH) is a rather common finding in preterm delivered neonates. However, prenatal diagnosis of ICH is rarely described in literature. We report on a series of cases that have been diagnosed during a 10 year period. Material and Methods: The archive of our ultrasound unit was searched for all cases of prenatally suspected ICH. Postnatal follow up from neonatology and pediatric registries was available for all cases. Results: During the study period, 8 fetuses were suspected to have ICH. All cases were confirmed by postnatal sonography and/or by magnetic resonance imaging (MRI). In 6 cases antenatal MRI confirmed the sonographic findings. Median (range) gestational age at diagnosis and delivery were 26.4 (28.3–36.5) and 34.6 (33.2–40.1) weeks, respectively. All cases were delivered by cesarean section. Prenatal sonographic findings included asymmetric ventriculomegaly with midline shift (n = 2), hyperechogenic parenchymal or intraventricular lesions (n = 4), and periventricular cystic lesions (n = 1). All cases were classified as severe ICH (Grade III in 5 cases, and grade 4 in 3 cases) as suggested in postnatal studies. Six cases were complicated by an aquaeduct stenosis requiring ventriculo-peritoneal shunting. Neurological deficits were found in all cases at follow up. Conclusions: All cases have been identified and accurately classified by antenatal ultrasound. However, antenatal MRI was often necessary for a conclusive diagnosis. In our cases with high grade ICH the outcome was invariably poor.