Luca Maranghi
Sapienza University of Rome
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European Journal of Obstetrics & Gynecology and Reproductive Biology | 1999
Juan Piazze; Maurizio M. Anceschi; Luca Maranghi; V Brancato; Emanuela Marchiani; Ermelando V. Cosmi
OBJECTIVE To study fetal lung maturity (FLM) as determined by amniotic fluid (AF) tests in diabetic pregnancies (DP) under euglycemic metabolic control, in comparison with matched controls (C). PATIENTS AND METHODS From 514 consecutive pregnancies where amniocentesis was performed for FLM assessment, we selected 45 glycemic controlled DP. Nineteen DP were Type I (IDDM) and 26 pregnancies were diagnosed Type III (GDM). Cases were matched to C by therapy with corticosteroids, gestational age at amniocentesis, pregnancy complications other than diabetes and gender. FLM was determined by the shake test and lamellar bodies (LB) count, lecithin/sphingomyelin (L/S) ratio (planimetric and stechiometric) and phosphatidylglycerol presence (PG). DP were further sub-divided according to gestational age period at amniocentesis, type of diabetes, associated therapy and fetal malformations. RESULTS RDS (n=2) and neonatal wet lung (n=5) were diagnosed in neonates from diabetic mothers. We found no statistical difference when comparing FLM indices between DP and C groups: shake test 3.1:1+/-1.2 vs. 2.7:1+/-1.2, P<0.40; planimetric L/S 3.4+/-1.4 vs. 3.1+/-2.0, P<0.27; stechiometric L/S 8.2+/-7.4 vs. 7.1+/-6.1, P<0.54; percentage of PG positivity 57% vs. 46%, P<0.13; lamellar bodies count (X10(3)/microl) 42.8+/-36.9 vs. 41.5+/-30.4, P<0.72. No differences were found between DP and controls for subgroups according to gestational age, type of Diabetes (IDDM or GDM), congenital lesions and associated therapy. CONCLUSIONS In euglycemic, metabolically controlled diabetic patients FLM is not delayed, however an increased risk for neonatal wet lung should be considered.
Journal of Perinatal Medicine | 2006
Juan Piazze; Stefano Gioia; Luca Maranghi; Maurizio M. Anceschi
Sir, We investigated the alterations in platelets, granulocytes, and RBC characteristics in cases affected by hypertension in pregnancy, in order to evaluate the severity of the disease. Pregnancy induced hypertension is defined as blood pressure )140/90 mmHg for the first time during pregnancy, without proteinuria. Preeclampsia (PE) is a complication of pregnancy affecting about 10% of primiparous women during the second half of pregnancy, is characterized by increased blood pressure and proteinuria, and is often associated with intrauterine growth restriction (IUGR). Changes in platelets and red blood cells (RBC) number and volume have been reported in hypertension during pregnancy w2x. Most studies have shown changes in platelet numbers, platelet survival, and mean platelet volume, which have been interpreted as evidence of increased platelet consumption w3, 4x, whereas other groups have related mean RBC volume to maternal blood pressure. The deleterious consequence of increasing blood pressure, is partially compensated by a concomitant decrease in RBC volume, thus attempting to counteract the viscous effects of a larger relative RBC mass with smaller cell size characteristics. Platelet count falls early in hypertension and precedes renal changes, proposing an active role of platelet consumption in the pathophysiology of this disorder. In the early stages of PE, platelet aggregation is increased, and in established severe disease it is decreased. This study was carried out prospectively in our Institute from January 2001 to May 2005. Sixty-one pregnant women were included in the study, with the diagnosis of
Journal of Maternal-fetal & Neonatal Medicine | 2004
Giovanni Nigro; E Sali; Maurizio M. Anceschi; Manuela Mazzocco; Luca Maranghi; A Clerico; Ma Castello
We report on an infant with multi-system disease including liver fibrosis, right microphthalmia with cataract, interstitial pneumonitis, and hyperechoic lesions in the basal ganglia and in the periventricular and thalamic regions. Prenatal ascites with hepatomegaly concomitantly with detection of cytomegalovirus (CMV) DNA in the amniotic fluid, following recurrent maternal CMV infection, had been shown. Although CMV culture and DNA detection were negative in the urine, the infant was given foscarnet because CMV infection was demonstrated in the liver by DNA detection and immunohistochemical staining. Favorable clinical outcome and absence of CMV in the liver were subsequently shown. Our case suggests that congenital CMV disease following maternal recurrence may not be associated with disseminated infection but only with intracellular infection. The diagnosis should therefore be based on CMV detection in the involved organs. Moreover, this is the first report on the possible efficacy and safety of foscarnet for therapy of immunocompetent infants with congenital CMV disease.
The Journal of Maternal-fetal Medicine | 2001
Juan Piazze; Maurizio M. Anceschi; A. Ruozzi Berretta; S. Vitali; Luca Maranghi; F. Amici; Ermelando V. Cosmi
Objective: To study the combination of computerized cardiotocography (cCTG) and the amniotic fluid index (AFI) in the prediction of neonatal acidemia at birth. Methods: A total of 89 singleton third-trimester high-risk pregnancies delivered by Cesarean section, with an AFI evaluated within 24 h from birth, and an antepartum cCTG performed within 6 h from delivery, were studied. The score was the sum of values for AFI (oligo/anhydramnios = 1, normal = 0) and cCTG (Dawes-Redman criteria, not met = 1, met = 0). The endpoint was to predict an abnormal neonatal outcome as defined by an umbilical artery pH of h 7.2. Results: Fifteen neonates had an umbilical artery pH of < 7.2. The combination of cCTG + AFI score was able to predict pH values ( h 7.20) with an OR = 2.83 ( p < 0.02). The diagnostic accuracy of the combination of cCTG + AFI was as follows: sensitivity 80%, specificity 58%, positive predictive value 28%, negative predictive value 83%. Comment: We suggest that the cCTG + AFI score may be of value in the prediction of neonatal acidemia and help in the management of third-trimester high-risk pregnancies.
International Journal of Gynecology & Obstetrics | 2002
Maurizio M. Anceschi; Juan Piazze; Luca Maranghi; A. Ruozi-Berretta; Ermelando V. Cosmi
An association between hypertension and increased serum levels of uric acid in pregnancy has long been known 1 , and a correlation between uric acid levels and neonatal morbidity has also been established 2,3 . We conducted this study to evaluate the association between maternal serum levels of uric acid, decreased fetal blood flow, and fetal acidemia in pregnancy-induced hypertension Ž . PIH . Eighty-four pregnant women, 39 with a diagnosis of PIH and 45 normotensive, who were evaluated for uric acid level also had Doppler velocimetry and computerized cardiotocography Ž . cCTG investigations. Cases and controls were all delivered by elective cesarean section. UmbiliŽ . cal artery UA pH was assessed at birth and neonatal acidemia was defined as a pH value of 7.15 and or a pCO value of 60 mmHg. 2
Journal of Perinatal Medicine | 2005
Juan Piazze; Luca Maranghi; Albana Cerekja; Paolo Meloni; Stefano Gioia; Luisa Fumian; Ermelando V. Cosmi; Maurizio M. Anceschi
Prenatal Diagnosis | 2002
Giovanni Nigro; Renato Torre; Eleonora Sali; Maura Auteri; Manuela Mazzocco; Luca Maranghi; Erich Cosmi
Journal of Perinatal Medicine | 2003
Maurizio M. Anceschi; Juan Piazze; Angelo Ruozi-Berretta; Erich Cosmi; Albana Cerekja; Luca Maranghi; Ermelando V. Cosmi
Obstetrics & Gynecology | 1998
Juan Piazze; Luca Maranghi; Giovanni Nigro; Giuseppe Rizzo; Ermelando V. Cosmi; Maurizio M. Anceschi
Journal of Maternal-fetal & Neonatal Medicine | 2004
Ermelando V. Cosmi; Giulio Bevilacqua; Luca Maranghi; Maurizio M. Anceschi