Cesarean Scar Pregnancy Spectrum: A Proposed Standardized Classification and Terminology for the Reporting of Pregnancy Developing in Uterine Cesarean Scar.

This article contains the academic, but more importantly clinical debate of the terminology of pregnancies after cesarean deliveries, namely cesarean scar pregnancies as well as increasingly relevant social aspects determining their management. Its main purpose is to offer a solution to the controversy created by the debate about the terminology of pregnancies implanted in, or on the uterine scar left behind by a cesarean delivery. The 2 opposing terms creating the argument are: cesarean scar pregnancy and cesarean scar ectopic pregnancy.

Preeclampsia: Insights into pathophysiological mechanisms and preventive strategies.

Preeclampsia is a hypertensive disorder of pregnancy associated with significant maternal and fetal complications. Its pathogenesis involves endothelial dysfunction, abnormal placentation, and coagulation abnormalities, leading to increased thrombotic and hemorrhagic risks. This narrative review provides an in-depth overview of the pathophysiological mechanisms underlying preeclampsia, with a particular focus on its thrombotic and hemorrhagic complications.

The Role of Lifestyle Intervention in Female Fertility: A Modifiable Factor for Preconception Health.

Infertility is a growing global phenomenon affecting millions of individuals and is characterized by multifactorial causes, including both lifestyle and environmental factors. These include smoking, chronic exposure to environmental pollutants, stress, excessive caffeine or alcohol intake, drug use, improper eating habits and physical inactivity. The potential to modify these behaviors has gained increasing interest due to its impact on reproductive health and its role in mitigating infertility.

The incidence of Bandl's ring and its impact on labor outcomes: a review of the published literature.

Introduction: Obstructed labor is a serious obstetric emergency that can lead to uterine rupture, and significant maternal and perinatal morbidity and mortality. Bandl first described this condition, of abnormal retraction of the uterus occurring during obstructed labor, characterized by a constriction between the thinned lower uterine segment and the thick, retracted upper uterine portion. To determine the incidence and the maternal and perinatal outcome in pregnancies showing Bandl's ring by reviewing the published literature.

Corpus Callosum to Choroid Plexus Distance for the Prenatal Diagnosis of Partial Agenesis or Hypoplasia of the Corpus Callosum: A Multicenter Study.

Objectives: Prenatal diagnosis of partial agenesis (pACC) or hypoplasia of the corpus callosum (CC) is hindered by the lack of objective and reproducible ultrasound signs. The aim of this study was to report the role of a new ultrasound sign, the distance between the choroid plexus (CP) of the third ventricle and the distal part of the CC, in identifying fetuses with partial agenesis (pACC) or hypoplasia of CC.

Methods: Retrospective multicenter case-control study including fetuses with pACC or hypoplasia of the CC confirmed at post-natal imaging or autopsy.

A protocol for developing, disseminating, and implementing a core outcome set for caesarean scar ectopic pregnancy research: COSCAR.

Background: Caesarean scar ectopic pregnancy (CSEP) is the most common of type of uterine ectopic pregnancy and is associated with significant morbidity. Prompt diagnosis and treatment is therefore of paramount importance. Currently there is no universally agreed treatment option for CSEP supported by any national or international society.

Management of Myomectomy Scar Pregnancy: A Scoping Review.

: Ectopic pregnancy (EP) is defined as the implantation of an embryo outside the uterine cavity, which can lead to high morbidity and mortality if not diagnosed and treated promptly. A rare form of EP is myomectomy scar pregnancy (MSP), where the embryo implants in a scar from a prior myomectomy. Due to its rarity, MSP presents unique diagnostic and therapeutic challenges.

What is the role of intrauterine transfusion after single intrauterine death in monochorionic twin pregnancies? Evidence from a systematic review and meta-analysis.

Objective: To investigate the role of intrauterine transfusion (IUT) in affecting the outcome of the surviving twin showing sign of fetal anemia after a single intrauterine fetal death (IUFD) in monochorionic (MC) twin pregnancies.

Methods: PubMed, Medline and Embase databases were searched (2010-2024). The inclusion criteria were studies reporting the outcome of fetuses showing signs of fetal anemia, defined as the presence of the peak systolic velocity (PSV) of the middle cerebral artery (MCA) >1.

Recent Advances in Diagnosis and Management of Cesarean Scar Pregnancy.

Cesarean scar pregnancy (CSP) is among the most severe iatrogenic complications of cesarean delivery (CD) and is associated with a high risk of severe hemorrhage, uterine rupture, and progression towards placenta accreta spectrum disorders. Prenatal diagnosis of CSP has been recently standardized through a modified Delphi consensus, which also allows risk stratification according of this anomaly. However, several issues on the management of CSP are still under debate.

Enhanced Myometrial Vascularity, a Little-Known Complication of Pregnancy: Filling the Knowledge-Gap.

In the last decades, clinicians reported that patients, after failed or terminated intrauterine or cesarean scar pregnancies, demonstrated increased vascularization of the adjacent uterine muscle layers by ultrasound (US). These "earned" the incorrect diagnosis: uterine arterio-venous malformation (AVM). This misnomer was used without etiologic scrutiny by clinicians and repeated in scientific articles and textbooks.

The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience.

Purpose: The objective of this study is to evaluate the impact of pelvic floor physical therapy (PFPT) on symptoms and quality of life in women who experienced third- and fourth-degree perineal tears (Obstetric Anal Sphincter Injuries, OASIS) during childbirth. OASIS can lead to anal incontinence and dyspareunia, having important implications regarding the quality of life and health of women but, unfortunately, there is no standard practice for postpartum care following OASIS.

Methods: In this retrospective observational study, patients diagnosed with OASIS between January 2016 and June 2023 were enrolled.

Diagnosis and management of congenital Cytomegalovirus: Critical Appraisal of Clinical Practice Guidelines.

Objectives: To review the currently available Clinical Practice Guidelines regarding the diagnosis and management of Cytomegalovirus (CMV) infection in pregnancy.

Methods: Medline, Turning Research into Practice (TRIP), Web of Science databases and scientific societies' websites were searched electronically up to April 2024. We included national and international Clinical Practice Guidelines regarding diagnosis, treatment and follow-up of CMV infection in pregnancy, published in English language.

Effectiveness of the Triple P Procedure and its modifications on reducing the blood loss and peripartum hysterectomy rates in women with Placenta Accreta Spectrum (PAS): a review of published literature.

Background: Placenta Accreta Spectrum (PAS) disorders has been reported to be associated with a maternal mortality rate of 7-10%, worldwide, and many women who survive, experience life changing morbidity. Triple P procedure (- perioperative placental localization and incision on the myometrium above the upper border of the placenta; - pelvic devascularisation; and -placental non-separation and myometrial excision) was developed in 2010 as a novel conservative alternative to peripartum hysterectomy to avoid severe maternal morbidity and mortality). There have been several modifications to the original Triple P Procedure to achieve "pelvic devascularisation" based on locally available resources.

Counselling in Fetal Medicine: Uncomplicated Twin Pregnancies.

Twin pregnancies account for 3% of all pregnancies and they are burdened by higher morbidity and mortality compared to singletons. The role of ultrasound in the screening, diagnosis and management of possible complications of twin pregnancies has been widely investigated in the current literature. However, despite the progress that have been made in the last decades regarding treatment and evidence-based management of complications, twin pregnancies remain at higher risk of adverse outcomes, requiring therefore dedicated surveillance.

Counselling in Fetal Medicine: Complications of Monochorionic Diamniotic Twin Pregnancies.

Twin pregnancies are at increased risk of morbidity and mortality compared to singletons. Among all twins, monochorionic pregnancies are at higher risk of specific and non-specific complications compared to dichorionic pregnancies. Therefore, it is of great importance to properly counsel future parents with monochorionic pregnancies regarding the risks of adverse outcomes and the modalities of monitoring and intervention of the potential complications.

The Effect of Endometriosis on In Vitro Fertilization Outcomes: A Systematic Review and Meta-Analysis.

Objectives: The purpose of this study was to evaluate the impact of endometriosis on various outcomes of in vitro fertilization (IVF), including live birth rates, clinical pregnancy rates, fertilization rates, and implantation rates, through a systematic review and meta-analysis.

Methods: Systematic searches were carried out using PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, and Web of Science from January 2010 to November 2023. Studies comparing IVF outcomes in women with and without endometriosis were included.

Outcome Reporting in Studies Investigating Treatment for Caesarean Scar Ectopic Pregnancy: A Systematic Review.

Background: Caesarean scar ectopic pregnancy (CSEP) is associated with significant maternal and foetal morbidity. However, the optimal treatment remains unknown.

Objectives: The aim of this study was to review outcomes reported in studies on CSEP treatment and outcome reporting quality.

Telemedicine ultrasound assessment for placenta accreta spectrum: Utility and interobserver reliability of asynchronous remote imaging review.

Objective: Management of patients with placenta accreta spectrum (PAS) by trained multidisciplinary teams is associated with improved outcomes. Ultrasound can predict intraoperative risks, but expert ultrasound imaging of PAS is often limited. Telemedicine is used increasingly in obstetrics, permitting expert consultation when essential resources are not available locally.

Klippel-Trénaunay-Weber Syndrome: Prenatal Diagnosis and Review of the Literature.

Klippel-Trénaunay-Weber syndrome (KTW) is a rare congenital disease, representing a challenge in prenatal diagnosis due to overlapping characteristics with other syndromes and no specific genetic markers known to date. We have collected all the cases present in the literature on the prenatal diagnosis of KTW, emphasizing common ultrasound findings that can guide the clinician and genetics to the prenatal counseling. Thus, we collected all the information about the postnatal prognosis and the necessity for treatment.

Outcomes of twin pregnancies complicated by prelabor rupture of membranes before 26 weeks of gestation: systematic review and meta-analysis.

Objective: To investigate the rate of obstetric and perinatal outcomes of premature rupture of membranes (PROM) occurring before 26 weeks in twin pregnancies.

Data Source: Medline, Embase, Cinahl and Web of Science databases were searched electronically up to January 2024.

Study Eligibility Criteria: The selection criteria included both prospective and retrospective studies of twin pregnancies with PROM before 26 weeks of gestation.

Emergency delivery in pregnancies at high probability of placenta accreta spectrum on prenatal imaging: a systematic review and meta-analysis.

Background: Placenta accreta spectrum disorders are associated with a high risk of maternal morbidity, particularly when surgery is performed under emergency conditions. This study aimed to investigate the incidence of emergency cesarean delivery in patients with a high probability of placenta accreta spectrum disorders on prenatal imaging and to compare the maternal and neonatal outcomes between patients requiring emergency cesarean delivery and those not requiring emergency cesarean delivery.

Data Sources: MEDLINE, Embase, Cochrane, and ClinicalTrials.

Sonographic Cortical Development and Anomalies in the Fetus: A Systematic Review and Meta-Analysis.

The aim of this systematic review is to report the normal cortical development of different fetal cerebral fissures on ultrasound, describe associated anomalies in fetuses with cortical malformations, and evaluate the quality of published charts of cortical fissures. The inclusion criteria were studies reporting development, anomalies, and reference charts of fetal cortical structures on ultrasound. The outcomes observed were the timing of the appearance of different cortical fissures according to different gestational age windows, associated central nervous system (CNS) and extra-CNS anomalies detected at ultrasound in fetuses with cortical malformation, and rate of fetuses with isolated anomaly.