Intravenous Ferric Carboxymaltose for the Treatment of Iron Deficiency Anemia During Pregnancy: Effects on Maternal and Fetal Wellbeing-A Multicenter Retrospective Observational Study.

: To assess the impact of intravenous ferric carboxymaltose (FCM) on fetal and maternal adverse effects in pregnant women diagnosed with iron deficiency anemia (IDA). : This is a multicenter retrospective study on 472 pregnant women diagnosed with moderate to severe IDA undergoing treatment with FCM between 2019 and 2025 at Careggi University Hospital (Florence) and Vittore Buzzi Children Hospital (Milan). Fetal wellbeing was assessed using computerized cardiotocography (cCTG) or ultrasound, based on gestational age at treatment.

Standardising Simulation-Based Obstetric Emergency Training: A Delphi Consensus Study.

Objective: To develop standardised Objective Structured Assessment of Technical Skills (OSATS) forms for major obstetric emergencies, thereby improving the quality and consistency of obstetric simulation training.

Design And Setting: A panel of national experts with extensive experience in teaching Gynaecology and Obstetrics, simulation training, and the clinical management of labour complications and peripartum emergencies.

Population And Methods: A Delphi process with four iterative rounds was conducted to create, evaluate, revise, and finalise OSATS checklists for 11 obstetric emergencies.

Perinatal Outcomes in Pregnancies Immediately following Stillbirth: A Multicenter, Prospective, Observational Study.

This study aimed to evaluate the outcomes of pregnancies immediately following stillbirth in relation to treatments prescribed.A prospective, observational study was conducted in patients with a history of stillbirth (≥22 weeks) between 2014 and 2022 across four Italian University Hospitals. Outcomes were stratified based on the cause of previous fetal death (classified according to ReCoDe classification) and treatment (low dose aspirin [LDA], low molecular weight heparin [LMWH], both, progesterone, or other drugs).

Optimizing Pregnancy Outcomes: The Role of Gynecologists in Preconceptional Care in Italy.

The preconceptional period is crucial for women and couples who desire children as it influences the progress and outcomes of a healthy pregnancy. Preconceptional care is now an accepted paradigm by most healthcare professionals. However, its implementation in healthcare programs is still in the early stages.

[Management of arrhythmias during pregnancy: a literature review in light of the Heart Rhythm Society consensus document].

Maternal mortality represents a crucial indicator of the quality of care, as stated by the World Health Organization. Non-obstetric mortality in Italy is equally derived from cardiovascular and hypertensive problems with an upward trend. The increased incidence of cardiovascular risk factors, the rise in maternal age, and the use of assisted reproduction suggest a growing impact of arrhythmias on maternal morbidity and mortality.

[Twin pregnancy in a young woman with Fontan circulation].

We report the case of a young woman with Fontan circulation who successfully completed a twin pregnancy. The key role of a multidisciplinary Pregnancy Heart Team for preconception counseling and pregnancy management is emphasized.

The Italian Perinatal Surveillance System SPItOSS: insights from Confidential Enquiries.

Background: An effective strategy to reduce perinatal mortality requires an active surveillance system. This includes monitoring cases, organizing multidisciplinary local audits, conducting Confidential Enquiries, identifying avoidable factors, and facilitating changes in the healthcare system. In 2017, the Italian Obstetric Surveillance System launched the SPItOSS pilot Perinatal Surveillance System.

P-glycoprotein expression is decreased in placenta accreta and placenta previa disorders.

Background: P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) are multidrug resistance (MDR) transporters that function as placental gatekeepers, lowering the fetal levels of diverse xenobiotics and toxins that may be circulating in the maternal blood throughout pregnancy. Placenta accreta spectrum (PAS) and the placenta previa (PP) disorders are obstetric pathologies encompassed by an abnormal invasion of chorionic villous tissue in the uterine wall or at the endocervical os, respectively. Given the fact that MDR transporters are involved in placentation and are highly responsive to inflammation, we hypothesized that immunostaining of P-gp and BCRP would be altered in PAS and in PP specimens.

The placenta in fetal death: molecular evidence of dysregulation of inflammatory, proliferative, and fetal protective pathways.

Background: It is estimated that over 2 million cases of fetal death occur worldwide every year, but, despite the high incidence, several basic and clinical characteristics of this disorder are still unclear. Placenta is suggested to play a central role in fetal death. Placenta produces hormones, cytokines and growth factors that modulate functions of the placental-maternal unit.

Stillbirths: results of a pilot population-based surveillance system in Italy (SPItOSS).

Objectives: to describe the results of a pilot population-based perinatal mortality surveillance system, with regards to stillbirths; to study maternal, obstetric, and foetal characteristics, evaluating risk factors and understanding causes.

Design: a cross-sectional study was conducted on incident cases of stillbirths collected by the surveillance system from July 2017 to June 2019 in three Italian Regions (Lombardy, Tuscany, and Sicily).

Setting And Participants: data on stillbirths, resulting from the in-hospital multidisciplinary audits, organised using the Significant Event Audit methodology, were analysed.

The "Preeclampsia and Hypertension Target Treatment" study: a multicenter prospective study to evaluate the effectiveness of the antihypertensive therapy based on maternal hemodynamic findings.

Background: Despite major advances in the pharmacologic treatment of hypertension in the nonpregnant population, treatments for hypertension in pregnancy have remained largely unchanged over the years. There is recent evidence that a more adequate control of maternal blood pressure is achieved when the first given antihypertensive drug is able to correct the underlying hemodynamic disorder of the mother besides normalizing the blood pressure values.

Objective: This study aimed to compare the blood pressure control in women receiving an appropriate or inappropriate antihypertensive therapy following the baseline hemodynamic findings.

Left ventricular remodeling in twin pregnancy, noninvasively assessed using hemodynamic forces and pressure-volume relation analysis: prospective, cohort study.

This study was designed to prospectively investigate the pattern of intraventricular hemodynamic forces (HDFs) associated with left ventricular (LV) function and remodeling in women with uncomplicated twin pregnancy. Transthoracic echocardiography was performed on 35 women (aged 35.9 ± 4.

Early Fetal Growth Restriction with or Without Hypertensive Disorders: a Clinical Overview.

Early onset fetal growth restriction (FGR) is one of the main adverse pregnancy conditions, often associated with poor neonatal outcomes. Frequently, early onset FGR is associated with early onset hypertensive disorders of pregnancy (HDP), and in particular preeclampsia (PE). However, to date, it is still an open question whether pregnancies complicated by early FGR plus HDP (FGR-HDP) and those complicated by early onset FGR without HDP (normotensive-FGR (n-FGR)) show different prenatal and postnatal outcomes and, consequently, should benefit from different management and long-term follow-up.

Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid.

Meconium-stained amniotic fluid (MSAF) is considered an alarming sign of possible fetal compromise and it has recently been reported that neonatal outcome correlates with the degree of meconium thickness. We retrospectively studied 400 term infants allocated in clear amniotic fluid and grade 1, 2, and 3 MSAF groups on the basis of color and thickness of AF. Multivariable logistic regression analysis was performed to evaluate the potential independent effect of delivery with MSAF of different severity on the risk of a composite adverse neonatal outcome.

Non-invasive Maternal Hemodynamic Assessment to Classify High-Risk Pregnancies Complicated by Fetal Growth Restriction.

Objectives: To verify whether the use of the temporal criterion of 32 weeks' gestation is effective in identifying maternal hemodynamic differences between early- and late-onset fetal growth restriction (FGR), and to test the statistical performance of a classificatory algorithm for FGR.

Materials And Methods: A prospective multicenter study conducted at three centers over 17 months. Singleton pregnant women with a diagnosis of FGR based on the international Delphi survey consensus at ≥ 20 weeks of gestation were included.

A study on the placenta in stillbirth: an evaluation of molecular alterations through next generation sequencing.

Introduction: Placental dysfunction is one of the most common causes of Intrauterine Fetal Demise (IUFD). Due to its characteristics, the placenta may be the target of molecular research aimed to investigate potential causes of IUFD. In the literature, there are no studies on human placentas that have investigated possible associations between somatic mutations and the occurrence of IUFD.

Placenta accreta spectrum: experience of conservative surgery during cesarean section and clinical and radiological management during pregnancy and follow-up.

Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion including placenta accreta, increta and percreta and is a major cause of maternal morbidity and mortality. Recently, a conservative surgical technique has been proposed as a valid alternative to peri-partum hysterectomy to reduce the short- and long-term risks for the mothers and to preserve fertility. Magnetic resonance imaging (MRI) seems to be useful first of all at the time of diagnosis and furthermore to investigate the course of conservative management of PAS.

Depression, anxiety, self-efficacy, and self-esteem in high-risk pregnancy.

Background: The aim of the study was to evaluate the levels of depression, state and trait anxiety, self-efficacy, and self-esteem among women with high-risk pregnancy due to previous adverse pregnancy outcomes (PAPOs) or prepregnancy diseases (PPD), before and after delivery, compared to controls.

Methods: An observational longitudinal study on psychological dimensions was conducted on 86 women attending a university referral center for high-risk pregnancy, by administering the Edinburgh Postnatal Depression Scale, the State and Trait Anxiety Inventory, the General Self-Efficacy Scale, and the Self-esteem Scale. A pretest (in the third trimester of pregnancy) and a follow-up measurement session (one month after the delivery) were applied.

Can the First Fasting Plasma Glucose Test in Pregnancy Predict Subsequent Gestational Complications?

Objective: To determine the best cut-off level of pregnant women's first fasting plasma glucose (FFPG) test results for the prediction of subsequent onset of gestational diabetes mellitus (GDM) and to examine the association between FFPG and maternal and neonatal outcomes in a large Caucasian population.

Methods: 1437 medical records of women with singleton pregnancies followed up between 2015 and 2018 were retrospectively analyzed. Data on FFPG tested in the first trimester and 75 g oral glucose tolerance test (OGTT) findings performed according to IADPSG criteria and Italian guidelines were collected and evaluated.

Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol.

Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area.

Difference in cardiac remodeling between female athletes and pregnant women: a case control study.

Objectives: The aim of this study was to detect possible differences in reversible cardiac remodeling occurring in sport training and twin pregnancy.

Background: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar.