{"title":"Clinical features and their associations with umbilical cord gas abnormalities.","authors":"Allison Payne, Gianna Wilkie, Katherine Leung, Heidi Leftwich","doi":"10.23736/S2724-606X.24.05482-4","DOIUrl":"10.23736/S2724-606X.24.05482-4","url":null,"abstract":"<p><strong>Background: </strong>We seek to identify risk factors associated with abnormal umbilical artery cord gas (UACG).</p><p><strong>Methods: </strong>This was a secondary analysis of the multicenter Consortium for Safe Labor dataset. This study included singleton, term deliveries with UACG available. Abnormal UACG was defined as pH≤7.0 or base excess >12 mmol/L. Odds Ratios were calculated using a multivariable logistic regression to determine clinical factors associated with abnormal UACG.</p><p><strong>Results: </strong>18,589 patients met inclusion criteria, with approximately 2% having an abnormal UACG. Those with prior Cesarean delivery (OR=1.49, 95% CI: 1.15-1.93), maternal diabetes (OR=1.67, 95% CI: 1.06-2.64), magnesium sulfate use (OR=1.81, 95% CI: 1.25-2.60), current Cesarean delivery (OR=2.56, 95% CI: 2.06-3.19), pre-eclampsia/HELLP (hemolysis, elevate liver enzymes, low platelet count) syndrome (OR=2.80, 95% CI: 1.79-4.36), and placental abruption (OR=4.81, 95% CI: 3.35-6.91) had increased odds of having abnormal UACG at delivery compared to those without.</p><p><strong>Conclusions: </strong>Diabetes, pre-eclampsia, placental abruption, and a history of prior Cesarean delivery were all associated with abnormal UACG in this cohort of singleton, term deliveries. These findings indicate that patients with pre-existing risk factors may be at an increased likelihood of adverse neonatal outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"437-443"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giancarlo Paradisi, Laura Anelli, Francesco Barletta, Francesco A Battaglia, Michelangelo Boninfante, Marco Bonito, Roberto Brunelli, Franco Carboni, Brigida Carducci, Annafranca Cavaliere, Mario Ciampelli, Giulio DE Matteis, Davide DE Vita, Michele Desiato, Antonio DI Cioccio, Romolo DI Iorio, Sergio Ferrazzani, Alessandro Lena, Francesca Lippa, Patrizia Magliocchetti, Francesco Maneschi, Marina Marceca, Emanuela Marinoni, Roberto Marzilli, Valerio Napolitano, Giorgio Nicolanti, Mino Oliva, Pierluigi Palazzetti, Carlo Piscicelli, Antonio Ragusa, Pietro Saccucci, Giovanna Salerno, Giovanbattista Serra, Fabrizio Signore, Vincenzo Spina, Herbert Valensise, Rossana Orabona, Antonio Lanzone
{"title":"Iron deficiency anemia in pregnancy and the postpartum: a practical approach by the Italian GOAL Working Group.","authors":"Giancarlo Paradisi, Laura Anelli, Francesco Barletta, Francesco A Battaglia, Michelangelo Boninfante, Marco Bonito, Roberto Brunelli, Franco Carboni, Brigida Carducci, Annafranca Cavaliere, Mario Ciampelli, Giulio DE Matteis, Davide DE Vita, Michele Desiato, Antonio DI Cioccio, Romolo DI Iorio, Sergio Ferrazzani, Alessandro Lena, Francesca Lippa, Patrizia Magliocchetti, Francesco Maneschi, Marina Marceca, Emanuela Marinoni, Roberto Marzilli, Valerio Napolitano, Giorgio Nicolanti, Mino Oliva, Pierluigi Palazzetti, Carlo Piscicelli, Antonio Ragusa, Pietro Saccucci, Giovanna Salerno, Giovanbattista Serra, Fabrizio Signore, Vincenzo Spina, Herbert Valensise, Rossana Orabona, Antonio Lanzone","doi":"10.23736/S2724-606X.24.05438-1","DOIUrl":"10.23736/S2724-606X.24.05438-1","url":null,"abstract":"<p><strong>Background: </strong>Iron deficiency and iron deficiency anemia represent global health issues, particularly during pregnancy and the postpartum. The present paper aims to summarize the appropriate management of these conditions in order to try to improve how clinicians perceive, diagnose and treat iron deficiency and iron deficiency anemia.</p><p><strong>Methods: </strong>An expert panel of Italian obstetricians of Lazio region was convened to evaluate the available literature on iron deficiency and iron deficiency anemia during pregnancy and the post-partum in order to try to define a flow chart on the appropriate management of such conditions; aspects related to the patient blood management have also been investigated.</p><p><strong>Results: </strong>According to both hemoglobin level and ferritin values, five the flow charts on the appropriate management of iron deficiency and iron deficiency anemia have been drawn.</p><p><strong>Conclusions: </strong>It is desired to define appropriate flow charts to treat iron deficiency and iron deficiency anemia, which are too often not promptly diagnosed and managed, in order to try to improve antenatal care.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"76 5","pages":"470-477"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonio Ramírez-Osuna, Encarnación Carmona-Sánchez, Nicolás Mendoza, Peter Chedraui
{"title":"Current practices and perceptions of misoprostol use for cervical preparation prior to outpatient hysteroscopy: a nationwide survey among gynecologists in Spain.","authors":"Antonio Ramírez-Osuna, Encarnación Carmona-Sánchez, Nicolás Mendoza, Peter Chedraui","doi":"10.23736/S2724-606X.24.05521-0","DOIUrl":"10.23736/S2724-606X.24.05521-0","url":null,"abstract":"<p><strong>Background: </strong>Although misoprostol has been used as a potential option for cervical priming prior to hysteroscopy, the available scientific evidence regarding its use is not always conclusive. The purpose of this article is to assess the different practices and criteria applied for the use of misoprostol use for cervical preparation in outpatient hysteroscopy without anesthesia among gynecologists across Spain, exploring the need for the corresponding evidence-based guidelines.</p><p><strong>Methods: </strong>We carried out a cross-sectional study in which a two-step approach survey was conducted. Firstly, an online pilot survey was conducted with a limited sample of 10 professionals from 10 centers to identify initial patterns and gather feedback. Subsequently, a comprehensive online survey was carried out over a larger sample of respondents. The comprehensive survey covered aspects of misoprostol usage, including dosage, timing, indications, safety concerns, and overall perception. The survey design allowed for a thorough examination of existing practices and provided valuable insights to help address the disparities noted in misoprostol use for cervical preparation in outpatient hysteroscopies.</p><p><strong>Results: </strong>Through the comprehensive online survey, we received response of 102 gynecologists from 54 centers across Spain. The overall results show a considerable variation in misoprostol use prior to hysteroscopy, with 21.57% of respondents not using misoprostol in any case, while a substantial majority (78.43%) use it selectively (68.83%) or consistently (9.8%). When asked about the type of patients, the vast majority (72.55%) use it in postmenopausal nulliparous patients, while its was used considerably less in premenopausal nulliparous patients (35.29%), postmenopausal multiparous patients (22.55%), and premenopausal multiparous patients (3.92%), whereas some choose not to use it in any patients (26.47%). Furthermore, 89.22% of respondents felt that there is a lack of clear criteria on misoprostol use, while 79.41% believed that it is necessary to establish such criteria.</p><p><strong>Conclusions: </strong>There was a diverse landscape of misoprostol use which underscores the complexity and individual approach to cervical preparation for an outpatient hysteroscopy. Indeed, the findings regarding its application, notably more prevalent among postmenopausal patients, contravene the prevailing body of published evidence. Moreover, a considerable proportion of respondents expressed the need for clear criteria, which emphasizes the importance of evidence-based protocols to guide the optimal use of misoprostol.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"403-409"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Menichini, Katia Rossi, Eleonora Bonini, Maria L Deicco, Francesca Monari, Simona DI Mario, Alberto Berardi, Fabio Facchinetti, Isabella Neri
{"title":"A prospective cohort study evaluating exclusive breastfeeding in late preterm infants.","authors":"Daniela Menichini, Katia Rossi, Eleonora Bonini, Maria L Deicco, Francesca Monari, Simona DI Mario, Alberto Berardi, Fabio Facchinetti, Isabella Neri","doi":"10.23736/S2724-606X.23.05411-8","DOIUrl":"10.23736/S2724-606X.23.05411-8","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding can be challenging in neonates born between 34 <sup>0/7</sup> and 36 <sup>6/7</sup> weeks gestation (late preterm).</p><p><strong>Methods: </strong>This prospective cohort study aims to evaluate exclusive breastfeeding at discharge, at three and six months of life in late preterm infants, and to identify facilitators and challenges to it. We included late preterm neonates eligible for the rooming-in. Data about breastfeeding at discharge, at three and six months of life were collected.</p><p><strong>Results: </strong>Two hundred and fourteen late preterm infants were included in the study. At discharge 70 infants (32.7%) were fed with human milk and 144 (67.2%) were not. Non-exclusive breastfeeding was more common in women who were primiparous, had hypertension, and who underwent cesarean sections. Non-exclusive breastfeeding was associated with a low birthweight (<2500 g), ≥2 blood glucose controls, weight loss >10%, and longer hospital stay. Early first latch-on and skin-to-skin contact were more frequently associated with exclusive human milk feeding (P<0.001). Late preterm neonates born at 35 weeks showed a significant increase in exclusive human milk feeding at 3 months compared to the rate at discharge (P=0.004).</p><p><strong>Conclusions: </strong>In this cohort, early first latch-on and immediate skin-to-skin contact resulted associated with exclusive human milk feeding. Despite formula-fed during hospitalization, infants born at ≥35 weeks gestation who were exclusively breastfed at follow-up increased.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"423-430"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138445434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Time to kiss goodbye the prolonged bladder catheterization after prolapse surgery.","authors":"Tala Kordiš, Ana Kofol, Mija Blaganje","doi":"10.23736/S2724-606X.23.05459-3","DOIUrl":"10.23736/S2724-606X.23.05459-3","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"478-479"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The association between decision and incision time by race and ethnicity.","authors":"Rodney Bruno, Gianna Wilkie, Julianne Lauring","doi":"10.23736/S2724-606X.24.05456-3","DOIUrl":"10.23736/S2724-606X.24.05456-3","url":null,"abstract":"<p><strong>Background: </strong>Identifying and reducing inequities in the delivery of care is crucial to improving health disparities in obstetric outcomes. This study sought to evaluate the effect of race and ethnicity on time from decision for cesarean delivery to incision following implementation of a case classification system.</p><p><strong>Methods: </strong>A retrospective cohort study was performed to identify women who had cesarean deliveries from October 1, 2020, to March 31, 2021, at a single, tertiary care institution. Medical records were reviewed for demographics and cesarean delivery case classification. Case classification was divided into STAT cesarean delivery (within 10 minutes), level A (within 30 minutes), level B (within 60 minutes), or scheduled/unscheduled other. The \"decision to incision time\" was determined from the time the case surgical order was placed to the case start time.</p><p><strong>Results: </strong>There were 565 eligible individuals who had a cesarean delivery during the study period, with 13.6% identifying as Black/African American, 29.0% as Hispanic/Latina, and 57.3% as White. Hispanic women were more likely to need interpreter services than other race/ethnicity groups. There was no statistically significant difference in \"decision to incision time\" by race/ethnicity. Within the total cohort, 51.8% of cesarean delivery cases went within the goal time according to case classification, which also did not differ by race/ethnicity.</p><p><strong>Conclusions: </strong>Race and ethnicity do not impact cesarean delivery \"decision to incision time\" or case classification. Only half of cesarean deliveries went within the goal time, so further evaluation to improve workflow and improve this metric for all patients is needed.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"431-436"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Capozzi, Giovanni Scambia, Roberto Sorge, Stefano Lello
{"title":"Trabecular bone score and bone frailty: an Italian observational retrospective study.","authors":"Anna Capozzi, Giovanni Scambia, Roberto Sorge, Stefano Lello","doi":"10.23736/S2724-606X.24.05502-7","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05502-7","url":null,"abstract":"<p><strong>Background: </strong>The primary purpose of this study was to verify if trabecular bone score (TBS) might fit with the changes of bone mineral density (BMD) confirming as a reliable marker of bone fragility.</p><p><strong>Methods: </strong>A retrospective observational study on 898 Italian women (aged 40-90 years) was conducted between January 2021 and February 2023. All recruited women were divided into two main groups according to TBS (Group A: TBS ≥1.31; Group B: TBS<1.31) and, further, in five subgroups according to age.</p><p><strong>Results: </strong>According to univariate ANOVA, there was not significant difference of BMI between group A and group B but Bonferroni Test found that BMI significantly differed for age subgroups and TBS value (P<0.05). ANOVA analysis reported that mean L1-L4 BMD and/or T-score were significantly different for age and TBS (P=0.000); Bonferroni Test found that L1-L4 BMD significantly differed in the comparison of age subgroups for Group A and Group B (P<0.05). Besides, Bonferroni analysis found significant differences regarding total and neck femoral BMD and/or T-score in the comparison between age subgroups for group A and group B (P<0.05). As for neck femoral BMD and T-score, all significances were observed for group B in the comparison between subgroups aged over 60 years and others (P<0.05). Multivariate logistic regression analysis showed that age and femoral neck BMD significantly contribute to TBS (P<0.05).</p><p><strong>Conclusions: </strong>Our results seem to suggest that low level of TBS may detect patients that could be more prone to bone frailty consistently with age and BMD at both vertebral and cortical level. However, its role in clinical practice should be refined.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultra-radical surgery for advanced ovarian cancer: a retrospective cohort study in a tertiary referral cancer center in the UK.","authors":"Konstantinos Palaiologos, Zoi Nikoloudaki, Tolu Adedipe, Marina Flynn, Susanne Booth, Pavlos Lykoudis, Theodoros Giannopoulos","doi":"10.23736/S2724-606X.22.05179-X","DOIUrl":"10.23736/S2724-606X.22.05179-X","url":null,"abstract":"<p><strong>Background: </strong>Ovarian cancer is the leading cause of death from gynecological cancer in the UK. The standard of care is a combination of surgery and chemotherapy. The aim of the treatment is the resection of all macroscopic disease. In selected cases of advanced ovarian cancer this is achieved with ultra-radical surgery. However, NICE encourages further research due to low quality evidence on the safety and efficacy of this extensive surgery. The aim of this study was to examine the morbidity and survival rates of ultra-radical surgery for advanced ovarian cancer performed in our unit and compare our findings with the current literature.</p><p><strong>Methods: </strong>This is a retrospective study of 39 patients diagnosed with stage IIIA-IV ovarian and primary peritoneal cancer who underwent surgery in our unit between 2012 and 2020. The main outcome measures were the perioperative complications, the disease-free survival, the overall survival rate and the recurrence rate.</p><p><strong>Results: </strong>The study enrolled 39 patients with stages IIIA-IV who were treated in our unit between 2012 and 2020. 21 patients were at stage III (53.8%) whereas 18 (46.1%) at stage IV. 14 patients underwent primary and 25 secondary debulking surgery. Major and minor complications occurred 17.9% and 56.4% of the patients, respectively. Complete cytoreduction following surgery was achieved in 24 cases (61.5%). The mean and the median survival time were 4.8 years and 5 years, respectively. The mean disease-free survival time was 2.9 years while median disease-free survival time was 2 years. Age (P=0.028) and complete cytoreduction (p=0.048) were found to be significantly associated with survival. Primary debulking surgery was significantly associated with lower probability of recurrence (P=0.049).</p><p><strong>Conclusions: </strong>Although the number of patients is relatively small, our study indicates that ultra-radical surgery in centers with high expertise may result in excellent survival rates with an acceptable rate of major complications. All patients in our cohort were operated by an accredited gynecological oncologist and a hepatobiliary general surgeon with a special interest in ovarian cancer. A few cases required input from a colorectal and a thoracic surgeon. We believe that the careful selection of the patients that can benefit from ultra-radical surgery and our model of joint surgery can explain our excellent results. Further research is essential to establish that ultra- radical surgery has an acceptable rate of morbidity for patients with advanced ovarian cancer.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"319-326"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9294495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michail Kalinderis, Kallirhoe Kalinderi, Apostolos Athanasiadis, Ioannis Kalogiannidis
{"title":"Εlectrosurgery: understanding of basic principles, safe practices and applications in gynecologic surgery.","authors":"Michail Kalinderis, Kallirhoe Kalinderi, Apostolos Athanasiadis, Ioannis Kalogiannidis","doi":"10.23736/S2724-606X.23.05308-3","DOIUrl":"10.23736/S2724-606X.23.05308-3","url":null,"abstract":"<p><p>Electrosurgery is a continuously evolving field that has nowadays become a necessity in operating theatres. The expanding use of electrosurgery has been associated with a high number of thermal injuries, thus the fundamental understanding of how each of the energy devices work and their effect on biological tissues is very important and continuing education regarding electrosurgical technology is paramount for avoiding patient complications. This review describes the basic principles and modalities of electrosurgery, their biological effects on tissues and variables that can affect them, the evolution in the field of electrosurgery, its wide use in gynecological procedures, as well as the risk and complications that are commonly seen in electrosurgery.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"376-385"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisa Montaguti, Diego Raimondo, Alessandro Arena, Josefina Diglio, Benedetta Orsini, Gaetana DI Donna, Paolo Casadio, Renato Seracchioli, Gianluigi Pilu
{"title":"Comparison between vaginal and laparoscopic cerclage in women with mid-trimester pregnancy loss or history of spontaneous preterm delivery.","authors":"Elisa Montaguti, Diego Raimondo, Alessandro Arena, Josefina Diglio, Benedetta Orsini, Gaetana DI Donna, Paolo Casadio, Renato Seracchioli, Gianluigi Pilu","doi":"10.23736/S2724-606X.23.05250-8","DOIUrl":"10.23736/S2724-606X.23.05250-8","url":null,"abstract":"<p><strong>Background: </strong>Women with unfavorable obstetric history can benefit from prophylactic cerclage (\"history indicated\") which can be performed vaginally or transabdominally with laparoscopic techniques. The aim of our study is to evaluate the effectiveness in the prevention of preterm birth of the vaginal technique and of the minimally invasive laparoscopic technique in women with an unfavorable obstetric history.</p><p><strong>Methods: </strong>This was a retrospective cohort study examining elective cerclages performed in women with adverse obstetrics history. The primary outcome was rate of early preterm and second trimester deliveries while other outcomes analyzed were surgical complications, the time needed for cerclage procedures, live birth rate, gestational age at delivery, birth weight, Apgar score.</p><p><strong>Results: </strong>Data from 64 women were analyzed; among them, 14 underwent a laparoscopic procedure (22%) while 50 a vaginal cerclage (78%). The two groups were homogeneous in terms of demographic characteristics, but of course differed significantly in terms of obstetrics history, as well as for the surgical indications of cerclage procedures. The rate of early preterm deliveries and second trimester miscarriage were the same in the vaginal and laparoscopic group (8%), comparable to what was reported in literature. The operative time was longer in the laparoscopic group, but with similar duration of the hospital stay. We reported no intraoperative complications in both groups.</p><p><strong>Conclusions: </strong>As the laparoscopic procedure, usually reserved for women with a previous failed vaginal cerclage, has been proved to be equally safe and effective, it may could be proposed to a wider group of women. Prospective randomized studies are needed to provide new and conclusive data about this topic.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"361-369"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}