Analysis of the Influence of Lunar Cycle on the Frequency of Spontaneous Deliveries: A Single-centre Retrospective Study.

BACKGROUND: Man, since ancient times, has been convinced of, and has researched scientific evidence that the barometric and gravitational forces play an important role in structural and biological variation of the planets, influencing the various forms of life. In particular, the synergistic relationships between variations in atmospheric pressure and gravitational forces on human gestation period have been the subject of rigorous observations and statistical calculations, which have not led to a universal conclusion in literature. OBJECTIVES: The aim of our work was to check whether there is a higher incidence of spontaneous deliveries, during the periods of full Moon than during the other phases of the Moon. METHODS: We performed a retrospective analysis of 327 non-induced vaginal deliveries in a year, divided by month. We subsequently analyzed the incidence of these deliveries during periods of full Moon Vs other lunar phases. RESULTS: We evidenced a statistically significant difference between the annual total spontaneous deliveries happened in full Moon periods Vs all other Moon phases (T= 2,3948; p=0,0256). However, we reported a discordant trend of deliveries in full Moon period, depending on each considered month. CONCLUSION: Since these differences were found both in increase and decrease, it is unacceptable the assumption of a linear correlation between periods of full Moon and increased frequency of spontaneous deliveries. For this reason, our data allow us to conclude that there is no need to increase the number of doctors and midwives in obstetric units during these periods.

Heterotopic pregnancy: case report.

Heterotopic pregnancy is the simultaneus development of an intrauterine pregnancy and ectopic pregnancy. It is a potentially fatal condition and rarely occurrs in natural conception cycles. A high incidence of heterotopic pregnancy is reported in pregnancies following an assisted reproduction technique (ART) with embryo transfer in utero. We report the case of heterotopic pregnancy via ART in a 42-year-old primigravida. She presented with pelvic pain and intraabdominal fluid collection. She was treated with laparoscopic surgery. At present the intrauterine pregnancy is in normal evolution.

Laparoscopic management of adnexal masses in postmenopause.

The study included 64 postmenopausal women with adnexal masses. The selection criteria included menopausal status, an ultrasound scan indicating a benign mass and serum levels of CA-125 below the cutoff (35 U/ml). The results of the study confirm that the removal of a cystic mass in postmenopausal patients with laparoscopic surgery is a more valid and acceptable alternative to traditional surgery.

Ovarian endometriotic cyst in a patient with Ellis-van Creveld's syndrome: case report.

Ellis-van Creveld (EvC) syndrome, or chondroectodermal dysplasia, is a rare genetic disorder associated with chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital cardiac malformations. The disorder is due to an autosomal-recessive mutation mapped to chromosome 4p16. It may occur with different phenotypes. The case of an ovarian endometriotic cyst in a patient suffering from EvC syndrome is reported.

Management of the second phase of labour: perineum protection techniques.

The obstetric experience alongside scientific evidences in literature indicate several management techniques during the expulsive period of labour to minimize obstetric complications. Among the various methods that can be used for the protection of the perineum during the expulsive phase, some are performed prepartum (perineum massage), while most are used during childbirth. Among the second group, progressively increasing importance is assumed by the manual techniques to protect the perineum (using the "hands-on" and "hands-off") and by episiotomy. These techniques, when used in accordance to the guidelines, may favour the reduction of adverse outcomes for both the mother and the newborn, both immediately after birth and after a longer time. The midwife should be aware of the evidences in literature so that a critical analysis of the available techniques can be made and put in action during the expulsive phase in order to protect the mother and the foetus from any unfavourable outcomes. Currently, clinical evidence in literature is directing obstetric and medical staff towards a careful analysis of the maternal-foetal parameters, in order to achieve a precise assessment of the risks factors of intrapartum and postpartum outcomes. Increasingly, there is the need for close collaboration between the midwife and medical staff to ensure proper personalized assistance based on the peculiar characteristics of the woman and the fetus.

Endocrine changes in postmenopausal women after high-dose danazol therapy.

BACKGROUND: Purpose of the study was to investigate changes in the hormonal pattern in postmenopausal women after high dose danazol therapy. In 16 postmenopausal women (mean age 66.4 +/- 8.6) treated with danazol 1.2 g/die x21 we studied serum levels, before and after therapy, of FSH, LH, E2, fE2, T, fT, D4-A, DHEAS, SHBG. METHODS: FSH, LH, SHBG by IRMA kits (DPC); E2, T, DHEAS, D4-A by RIA kits (Sorin Biomedica) after celite microcolumn chromatography; fT by coat-A-count kit (DPC); fE2 by equilibrium dialysis; serum albumin by bromocresol-green colorimetric methods. RESULTS: After therapy there was a statistically significant decrease of LH by 13%, of FSH by 19%, SHBG by 84% and increase of fE2 by 24.5%, fT by 77%. Other hormones show changes that are not statistically significant. CONCLUSIONS: In postmenopausal women danozol therapy, even if at a higher dose, has about same effect on hormonal pattern as in normally cycling women. Danazol showed a clear antigonadotropic effect and can play a role in therapy when reduction of gonadotrophins and E2 secretion is desirable.

Clinical trial comparing the activity and efficacy of ibuprofen isobutanolammonium vs Benzydamine hydrochloride, applied as vaginal irrigations, in patients with vaginitis.

This study was conducted on 30 female patients (average age: 40.5 +/- 11 years, age range 19-65), affected by vulval and/or vaginal phlogosis with a prevalence of uterine fibromyomatosis and metrorrhagia of a varied nature. Sixteen patients were affected with vulvitis and 14 with vulvovaginitis. Fifteen patients were assigned to the treatment with Ibuprofen isobutanolammonium and 15 to the treatment with Benzydamine hydrochloride. Both the subjective symptoms (burning and itching) and the objective symptoms (erythema, oedema, exudation) showed a marked reduction as early as the third day of treatment and the comparison between the score at the start of treatment and on day three of the treatment was highly significant in both study groups (p < 0.01). This improvement was, however, more marked in the group of patients treated with ibuprofen isobutanolammonium, where a more rapid reduction of both the subjective and objective symptoms was observed on the third day. This trend, although not as marked as on the third day, was confirmed at the end of the study, on the seventh day.

Fetal echocardiography: a comparison of different techniques.

There is great availability on the market of echocardiographic instruments that have innovative technological systems which use second harmonic imaging. The true usefulness and applicability of these instruments in fetal echocardiography have yet to be verified. The objective of the present study was to verify the impact of this echographic technology in the diagnostic evaluation of the fetal cardiovascular system. Thus, an Acuson Sequoia echograph which uses native tissue harmonic imaging (NTHI) was used to examine 30 pregnant women between the 28th and 32nd week of gestation. The b-mode and m-mode images were acquired and recorded by the conventional method and by the second harmonic imaging method without contrast medium. Two experts in the field analyzed and compared the images recorded by the two methods and made diagnostic and qualitative judgements. The 30 cases examined were unanimously determined to have no visible echo pathologies. The morpho-biometric evaluation obtained by the two methods did not show any significant differences and the quality of the images obtained by the traditional method was found on average to be higher. In conclusion we believe that the use of second harmonic imaging for studies of the fetal heart does not seem to offer any advantages with respect to the conventional method.

Cryopreservation of oocytes after vitrification.

Recently the majority of studies and research in the field of physiopathology of reproduction have been oriented towards cryopreservation of female eggs. This could resolve the ethical problems connected with the preservation of the embryo and with the gestation of the surplus oocytes collected after cycles of ovarian hyperstimulation. Notwithstanding that extraordinary results have been obtained in the field of cryopreservation of embryos and spermatozoa, the freezing of oocytes involves unfortunately many difficulties in relation, above all, to deep morphostructural and functional modifications which take place due to the low temperatures and to the toxic action of cryoprotective agents. The aim of this work was to test and then verify whether an efficient method of preserving the female egg cells by freezing in order to be able to subsequently use them for in vitro fertilization. The conclusions of this study, even if not highly encouraging, have allowed us to better evaluate the damage caused by low temperatures and at the same time should stimulate us and other researchers in this field to find new methods which will allow us to reach higher aspirations.

Voluminous ovarian cystoma in term pregnancy: case report.

Treatment of a large voluminous serous cystoadenofibroma during a cesarean section is described. The relative frequency of such pathology in pregnancy and the importance of early diagnosis are discussed.

Benefits of antibiotic prophylaxis in laparoscopic gynaecological surgery.

The prevention of infectious complications by antibiotic prophylaxis has made traditional or laparoscopic surgery much safer but at the same time has contributed to an uncontrolled and often irrational use of every kind of antibiotic. In this study we wanted to show that often mini-invasive surgery like laparoscopy can be practised without the use of antibiotics. Thus, postoperatively several patients undergoing laparoscopic, diagnostic and operative interventions were followed-up. The results showed that subjects without antibiotic therapy did not have any symptomatology that could be ascribed to bacterial infections. In conclusion this study has demonstrated that laparoscopic surgery, especially without any complications, should follow the elementary rules of surgical techniques and surgical asepsis and that antibiotic prophylaxis is not always necessary.

Early induction of labor with PGE2-intravaginal gel in premature rupture of membranes.

Results of induction of labor with PGE2-intravaginal gel in PROM, were evaluated considering the best management.