Universal Sars-Cov-2 Screening in Pregnant Women: Experience from the Italian Epidemic Outbreak.

BACKGROUND AND AIM: Sars-CoV-2 infection has rapidly spread worldwide following the first cases reported in China. Piacenza is one of the most affected cities in Italy. Many infections occurred in the hospital due to the high frequency of patients and healthcare professionals interaction. The aim of the work is to evaluate advantages of universal screening for Sars-Cov-2 in pregnant women admitted to a hospital setting and calculate frequency of infection in an obstetrical population.  Methods: all pregnant women attending Guglielmo da Saliceto Hospital in Piacenza from 22nd April to 18th June 2020 were screened for Sars-Cov-2 using a nasopharyngeal swab.  Results: 240 pregnant women were tested upon admission: all twelve (5%) testing positive were asymptomatic. None of the positive asymptomatic women developed COVID-19 symptoms or adverse perinatal outcomes. CONCLUSIONS: the diagnosis of asymptomatic pregnant women through universal screening provides the opportunity to protect mothers, babies and heath care workers. In accordance with other studies, our findings add to the growing body of evidence showing high rates of asymptomatic infection in the healthcare setting and highlight a critical need for universal screening of pregnant women.

Vulvar lichen sclerosus: A new regenerative approach through fat grafting.

OBJECTIVE. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. METHODS. Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. RESULTS. 34 out of 36 patients (94%) showed a better vulvar trophismof the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia major a and minor a, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p b 0001) and FSFI (p b 0001). CONCLUSIONS. Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life.

Ovarian recovery after laparoscopic enucleation of ovarian cysts: insights from echographic short-term postsurgical follow-up.

STUDY OBJECTIVE: To evaluate damage to ovarian reserve following laparoscopic cystectomy of benign ovarian cysts. DESIGN: Prospective study (Canadian Task Force classification II-3). SETTING: Tertiary gynecologic endoscopic unit at a university-affiliated hospital. PATIENTS: Thirty-one patients who underwent excision of monolateral (n=25) or bilateral (n=6) benign ovarian cysts. INTERVENTIONS: Serial transvaginal ultrasound examinations during the first and third postsurgical menstrual cycles. The following ovarian echographic variables were evaluated: antral follicle count, ovarian volume, stromal blood flow, and side of ovulation. Two types of statistical analysis were performed: a paired analysis comparing operated and intact ovaries of the same patient and a prospective analysis comparing ecographic characteristics of the operated gonad at first and second evaluation. MEASUREMENTS AND MAIN RESULTS: Antral follicle count and stromal blood flow were not significantly affected by surgery. While ovarian volume was similar in the operated and in the contralateral intact gonad at the first ultrasound evaluation, the volume of the operated ovary was significantly reduced at the second assessment. The median (interquartile range) of the percentage of this reduction was 33% (18%-81%). This progressive reduction was confirmed by prospectively analyzing the operated ovaries. An increased probability of ovulation in the intact gonad was observed at both assessments. CONCLUSION: Laparoscopic excision of ovarian cysts is associated with damage to ovarian reserve, at least immediately after surgery. This effect does not appear to be consequent to an injury to ovarian vascularization.