COVID-19 and pregnancy: clinical outcomes and scientific evidence about vaccination.

Pregnant women and their infants are at high risk to develop a severe COVID-19, with increased rates of hospitalisation to intensive care units, need for mechanical ventilation and mortality. Preterm birth, fetal vascular malperfusion, and premature rupture of membrane have been the most reported adverse pregnancy outcomes and these effects have been especially associated with the onset of the disease at early gestational age. The early expression of ACE2 and TMPRSS2 in human embryos has been proven, determining an increased susceptibility to SARS-CoV-2. Preterm infants born to women infected by SARS-CoV-2 have a higher risk of need for specialist neonatal care with prolonged hospitalization. Moreover, inflammation of developing embryos could cause long-term defects, regardless of vertical transmission of SARS-CoV-2. Due to Maternal Immune Activation (MIA), in utero inflammation is associated with neurodevelopmental, cognitive and psychiatric disorders in affected offspring. Despite risks that COVID-19 could induce in pregnancy, there are not many published data describing the safety and/or efficacy of COVID-19 vaccines in pregnant women, commonly not included in vaccine research. The evidence from the few pregnant women unintentionally enrolled in clinical trials and vaccinated suggests that COVID-19 vaccines, both based on mRNA and viral vectors, do not pose significant risks to the fetus or breastfeeding infants. Moreover, human studies using mRNA-based vaccines against Zika virus, influenza, and rabies have reported good safety and immunogenicity during pregnancy. In this review, we evaluate the role of COVID-19 in adverse pregnancy and neonatal outcomes and the need to vaccinate pregnant women.

[Cytomegalovirus transmission following a blood transfusion]. / Trasmissione di citomegalovirus in seguito ad emotrasfusione.

In order to assess the incidence of anti-CMV antibodies in blood donors and the possible transmission of infection in blood transfusions, 900 donors, 60 patients serum negative or positive patients given serum positive blood and 5 immature serum negative patients given serum negative blood were examined. At 67.11% the incidence of anti-CMV antibodies in the donors was in line with reports in the literature. It was also noted that reinfection arose when serum positive blood was given (36.36% of the serum negative patients and 10.52% of the serum positive ones developed anti-CMV antibodies indicating infection or reinfection; none of the 5 immature patients revealed anti-CMV antibodies). It is concluded that the routine search for anti-CMV antibodies is impracticable given the high incidence of serum-positive donors and that the technique should be reserved for particular cases: the young, the pregnant, transplant patients, immunodepressed subjects. However the best way to prevent the transmission of disease remains the avoidance of unnecessary transfusions.

[Use of monoclonal antibodies in the immunohematological diagnosis]. / L'impiego degli anticorpi monoclonali nella diagnostica immunoematologica.

A review of the data in the literature suggests that monoclonal antibodies will become the standard reagents given their high specificity and constant quality. It is hypothesised that their primary use will be in immunopharmacology or immunoradiotherapy.

[The use of anti-A, anti-B and anti-AB monoclonal antibodies in a blood transfusion center. Preliminary results]. / Utilizzazione di anticorpi monoclonali anti-A, anti-B e anti-AB nel centro trasfusionale. Risultati preliminari.

The properties of the anti-A, anti-B and anti-AB monoclonal antibodies were investigated by comparing these with 3 polyclonal antibodies with particular emphasis on specificity, titre and take-up. The results obtained suggest that monoclonal antibodies are highly specific and possess a similar titre but a superior take-up capacity to the polyclonal antibodies. It is concluded that they will be extremely valuable in immunohaematology laboratories.

[Necrotizing enteritis due to hypersensitivity reaction (similar to Arthus phenomenon)]. / Enterite necrotizzante da reazione di ipersensibilità (Arthus simile).

Necrotizing enteritis is a clinico-pathological entity, marked by segmentary necrosis of jejunum and ileum, variously extended, and is a rather rare picture, the etiopathogenesis of which is prevailingly supported by troubles in the intestinal circulation or by intestinal locations of reactions of hypersensitivity (Arthus-similar allergic reaction). The authors start from a case they had the opportunity to observe and successfully surgically treated, and discuss its etiopathogenetic and therapeutical implications in the light of an up-to-date reviewing of the literature thereabout.

[Indications and technic for autotransfusion in surgery]. / Indicazioni e tecnica dell'autotransfusione in chirurgia.

The authors, after considering the advantages of autotransfusion, report their experience about 14 election patients operated on, and emphasize the usefulness of the usefulness of the method, designed to remove the iatrogenous pathology involved in the transfusions of homologous blood.

[Aneurysm of the superficial femoral artery]. / Aneurisma dell'arteria femorale superficiale.

The authors start from a case of aneurysm of the superficial femoral artery, they had the opportunity to observe, and discuss the etiopathogenetic, diagnostic and clinical problems involved in this disease. Then, they dwell upon the main therapeutical solutions suggested, and declare inclined to endoaneurysmography with interposition of autologous or heterologous grafting.

[Intentional normovolemic hemodilution (preliminary results)]. / L'emodiluizione normovolemica intenzionale (risultati preliminari).

The authors, after illustrating the advantages of hemodilution from the rheological, hemodynamic and district microcirculatory standpoint, illustrate their experience about 11 patients treated with such method. They point out the advantages this method can bring in both reducing the iatrogenous pathology involved in the hemodilution and reducing the difficulties faced by blood-banks and the costs burdening on the medical services.

[Use of mannitol and propranolol in the treatment of experimental acute renal failure (histomorphological study)]. / L'impiego del mannitolo e del prophanololo nel trattamento dell'insufficienza renale acuta sperimental e (studio istomorfologico).

Experimental research was carried out in order to ascertain whether administration of drugs capable of acting on the renal circulation, such as mannitol and propanol, in addition to improving the renal function, also have a protective effect on the histomorphological alterations induced by the acute renal ischemia. On the basis of the results of the research the Authors conclude by asserting that the combined use of mannitol and propanol has a real protective effect in preventing or attenuating lesions of the kidney caused by serious acute renal failure.