Italian Journal of Gynaecology & Obstetrics

𝗟𝗮𝗿𝗴𝗲 𝗮𝗯𝗱𝗼𝗺𝗶𝗻𝗮𝗹 𝗺𝗮𝘀𝘀𝗲𝘀 is rarely seen in clinical practice and #imaging is readily accessible. 𝗔𝗻𝗱𝗿𝗲𝗮 𝗚𝗼𝗻𝘇á𝗹𝗲𝘇 𝗗𝗲 𝗚𝗼𝗱𝗼𝘀, 𝗙𝗿𝗮𝗻𝗰𝗶𝘀𝗰𝗼 𝗝𝗮𝘃𝗶𝗲𝗿 𝗧𝗲𝗷𝗲𝗿𝗼 𝗣𝗶𝗻𝘁𝗼𝗿, 𝗘𝗻𝗿𝗶𝗾𝘂𝗲 𝗔𝘀𝗲𝗻𝘀𝗶𝗼 𝗗𝗶𝗮𝘇 and David Pacheco Sánchez presented a #video clinical case of giant ovarian serous #cystadenoma resected by #laparoscopy preserving the right #ovarian parenchyma in a 25-year-old woman who faced an in­crease in abdominal circumference for a year. A CT scan revealed large hypodense mass measuring 30 × 20 × 10 cm.

Uterine rupture during #pregnancy is an uncommon and severe complication, often leading to significant #risks for the mother and the baby. The occurrence of a silent, spontaneous uterine rupture 𝘄𝗶𝘁𝗵𝗼𝘂𝘁 𝗰𝗮𝘂𝘀𝗶𝗻𝗴 𝗵𝗮𝗿𝗺 to the mother or the newborn 𝗶𝘀 𝗲𝘅𝘁𝗿𝗲𝗺𝗲𝗹𝘆 𝗿𝗮𝗿𝗲. Felice Sorrentino, Lorenzo Vasciaveo, Francesca Greco, Maria Grazia Morena, Guglielmo Stabile, Francesco De Seta, Stefano Restaino, Antonio Simone Laganà and Luigi Nappi reported a case of a silent, spontaneous uterine rupture that was identified during a scheduled cesarean section at 38 weeks and 4 days of gestation in a patient who had undergone two previous cesarean sections. Both the mother and the baby were discharged in good health three days after the procedure, with no #complications. Despite the rupture and the extrusion of the intact amniotic sac, there were no adverse effects. The global rate of #cesarean deliveries has risen in recent years, and uterine rupture remains a rare but serious #emergency with potentially severe outcomes. This case demonstrates that uterine rupture can occur during pregnancy before the onset of labor, without any noticeable signs or symptoms. 𝗣𝗿𝗼𝗺𝗽𝘁 𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀 is essential, and future research should aim to identify more reliable #indicators to assess the risk of silent uterine rupture and determine the optimal timing for #delivery in patients with previous cesarean sections.

Polycystic ovarian syndrome (#PCOS) is the most common reproductive disorder among women. Women with PCOS have a significantly higher risk of #infertility, #insulin resistance, and type 2 #diabetes. #Ultrasound plays a crucial role in diagnosing PCOS. The study of neda akhoundi, 𝗭𝗮𝗵𝗿𝗮 𝗡𝗮𝘀𝗲𝗿𝗶, 𝗔𝗹𝗶𝗿𝗲𝘇𝗮 𝗦𝗶𝗮𝗺𝗶, 𝗞𝗼𝗯𝗿𝗮 𝗛𝗮𝘇𝗮𝗿𝗮 and 𝗦𝗮𝗿𝗮 𝗛𝗮𝘇𝗮𝗿𝗮 aimed to evaluate the diagnostic value of various ultrasound features of PCOS in detecting infertility among 246 women with PCOS. Participants underwent #ultrasonography between days 3 and 7 of their menstrual cycle to measure ovarian volume, total follicle count, follicle distribution pattern (#peripherally distributed versus #randomly distributed), and the S/A ratio. The findings indicate that 𝗽𝗲𝗿𝗶𝗽𝗵𝗲𝗿𝗮𝗹𝗹𝘆 𝗱𝗶𝘀𝘁𝗿𝗶𝗯𝘂𝘁𝗲𝗱 𝗳𝗼𝗹𝗹𝗶𝗰𝗹𝗲𝘀 𝗮𝗻𝗱 𝗮𝗻 𝗼𝘃𝗮𝗿𝗶𝗮𝗻 𝘃𝗼𝗹𝘂𝗺𝗲 𝗴𝗿𝗲𝗮𝘁𝗲𝗿 𝘁𝗵𝗮𝗻 𝟭𝟬 𝗰𝗰 𝗰𝗮𝗻 𝘀𝗲𝗿𝘃𝗲 𝗮𝘀 𝗲𝗳𝗳𝗲𝗰𝘁𝗶𝘃𝗲 𝘀𝗰𝗿𝗲𝗲𝗻𝗶𝗻𝗴 𝘁𝗲𝘀𝘁𝘀 𝗳𝗼𝗿 𝗱𝗲𝘁𝗲𝗰𝘁𝗶𝗻𝗴 𝗶𝗻𝗳𝗲𝗿𝘁𝗶𝗹𝗶𝘁𝘆 in women with PCOS.

Rh #alloimmunization is a condition where #antibodies develop against fetal red blood cell #antigens, 𝗽𝗼𝘁𝗲𝗻𝘁𝗶𝗮𝗹𝗹𝘆 𝗹𝗲𝗮𝗱𝗶𝗻𝗴 𝘁𝗼 𝘀𝗲𝘃𝗲𝗿𝗲 𝗰𝗼𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀. Despite its significance, there is limited research on the awareness of this condition among pregnant women. Soha Albeitawi, Saba Alsmadi, 𝗝𝗲𝗵𝗮𝗱 𝗙𝗲𝗿𝗮𝘀 𝗔𝗹𝗦𝗮𝗺𝗵𝗼𝗿𝗶, Mu'taz Hanandeh, 𝗠𝗮𝗷𝗲𝗱 𝗡𝗮𝗺𝗮𝗿𝗻𝗲𝗵, 𝗔𝘆𝘀𝗵𝗲𝗵 𝗔𝗹𝗶 𝗔𝗹𝘀𝗵𝗼𝗿𝗺𝗮𝗻, 𝗬𝗮𝗿𝗮 𝗔𝗹𝗷𝗮𝗿𝗿𝗮𝗵, 𝗬𝗮𝘇𝗮𝗻 𝗔𝗯𝘂𝗛𝗮𝗾, 𝗗𝗮𝗻𝗶𝗮 𝗗𝗮𝗿𝘄𝗶𝘀𝗵 signed a cross-sectional study which aimed to evaluate the awareness of Rh alloimmunization among pregnant women in northern #Jordan, as a preliminary step towards improving healthcare services. Data were collected using a validated questionnaire that covered 𝗱𝗲𝗺𝗼𝗴𝗿𝗮𝗽𝗵𝗶𝗰𝘀, 𝗮𝘄𝗮𝗿𝗲𝗻𝗲𝘀𝘀 𝗼𝗳 𝗯𝗹𝗼𝗼𝗱 𝘁𝘆𝗽𝗲, 𝗰𝘂𝗿𝗿𝗲𝗻𝘁 𝗽𝗿𝗲𝗴𝗻𝗮𝗻𝗰𝘆 𝗵𝗶𝘀𝘁𝗼𝗿𝘆, 𝗮𝗻𝘁𝗶-𝗗 𝗶𝗺𝗺𝘂𝗻𝗼𝗴𝗹𝗼𝗯𝘂𝗹𝗶𝗻 𝗮𝗱𝗺𝗶𝗻𝗶𝘀𝘁𝗿𝗮𝘁𝗶𝗼𝗻, 𝗮𝗻𝗱 𝗸𝗻𝗼𝘄𝗹𝗲𝗱𝗴𝗲 𝗼𝗳 𝗥𝗵 𝗮𝗹𝗹𝗼𝗶𝗺𝗺𝘂𝗻𝗶𝘇𝗮𝘁𝗶𝗼𝗻. The results showed that 39.5% of participants were aware of Rh alloimmunization, its complications, and anti-D immunoglobulin. A significant association was found between higher #knowledge levels and factors such as: ➡ higher education ➡ better socioeconomic status ➡ first pregnancy ➡ negative Rh status ➡ exposure to sensitizing events during pregnancy ➡ anti-D immunoglobulin administration

Between May 2022 and November 2022, Gloriya Grifth Manuel, Dr. Jesteena John, and 𝗔𝗳𝗿𝗮 𝗠.𝗔 conducted a case-control study with 456 pregnant women, 154 cases and 302 controls, to investigate the factors that influence the occurrence of #preeclampsia and #eclampsia. The study used an unmatched design, collecting data daily from participants visiting the 𝗢𝗯𝘀𝘁𝗲𝘁𝗿𝗶𝗰𝘀 𝗮𝗻𝗱 𝗚𝘆𝗻𝗲𝗰𝗼𝗹𝗼𝗴𝘆 𝗱𝗲𝗽𝗮𝗿𝘁𝗺𝗲𝗻𝘁. Data collection was carried out using pretested, interviewer-administered questionnaires, Factors such as: ✔ previous #history of #preeclampsia ✔ family history of #hypertension ✔ family history of #diabetes mellitus ✔ low #vegetable consumption were identified to make the patients 𝗺𝗼𝗿𝗲 𝗽𝗿𝗼𝗻𝗲 𝘁𝗼 𝗱𝗲𝘃𝗲𝗹𝗼𝗽𝗲 preeclampsia/eclampsia #Healthcare providers should promote health-seeking #behavior among pregnant women to help in the early diagnosis of preeclampsia.

𝗘𝗰𝘁𝗼𝗽𝗶𝗮 𝗰𝗼𝗿𝗱𝗶𝘀 (EC) is a rare condition where the #heart is located outside its normal position. The exact cause is unknown but is likely linked to #genetic and #environmental factors. 𝗩𝗮𝗹𝗲𝗿𝗶𝗮 𝗚𝗵𝗶𝘀𝘂, marta gargiulo, Stefania Sanna, Agnese Rapisarda, 𝗖𝗹𝗮𝗿𝗮 𝗚𝗲𝗿𝗼𝘀𝗮, 𝗥𝗼𝗯𝗲𝗿𝘁𝗮 𝗠𝘂𝗿𝗿𝘂, Sabrina Giglio, Stefano Angioni MD PhD discuss a rare case of EC with a unique #deletion on the short 𝗮𝗿𝗺 𝗼𝗳 𝗰𝗵𝗿𝗼𝗺𝗼𝘀𝗼𝗺𝗲 𝟭𝟵 (19p13.3), which includes the genes TLE6-2-5, GNA11, GNA15, S1PR4, and NCLN. A 28-year-old woman, pregnant for the first time, was referred to the hospital for an #abortion. An ultrasound at 17 weeks of pregnancy showed a #fetus with EC, where the 𝗵𝗲𝗮𝗿𝘁 𝘄𝗮𝘀 𝗽𝗿𝗼𝘁𝗿𝘂𝗱𝗶𝗻𝗴 𝗳𝗿𝗼𝗺 𝘁𝗵𝗲 𝗿𝗶𝗴𝗵𝘁 𝘀𝗶𝗱𝗲 𝗼𝗳 𝘁𝗵𝗲 𝗰𝗵𝗲𝘀𝘁. The patient had a 𝘁𝗵𝗲𝗿𝗮𝗽𝗲𝘂𝘁𝗶𝗰 𝗮𝗯𝗼𝗿𝘁𝗶𝗼𝗻. An examination of the fetus and a whole genome a-CGH test on a sample of fetal skin #DNA were conducted. The fetal karyotype was 46, XX.

An #omphalocele - one of the most common congenital abdominal wall defects, characterized by the absence of abdominal muscles, fascia, and skin - was diagnosed at 17th week of gestation by Andrea Dagelic, Andrea Etrusco, Antonio D’Amato, Chiantera Vito, Indira Kosovic, 𝗞𝗹𝗮𝘂𝗱𝗶𝗼 𝗣𝗷𝗲𝗿 𝗠𝗶𝗹𝘂𝗻𝗼𝘃𝗶ć, Mislav Mikuš and Jelena Marušić. The #karyotype showed a 46XX karyotype. After careful #counseling, the woman decided to continue the pregnancy, despite the condition usually requires urgent surgical intervention. The pregnancy was carried to term at 39th week of pregnancy by elective #cesarean section. The child was followed until the age of two years. The treatment to which the newborn was submitted was divided in two stages: ➡ suspension of the #hernia sac with mercurochrome solution; ➡ an operative approach with reduction of the hernia sac.

132 patients seeking 𝗶𝗻𝘁𝗿𝗮𝗰𝘆𝘁𝗼𝗽𝗹𝗮𝘀𝗺𝗶𝗰 𝘀𝗽𝗲𝗿𝗺 𝗶𝗻𝗷𝗲𝗰𝘁𝗶𝗼𝗻 (ICSI) for sex selection in #Egypt private infertility centre were included to compare injecting slowly motile #sperms versus rapidly motile ones in 𝗽𝗿𝗲-𝗶𝗺𝗽𝗹𝗮𝗻𝘁𝗮𝘁𝗶𝗼𝗻 #𝗴𝗲𝗻𝗲𝘁𝗶𝗰 𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀 (PGD). #Spermatozoa with slowly progressive motility were selected and used for ICSI (group A = 94), and spermatozoa with rapidly progressive motility were selected and used for ICSI (group B = 38). Day 3 after fertilization, PGD regarding the gender of the resulted #embryos were performed, recorded and compared. Using 𝘀𝗹𝗼𝘄𝗹𝘆 𝗺𝗼𝘁𝗶𝗹𝗲 𝘀𝗽𝗲𝗿𝗺𝘀 in ICSI cases requiring sex selection, yielded more 𝗺𝗮𝗹𝗲 𝗲𝗺𝗯𝗿𝘆𝗼𝘀, 𝗯𝘂𝘁 𝗱𝗶𝗱 𝗻𝗼𝘁 𝗿𝗲𝗮𝗰𝗵 𝘀𝘁𝗮𝘁𝗶𝘀𝘁𝗶𝗰𝗮𝗹𝗹𝘆 𝘀𝗶𝗴𝗻𝗶𝗳𝗶𝗰𝗮𝗻𝗰𝗲. On the contrary, using r𝗮𝗽𝗶𝗱𝗹𝘆 𝗺𝗼𝘁𝗶𝗹𝗲 𝘀𝗽𝗲𝗿𝗺𝘀 yielded more 𝗳𝗲𝗺𝗮𝗹𝗲 𝗲𝗺𝗯𝗿𝘆𝗼𝘀 𝗮𝗻𝗱 𝗮𝗰𝗵𝗶𝗲𝘃𝗲𝗱 𝗮 𝘀𝘁𝗮𝘁𝗶𝘀𝘁𝗶𝗰𝗮𝗹𝗹𝘆 𝘀𝗶𝗴𝗻𝗶𝗳𝗶𝗰𝗮𝗻𝘁 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲. Authors: Suzan Elsharkawy, 𝗠𝗼𝗵𝗮𝗺𝗲𝗱 𝗛𝘂𝘀𝘀𝗲𝗶𝗻 𝗞𝗵𝗮𝗹𝗶𝗹, 𝗪𝗮𝗲𝗹 𝗦𝗮𝗺𝗶𝗿 𝗘𝗹𝗴𝗮𝘇𝗮𝘆𝗲𝗿𝗹𝗶 Alexandria University

Laser assisted #thinning and #drilling techniques have been used to address zonal hardening during assisted reproduction (AR). 𝗧𝗮𝗺𝗲𝗿 𝗘𝗹𝗻𝗮𝗵𝗮𝘀, Mazen Abdel-Rasheed, Mohamed Nasr, 𝗘𝗺𝗮𝗻 𝗔. 𝗛𝗮𝘀𝘀𝗮𝗻, 𝗘𝗵𝗮𝗯 𝗦𝗮𝗹𝗮𝗺𝗮 aimed to study the effect of laser assisted hatching on cryopreserved #embryos, comparing both laser assisted thinning and laser assisted drilling techniques and their effects on both implantation rate #chemical and clinical #pregnancies. Laser thinning technique for cryopreserved embryos 𝗶𝗻𝗰𝗿𝗲𝗮𝘀𝗲𝗱 both the 𝗰𝗵𝗲𝗺𝗶𝗰𝗮𝗹 𝗮𝗻𝗱 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗿𝗲𝗴𝗻𝗮𝗻𝗰𝘆 𝗿𝗮𝘁𝗲𝘀 in frozen embryo transfer especially above age of 35 years old and it seems to have the upper hand in relation to laser opening technique.

Four-vessel umbilical cord (FVUC) is a rare embryonic #anomaly, characterized by the presence of an umbilical cord with 4 #vessels, usually 2 #arteries and 2 #veins. A more uncommon anomaly is when a FVUC is made by 𝘁𝗵𝗿𝗲𝗲 𝗮𝗿𝘁𝗲𝗿𝗶𝗲𝘀 𝗮𝗻𝗱 𝗼𝗻𝗲 𝘃𝗲𝗶𝗻, with only two cases described in the literatures. Despite the scarcity of cases, 𝗦𝗮𝗿𝗮 𝗠𝗮𝗿𝗶, Mario Polichetti, 𝗠𝗮𝗿𝗶𝗮 𝗔𝗻𝘁𝗼𝗻𝗶𝗲𝘁𝘁𝗮 𝗖𝗮𝘀𝘁𝗮𝗹𝗱𝗶, 𝗩𝗶𝗿𝗴𝗶𝗻𝗶𝗮 𝗚𝗮𝗿𝗴𝗮𝗻𝗼, 𝗘𝗹𝗶𝘀𝗮𝗯𝗲𝘁𝘁𝗮 𝗚𝗿𝗮𝗴𝗻𝗮𝗻𝗼, gabriele saccone, 𝗠𝗮𝗿𝗶𝗮𝘃𝗶𝘁𝘁𝗼𝗿𝗶𝗮 𝗟𝗼𝗰𝗰𝗶 and 𝗔𝗻𝘁𝗼𝗻𝗶𝗼 𝗠𝗼𝗹𝗹𝗼 reported the rare case of #FVUC with three arteries and one vein.