107 pubblicazioni classificate nel seguente modo:

Length but not transverse diameter of the excision specimen for high-grade cervical intraepithelial neoplasia (CIN 2-3) is a predictor of pregnancy outcome
EUROPEAN JOURNAL OF CANCER PREVENTION
Autore/i: Liverani, Carlo A.; DI GIUSEPPE, Jacopo; Clemente, Nicolo'; DELLI CARPINI, Giovanni; Monti, Ermelinda; Fanetti, Fabiana; Bolis, Giorgio; Ciavattini, Andrea
Classificazione: 1 Contributo su Rivista
Abstract: The objective of this study was to analyze the impact of cone characteristics (depth, transverse diameter, and volume) on subsequent pregnancies after the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2-3). Pregnancy outcomes (preterm birth, gestational age at birth, mode of delivery, and birth weight) of 501 women with singleton gestations and no previous preterm birth or history of late miscarriage, who had previously undergone a single LEEP for CIN 2-3, were retrospectively analyzed with respect to length, transverse diameter, and volume of the excision specimen. The overall incidence of preterm birth was 2.4%. The rate of preterm birth in women with length greater than 20 mm or volume greater than 2.5 cm was significantly higher than that in women with length between 15 and 19 mm (15.6 vs. 3.9%, P=0.02) or women with volume between 2.0 and 2.4 cm (5.8 vs. 1.6%, P=0.04). A linear inverse correlation (r=-0.3, P<0.001) between gestational age at birth and length, but not volume (r=0.0, P=0.9) or transverse diameter (r=0.2, P<0.0001), emerged. The mode of delivery was not affected by cone characteristics. Length, but not transverse diameter and volume, of the excised specimen seems to be related to a lower gestational age at birth. When excisions are performed under strict colposcopic guidance, with a correct modulation of cone length, the risk for preterm birth and cesarean delivery in subsequent pregnancies is not increased.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/240092

Hypovitaminosis D and "small burden" uterine fibroids: Opportunity for a vitamin D supplementation
MEDICINE
Autore/i: Ciavattini, Andrea; DELLI CARPINI, Giovanni; Serri, Matteo; Vignini, Arianna; Sabbatinelli, Jacopo; Tozzi, Alessandra; Aggiusti, Alice; Clemente, Nicolo'
Classificazione: 1 Contributo su Rivista
Abstract: The aim of this study was to evaluate the effect of vitamin D supplementation in women with hypovitaminosis D and "small burden" uterine fibroids.This study focused on 208 women diagnosed with uterine fibroids and concomitant hypovitaminosis D, from January to December 2014. One hundred eight women of the initial study population were diagnosed with "small burden" uterine fibroids. Among them, those who underwent a proper vitamin D supplementation constituted the "study group" (n = 53), while women who spontaneously refused the therapy or did not perform it properly, constituted the "control group" (n = 55). The characteristics of uterine fibroids, the fibroid-related symptoms, and the vitamin D serum levels were evaluated 12 months after the initial diagnosis.In women with uterine fibroids, a negative correlation emerged between the baseline 25-hydroxy-cholecalciferol (25-OH-D3) concentration and both the volume of the largest fibroid (r = -0.18, P = 0.01) and the total volume of fibroids (r = -0.19, P = 0.01). No correlation was found between the baseline 25-OH-D3 levels and the number of fibroids per patient (r = -0.10, P = 0.16). In women of the "study group," a significant increase in the 25-OH-D3 serum level was observed after 12 months of supplementation, and a lower rate of surgical or medical treatment due to the "progression to extensive disease" was reported (13.2% vs 30.9%, P = 0.05).Supplementation therapy with 25-OH-D3 restores normal vitamin D serum levels in women with "small burden" fibroids. In these women, vitamin D supplementation seems to reduce the progression to an extensive disease, and thus the need of conventional surgical or medical therapy.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/244870

Thickness of preperitoneal fat as a predictor of malignancy in overweight and obese women with endometrial polyps
ONCOLOGY LETTERS
Autore/i: Ciavattini, Andrea; Di Giuseppe, Jacopo; Clemente, Nicolò; Moriconi, Lorenzo; Delli Carpini, Giovanni; Montik, Nina; Mazzanti, Laura
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/235740

Loop electrosurgical excision procedure and risk of miscarriage
FERTILITY AND STERILITY
Autore/i: Ciavattini, Andrea; Clemente, Nicolo'; DELLI CARPINI, Giovanni; Gentili, Chiara; DI GIUSEPPE, Jacopo; Barbadoro, Pamela; Prospero, Emilia; Liverani, Carlo Antonio
Classificazione: 1 Contributo su Rivista
Abstract: To evaluate the risk of miscarriage in the subsequent pregnancy after a loop electrosurgical excision procedure (LEEP), also considering time elapsed from LEEP to pregnancy.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/225483

Number and size of uterine fibroids and obstetric outcomes.
THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Autore/i: Ciavattini, Andrea; Clemente, Nicolo'; DELLI CARPINI, Giovanni; DI GIUSEPPE, Jacopo; Giannubilo, Stefano Raffaele; Tranquilli, Andrea Luigi
Classificazione: 1 Contributo su Rivista
Abstract: Objective: Estimating the impact of sonographically identified multiple or large (≥5 cm in diameter) fibroids on obstetric outcomes. Methods: Retrospective cohort study of 219 women with uterine fibroids (identified on a routine second-trimester ultrasound survey over a 3-year period, 2010-2012) and their age-matched controls. Inclusion criteria were singleton pregnancy, delivery at >24 weeks of gestation and no pathological conditions (chronic hypertension, gestational diabetes or pre-existing diabetes mellitus, uterine anomalies or fetal malformations). Results: Compared to women with no fibroids, women with multiple fibroids (n = 34) had a significantly higher rate of preterm birth (29.4% versus 5%, p < 0.001), cesarean section (73.5% versus 37%, p < 0.001) and breech presentation (11.8% versus 2.7%, p = 0.04). Women with large fibroids (n = 48) had a higher rate of preterm birth (16.7% versus 5%, p = 0.01) and pPROM (10.4% versus 0.5%, p < 0.001). By multivariate analysis, only multiple fibroids and previous preterm birth showed an independent significant association with preterm birth (OR = 7.37, 95% CI 2.50-21.68 and OR = 13.01, 95% CI 3.56-47.52, respectively). Conclusions: Women with uterine fibroids are at an increased risk of obstetric complications. In particular, multiple rather than large fibroids are associated with a significantly increased risk of preterm birth and cesarean delivery while large fibroids are associated with a higher risk of pPROM. No correlation with IUGR, placenta previa or placental abruption was found.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/205931

Predictors of malignancy in endometrial polyps: a multi-institutional cohort study
EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY
Autore/i: Litta, P.; DI GIUSEPPE, Jacopo; Moriconi, Lorenzo; DELLI CARPINI, Giovanni; Piermartiri, MARIA GIOVANNA; Ciavattini, Andrea
Classificazione: 1 Contributo su Rivista
Abstract: Abstract PURPOSE OF INVESTIGATION: The risk of endometrial cancer in women with endometrial polyps (EPs) has been reported to vary between 0.3% and 4.8%. There is a lack of data about the management of asymptomatic women with incidental diagnosis of EPs. In the present study the authors correlated demographic and clinical characteristics with histopathological features of the EPs hysteroscopically removed. MATERIALS AND METHODS: An observational multi-institutional cohort study was conducted from February 2010 to December 2012 to identify all the premenopausal and postmenopausal women consecutively undergoing hysteroscopic polypectomy. The data of women were reviewed and clinical features were related to histopathologic results. RESULTS: The patients recruited were 813. The mean age was 52.5 years (range 22-87). The results showed a correlation between older age, high body mass index (BMI) and obesity, postmenopausal state, abnormal uterine bleeding (AUB), hypertension, and risk of malignant EPs. On multivariable analysis, the correlation remained only for age (OR 1.08, 95% CI 1.03 - 1.14) and AUB (OR 3.53, 95% CI 1.87 - 6.65). CONCLUSION: Older patients in postmenopausal status with AUB, a high BMI, and hypertension are at higher risk for premalignant and malignant polyps. In these patients a surgical approach should be used, consisting in hysteroscopical removing of the polyp.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/209113

Risk of recurrent menorrhagia after hydrothermoablation: role of GnRH analogues neoadjuvant treatment in long-term successful rate
CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY
Autore/i: Litta, P.; Saccardi, C.; Tommasi, L.; DI GIUSEPPE, Jacopo; DELLI CARPINI, Giovanni; Ciavattini, Andrea
Classificazione: 1 Contributo su Rivista
Abstract: OBJECTIVE: To evaluate the long-term effectiveness of presurgical therapy with GnRH analogues in patients who underwenthydrothermal endometrial ablation (HTA) for menorrhagia and assess the relationship between sonographically measured myometrium thickness and pelvic pain. MATERIALS AND METHODS: A prospective randomized control study comparing 15 women (Group A) with presurgical subcutaneous triptorelin depot injection before HTA with controls (Group B, n = 15). Inclusion criteria were: recurrent menorrhagia, uterus length < 12 cm, no previous hormonal therapy for at least six month, and family plan completed. Student's t test was applied, as appropriate, to compare continuous variables. Proportion were compared with chi-squared. RESULTS: After 12 months of follow-up, Group A showed a significantly lower (0% vs 20%; p = 0.03) failure rate after hydrothermoablation than the Group B and a generally higher successful rate at 24 and 48 months. The discomfort, evaluated with VAS, showed a mean value of 47.6 +/- 15.9 +/- SD); 96.7% of women reported a mild-moderate postoperative pain. No perioperative and late complications were recorded. CONCLUSIONS: Presurgical treatment with GnRH analogues seems to improve long-term efficacy of HTA. Perioperative pelvic pain seems to not be affected by myometrium thickness.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/209114