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Papers by Enrico Ferrazzi

Research paper thumbnail of Clinical relevance of SARS-CoV-2 infection in late pregnancy

BMC Pregnancy and Childbirth, Jul 12, 2021

Research paper thumbnail of HIV and reproductive care

Research paper thumbnail of Advisory Board Italiano sulla sindrome dell'ovaio policistico (PCOS): dalle osservazioni all'esperienze cliniche sull'uso del mioinositolo (MYO) e dell'acido alfa-lipoico (ALA) per migliorare i quadri della sindrome

Minerva Ginecologica, 2020

Research paper thumbnail of Childbirth Care among SARS-CoV-2 Positive Women in Italy

International Journal of Environmental Research and Public Health, 2021

The new coronavirus emergency spread to Italy when little was known about the infection’s impact ... more The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery roo...

Research paper thumbnail of Prelabor rupture of membranes at term: A possible hematological triage in addition to vagino-rectal beta-hemolytic streptococcus screening for early labor induction

PLOS ONE, 2022

Introduction A potential complication of term prelabor rupture of membranes (term PROM) is chorio... more Introduction A potential complication of term prelabor rupture of membranes (term PROM) is chorioamnionitis with an increased burden on neonatal outcomes of chronic lung disease and cerebral palsy. The purpose of the study was to analyze the efficacy of a standing clinical protocol designed to identify women with term PROM at low risk for chorioamnionitis, who may benefit from expectant management, and those at a higher risk for chorioamnionitis, who may benefit from early induction. Material and methods This retrospective study enrolled all consecutive singleton pregnant women with term PROM. Subjects included women with at least one of the following factors: white blood cell count ≥ 15×100/μL, C-reactive protein ≥ 1.5 mg/dL, or positive vaginal swab for beta-hemolytic streptococcus. These women comprised the high risk (HR) group and underwent immediate induction of labor by the administration of intravaginal dinoprostone. Women with none of the above factors and those with a low r...

Research paper thumbnail of MYNd&CO (Mindfulness, Yoga, Nutrition, development & Coaching, and Osteopathy) randomized controlled trial for a positive psychophysical experience in pregnancy and after birth: a study protocol

Acta Bio Medica : Atenei Parmensis, 2021

Background and aim of the study: The medicalisation of birth pathway may negatively impact on wom... more Background and aim of the study: The medicalisation of birth pathway may negatively impact on women’s empowerment, enhancing distress even in cases of healthy pregnancies. We have built a program which is comprised of Mindfulness, Yoga, Nutrition, development & Counselling, Coaching, antenatal classes, and Osteopathic treatment (MYNd&CO). Methods: This study is a randomized controlled trial involving low-risk pregnant women. They will be randomized to the experimental (MYNd&CO intervention plus standard care) or control group (standard care). The primary (general health and wellbeing, maternal distress) and secondary outcome measures (urinary incontinence, sexual problems, and physical wellbeing) will be assessed via questionnaires at baseline and 6 months after childbirth. The independent-samples t-test and Chi-square will be used to detect changes in the outcomes between intervention and control group. Discussion: The trial is expected to increase knowledge about the effectiveness...

Research paper thumbnail of Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study

Scientific Reports, 2021

Coronavirus disease 2019 (COVID-19) is a pandemic viral disease affecting also obstetric patients... more Coronavirus disease 2019 (COVID-19) is a pandemic viral disease affecting also obstetric patients and uncertainties exist about the prognostic role of inflammatory biomarkers and hemocytometry values in patients with this infection. To clarify that, we have assessed the values of several inflammatory biomarkers and hemocytometry variables in a cohort of obstetric patients hospitalized with COVID-19 and we have correlated the values at admission with the need of oxygen supplementation during the hospitalization. Overall, among 62 (27.3%) pregnant women and 165 (72.7%) postpartum women, 21 (9.2%) patients received oxygen supplementation and 2 (0.9%) required admission to intensive care unit but none died. During hospitalization leukocytes (p < 0.001), neutrophils (p < 0.001), neutrophils to lymphocytes ratio (p < 0.001) and C reactive protein (p < 0.001) decreased significantly, whereas lymphocytes (p < 0.001), platelets (p < 0.001) and ferritin (p = 0.001) increased...

Research paper thumbnail of SAT0207 ANTI-SSA/RO Positivity and Congenital Heart Block: Obstetric and Fetal Outcome in a Cohort of Anti-Ssa/Ro Positive Pregnant Women with and Without Auto-Immune Diseases from Three Italian Tertiary Referral Centers

Annals of the Rheumatic Diseases, 2020

Background:neonatal lupus syndrome (NLS) is an acquired disease caused by the trasplacental passa... more Background:neonatal lupus syndrome (NLS) is an acquired disease caused by the trasplacental passage of anti-SSA antibodies. Congenital heart block (CHB) represents the most serious manifestation of NLS. The rate of CHB in Anti-SSA positive pregnant women ranges from 1 to 5% in different studiesObjectives:to retrospectively assess the prevalence of CHB in a cohort of anti-SSA positive pregnant women followed in 3 Italian tertiary centersMethods:pregnancies of anti-SSA positive women attending the pregnancy clinic of ASST Pini CTO/Policlinico Mangiagalli, Rheumatology Division of Spedali Civili, Brescia and Rheumatology Division of Ospedale S Matteo, Pavia from 2009 to 2019 were included. Patients underwent monthly clinical examination. Fetal heart rate was assessed weekly by Doppler ultrasound from 14thto 26thgestational week. On week 14 and 26, a fetal echocardiography was performed. A EKG was performed at birthResults:351 prospectively followed pregnancies in 292 anti-SSA/Ro positi...

Research paper thumbnail of Current use and performance of the different fetal growth charts in the Italian population

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2020

Research paper thumbnail of Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study

American Journal of Obstetrics and Gynecology, 2021

Research paper thumbnail of Global interim guidance on coronavirus disease 2019 (COVID‐19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals

International Journal of Gynecology & Obstetrics, 2020

In response to the World Health Organization (WHO) statements and international concerns regardin... more In response to the World Health Organization (WHO) statements and international concerns regarding the coronavirus disease 2019 (COVID‐19) outbreak, FIGO has issued comprehensive guidance for the management of pregnant women.

Research paper thumbnail of Maternal hemodynamics: a method to classify hypertensive disorders of pregnancy

American Journal of Obstetrics and Gynecology, 2018

Research paper thumbnail of Relevance of Haemodynamics in Treating Pre-eclampsia

Current Hypertension Reports, 2017

Research paper thumbnail of A developmental approach to the prevention of hypertension and kidney disease: a report from the Low Birth Weight and Nephron Number Working Group

Lancet (London, England), Jul 9, 2017

Research paper thumbnail of Is middle cerebral artery Doppler related to neonatal and 2-year infant outcome in early fetal growth restriction?

American journal of obstetrics and gynecology, Jan 10, 2017

Reduced fetal middle cerebral artery Doppler impedance is associated with hypoxemia in fetal grow... more Reduced fetal middle cerebral artery Doppler impedance is associated with hypoxemia in fetal growth restriction. It remains unclear as to whether this finding could be useful in timing delivery, especially in the third trimester. In this regard there is a paucity of evidence from prospective studies. The aim of this study was to determine whether there is an association between middle cerebral artery Doppler impedance and its ratio with the umbilical artery in relation to neonatal and 2 year infant outcome in early fetal growth restriction (26(+0)-31(+6) weeks of gestation). Additionally we sought to explore which ratio is more informative for clinical use. This is a secondary analysis from the Trial of Randomized Umbilical and Fetal Flow in Europe, a prospective, multicenter, randomized management study on different antenatal monitoring strategies (ductus venosus Doppler changes and computerized cardiotocography short-term variation) in fetal growth restriction diagnosed between 26...

Research paper thumbnail of HIV and reproductive care

Research paper thumbnail of A Case of Ultrasound Diagnosis of Fetal Hiatal Hernia in Late Third Trimester of Pregnancy

Case Reports in Obstetrics and Gynecology, 2015

Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most... more Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most commonly the stomach, through a physiological but overlax esophageal hiatus into the thoracic cavity. Prenatal diagnosis of this anomaly is unusual and only eight cases have been reported in the literature. In this paper we describe a case of congenital hiatal hernia that was suspected at ultrasound at 39 weeks’ gestation, on the basis of a cystic mass in the posterior mediastinum, juxtaposed to the vertebral body. Postnatal upper gastrointestinal tract series confirmed the prenatal diagnosis. Postnatal management was planned with no urgency. Hiatal hernia is not commonly considered in the differential diagnosis of fetal cystic chest anomalies. This rare case documents the importance of prenatal diagnosis of this anomaly for prenatal counseling and postnatal management.

Research paper thumbnail of Acceleration and deceleration capacity of fetal heart rate in an in-vivo sheep model

PloS one, 2014

Fetal heart rate (FHR) variability is an indirect index of fetal autonomic nervous system (ANS) i... more Fetal heart rate (FHR) variability is an indirect index of fetal autonomic nervous system (ANS) integrity. FHR variability analysis in labor fails to detect early hypoxia and acidemia. Phase-rectified signal averaging (PRSA) is a new method of complex biological signals analysis that is more resistant to non-stationarities, signal loss and artifacts. It quantifies the average cardiac acceleration and deceleration (AC/DC) capacity. The aims of the study were: (1) to investigate AC/DC in ovine fetuses exposed to acute hypoxic-acidemic insult; (2) to explore the relation between AC/DC and acid-base balance; and (3) to evaluate the influence of FHR decelerations and specific PRSA parameters on AC/DC computation. Repetitive umbilical cord occlusions (UCOs) were applied in 9 pregnant near-term sheep to obtain three phases of MILD, MODERATE, and SEVERE hypoxic-acidemic insult. Acid-base balance was sampled and fetal ECGs continuously recorded. AC/DC were calculated: (1) for a spectrum of T...

Research paper thumbnail of Assessment of Coupling between Trans-Abdominally Acquired Fetal ECG and Uterine Activity by Bivariate Phase-Rectified Signal Averaging Analysis

Research paper thumbnail of Morphological analysis of the fetal electrocardiogram during pregnancy

Journal of Perinatal Medicine, 1984

Research paper thumbnail of Clinical relevance of SARS-CoV-2 infection in late pregnancy

BMC Pregnancy and Childbirth, Jul 12, 2021

Research paper thumbnail of HIV and reproductive care

Research paper thumbnail of Advisory Board Italiano sulla sindrome dell'ovaio policistico (PCOS): dalle osservazioni all'esperienze cliniche sull'uso del mioinositolo (MYO) e dell'acido alfa-lipoico (ALA) per migliorare i quadri della sindrome

Minerva Ginecologica, 2020

Research paper thumbnail of Childbirth Care among SARS-CoV-2 Positive Women in Italy

International Journal of Environmental Research and Public Health, 2021

The new coronavirus emergency spread to Italy when little was known about the infection’s impact ... more The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery roo...

Research paper thumbnail of Prelabor rupture of membranes at term: A possible hematological triage in addition to vagino-rectal beta-hemolytic streptococcus screening for early labor induction

PLOS ONE, 2022

Introduction A potential complication of term prelabor rupture of membranes (term PROM) is chorio... more Introduction A potential complication of term prelabor rupture of membranes (term PROM) is chorioamnionitis with an increased burden on neonatal outcomes of chronic lung disease and cerebral palsy. The purpose of the study was to analyze the efficacy of a standing clinical protocol designed to identify women with term PROM at low risk for chorioamnionitis, who may benefit from expectant management, and those at a higher risk for chorioamnionitis, who may benefit from early induction. Material and methods This retrospective study enrolled all consecutive singleton pregnant women with term PROM. Subjects included women with at least one of the following factors: white blood cell count ≥ 15×100/μL, C-reactive protein ≥ 1.5 mg/dL, or positive vaginal swab for beta-hemolytic streptococcus. These women comprised the high risk (HR) group and underwent immediate induction of labor by the administration of intravaginal dinoprostone. Women with none of the above factors and those with a low r...

Research paper thumbnail of MYNd&CO (Mindfulness, Yoga, Nutrition, development & Coaching, and Osteopathy) randomized controlled trial for a positive psychophysical experience in pregnancy and after birth: a study protocol

Acta Bio Medica : Atenei Parmensis, 2021

Background and aim of the study: The medicalisation of birth pathway may negatively impact on wom... more Background and aim of the study: The medicalisation of birth pathway may negatively impact on women’s empowerment, enhancing distress even in cases of healthy pregnancies. We have built a program which is comprised of Mindfulness, Yoga, Nutrition, development & Counselling, Coaching, antenatal classes, and Osteopathic treatment (MYNd&CO). Methods: This study is a randomized controlled trial involving low-risk pregnant women. They will be randomized to the experimental (MYNd&CO intervention plus standard care) or control group (standard care). The primary (general health and wellbeing, maternal distress) and secondary outcome measures (urinary incontinence, sexual problems, and physical wellbeing) will be assessed via questionnaires at baseline and 6 months after childbirth. The independent-samples t-test and Chi-square will be used to detect changes in the outcomes between intervention and control group. Discussion: The trial is expected to increase knowledge about the effectiveness...

Research paper thumbnail of Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study

Scientific Reports, 2021

Coronavirus disease 2019 (COVID-19) is a pandemic viral disease affecting also obstetric patients... more Coronavirus disease 2019 (COVID-19) is a pandemic viral disease affecting also obstetric patients and uncertainties exist about the prognostic role of inflammatory biomarkers and hemocytometry values in patients with this infection. To clarify that, we have assessed the values of several inflammatory biomarkers and hemocytometry variables in a cohort of obstetric patients hospitalized with COVID-19 and we have correlated the values at admission with the need of oxygen supplementation during the hospitalization. Overall, among 62 (27.3%) pregnant women and 165 (72.7%) postpartum women, 21 (9.2%) patients received oxygen supplementation and 2 (0.9%) required admission to intensive care unit but none died. During hospitalization leukocytes (p < 0.001), neutrophils (p < 0.001), neutrophils to lymphocytes ratio (p < 0.001) and C reactive protein (p < 0.001) decreased significantly, whereas lymphocytes (p < 0.001), platelets (p < 0.001) and ferritin (p = 0.001) increased...

Research paper thumbnail of SAT0207 ANTI-SSA/RO Positivity and Congenital Heart Block: Obstetric and Fetal Outcome in a Cohort of Anti-Ssa/Ro Positive Pregnant Women with and Without Auto-Immune Diseases from Three Italian Tertiary Referral Centers

Annals of the Rheumatic Diseases, 2020

Background:neonatal lupus syndrome (NLS) is an acquired disease caused by the trasplacental passa... more Background:neonatal lupus syndrome (NLS) is an acquired disease caused by the trasplacental passage of anti-SSA antibodies. Congenital heart block (CHB) represents the most serious manifestation of NLS. The rate of CHB in Anti-SSA positive pregnant women ranges from 1 to 5% in different studiesObjectives:to retrospectively assess the prevalence of CHB in a cohort of anti-SSA positive pregnant women followed in 3 Italian tertiary centersMethods:pregnancies of anti-SSA positive women attending the pregnancy clinic of ASST Pini CTO/Policlinico Mangiagalli, Rheumatology Division of Spedali Civili, Brescia and Rheumatology Division of Ospedale S Matteo, Pavia from 2009 to 2019 were included. Patients underwent monthly clinical examination. Fetal heart rate was assessed weekly by Doppler ultrasound from 14thto 26thgestational week. On week 14 and 26, a fetal echocardiography was performed. A EKG was performed at birthResults:351 prospectively followed pregnancies in 292 anti-SSA/Ro positi...

Research paper thumbnail of Current use and performance of the different fetal growth charts in the Italian population

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2020

Research paper thumbnail of Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study

American Journal of Obstetrics and Gynecology, 2021

Research paper thumbnail of Global interim guidance on coronavirus disease 2019 (COVID‐19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals

International Journal of Gynecology & Obstetrics, 2020

In response to the World Health Organization (WHO) statements and international concerns regardin... more In response to the World Health Organization (WHO) statements and international concerns regarding the coronavirus disease 2019 (COVID‐19) outbreak, FIGO has issued comprehensive guidance for the management of pregnant women.

Research paper thumbnail of Maternal hemodynamics: a method to classify hypertensive disorders of pregnancy

American Journal of Obstetrics and Gynecology, 2018

Research paper thumbnail of Relevance of Haemodynamics in Treating Pre-eclampsia

Current Hypertension Reports, 2017

Research paper thumbnail of A developmental approach to the prevention of hypertension and kidney disease: a report from the Low Birth Weight and Nephron Number Working Group

Lancet (London, England), Jul 9, 2017

Research paper thumbnail of Is middle cerebral artery Doppler related to neonatal and 2-year infant outcome in early fetal growth restriction?

American journal of obstetrics and gynecology, Jan 10, 2017

Reduced fetal middle cerebral artery Doppler impedance is associated with hypoxemia in fetal grow... more Reduced fetal middle cerebral artery Doppler impedance is associated with hypoxemia in fetal growth restriction. It remains unclear as to whether this finding could be useful in timing delivery, especially in the third trimester. In this regard there is a paucity of evidence from prospective studies. The aim of this study was to determine whether there is an association between middle cerebral artery Doppler impedance and its ratio with the umbilical artery in relation to neonatal and 2 year infant outcome in early fetal growth restriction (26(+0)-31(+6) weeks of gestation). Additionally we sought to explore which ratio is more informative for clinical use. This is a secondary analysis from the Trial of Randomized Umbilical and Fetal Flow in Europe, a prospective, multicenter, randomized management study on different antenatal monitoring strategies (ductus venosus Doppler changes and computerized cardiotocography short-term variation) in fetal growth restriction diagnosed between 26...

Research paper thumbnail of HIV and reproductive care

Research paper thumbnail of A Case of Ultrasound Diagnosis of Fetal Hiatal Hernia in Late Third Trimester of Pregnancy

Case Reports in Obstetrics and Gynecology, 2015

Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most... more Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most commonly the stomach, through a physiological but overlax esophageal hiatus into the thoracic cavity. Prenatal diagnosis of this anomaly is unusual and only eight cases have been reported in the literature. In this paper we describe a case of congenital hiatal hernia that was suspected at ultrasound at 39 weeks’ gestation, on the basis of a cystic mass in the posterior mediastinum, juxtaposed to the vertebral body. Postnatal upper gastrointestinal tract series confirmed the prenatal diagnosis. Postnatal management was planned with no urgency. Hiatal hernia is not commonly considered in the differential diagnosis of fetal cystic chest anomalies. This rare case documents the importance of prenatal diagnosis of this anomaly for prenatal counseling and postnatal management.

Research paper thumbnail of Acceleration and deceleration capacity of fetal heart rate in an in-vivo sheep model

PloS one, 2014

Fetal heart rate (FHR) variability is an indirect index of fetal autonomic nervous system (ANS) i... more Fetal heart rate (FHR) variability is an indirect index of fetal autonomic nervous system (ANS) integrity. FHR variability analysis in labor fails to detect early hypoxia and acidemia. Phase-rectified signal averaging (PRSA) is a new method of complex biological signals analysis that is more resistant to non-stationarities, signal loss and artifacts. It quantifies the average cardiac acceleration and deceleration (AC/DC) capacity. The aims of the study were: (1) to investigate AC/DC in ovine fetuses exposed to acute hypoxic-acidemic insult; (2) to explore the relation between AC/DC and acid-base balance; and (3) to evaluate the influence of FHR decelerations and specific PRSA parameters on AC/DC computation. Repetitive umbilical cord occlusions (UCOs) were applied in 9 pregnant near-term sheep to obtain three phases of MILD, MODERATE, and SEVERE hypoxic-acidemic insult. Acid-base balance was sampled and fetal ECGs continuously recorded. AC/DC were calculated: (1) for a spectrum of T...

Research paper thumbnail of Assessment of Coupling between Trans-Abdominally Acquired Fetal ECG and Uterine Activity by Bivariate Phase-Rectified Signal Averaging Analysis

Research paper thumbnail of Morphological analysis of the fetal electrocardiogram during pregnancy

Journal of Perinatal Medicine, 1984