Antonella Vimercati | Università degli Studi di Bari (original) (raw)
Papers by Antonella Vimercati
Geburtshilfe Und Frauenheilkunde, Jul 20, 2016
PubMed, Nov 1, 1996
Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography h... more Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.
PubMed, May 7, 1999
Ehlers-Danlos syndrome is a heterogeneous group of diseases, where connective tissue laxity is th... more Ehlers-Danlos syndrome is a heterogeneous group of diseases, where connective tissue laxity is the main feature. Several pregnancy and delivery complications, mainly related to vascular and uterine rupture or to soft tissue tears, are described. A case of a full term pregnancy is reported and the clinical value of obstetrical management is discussed.
Maturitas, Feb 1, 2002
Objecti6e: To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascul... more Objecti6e: To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascular health in menopause, compared with the effects of the hormone replacement therapy (HRT). Methods: 187 healthy asymptomatic postmenopausal women, aged 39-60, were recruited and randomized into three groups: a soy rich diet group, a HRT group, and a control group. Lipid profile, body mass index, blood pressure, endometrial thickness, uterine artery resistance index (RI), were evaluated in all the participants at the baseline, after 6 months, and at the end of the study. Results: After a 6-month intervention period, the lipid profile in the soy rich diet group showed a favourable outcome, similar to that observed in the HRT group, but compliance to the diet was low. Conclusion: Soy products may be used in the prevention of cardiovascular risk in postmenopausal women because of their efficacy in contrasting the negative effects of menopause on the cardiovascular system, but our findings should be confirmed; moreover, suitable strategies to improve the compliance have to be considered.
American Journal Of Obstetrics & Gynecology Mfm, Jul 1, 2023
Journal of Maternal-fetal & Neonatal Medicine, Mar 6, 2022
PubMed, 2000
The interaction between pregnancy, Diabetes Mellitus and thyroid disturbance needs a particular a... more The interaction between pregnancy, Diabetes Mellitus and thyroid disturbance needs a particular attention. The antithyroid antibodies are more frequent in pregnant women with insulin-dependent diabetes mellitus (IDDM) than in normal pregnant women. Beside, an increased prevalence of subclinic ipotyroidism has been described in pregnant diabetic women. The object of this study is to verify if women with insulin-dependent diabetes mellitus have more probability than normal women to develop a thyroid pathology in pregnancy, in an area with sufficient iodine. Twenty-eight women have been studied: 15 with IDDM, with age 20-37 years, and 13 healthy women, with the same age. Patients were evaluated at the following time-intervals: 9-12 and 18-20 weeks' gestation, at delivery and six months after delivery. Diabetic women followed an insulinic therapy optimized for to reach a good metabolic control. All follow the patients had a thyroid ecography to evaluate thyroid volume and possible presence of nodular formation or others pathologic signs. A blood sample to assay FT3, FT4, TSH, of the antibodies Anti-Thyreoperoxidase (Anti-TPO) and Anti-Thyreoglobulin (Anti-TG). A urine specimen taken to evaluate the iodine excretion. No significant difference was observed between diabetic and normal women, for the values of TSH (p < 0.2), FT4(p < 0.7), FT3(p < 0.6). Instead a significant difference was found between the thyroid volume (p < 0.04), in the diabetic patients versus the normal women, at delivery and six months after delivery. The results of this study underline the importance of the screening of the thyroid function and morphology, in all the pregnant women and, particularly, in the diabetic patients, to find the presence of glandular alterations as early as possible.
Clinical Microbiology and Infection
International Journal of Molecular Sciences
Authors investigated the catecholaminergic neurotransmitters (chNs) quantitative modifications in... more Authors investigated the catecholaminergic neurotransmitters (chNs) quantitative modifications in pregnant uterine Lower Uterine Segment (LUS) during prolonged labor (PL) with the fetus in an occiput-posterior position (OPP), in occiput transverse position (OTP) and in fetal head asynclitism, all diagnosed by Intrapartum Ultrasonography (IU). The chNs neurotransmitters, particularly adrenaline (or epinephrine-A) and noradrenaline (or norepinephrine-N), were evaluated in LUS fragments sampled during CS of 34 patients undergoing urgent cesarean section (CS) in PL, compared to chNs fibers in the LUS of 36 women submitted to elective CS. All results were statistically analyzed to understand the differences in neurotransmitters morphological analysis by scanning electronic microscopy examination (SEM). The LUS fragments analysis revealed a reduction of A and N fibers in LUS during PL, compared with the expression of A and N fibers in LUS during elective CS. The PL for OPP, the OTP and as...
XII Congresso Nazionale della Società Italiana di Colposcopia e Patologia Cervico Vaginale, 1997
CIC Edizioni Internazionali, 1999
Additional file 2. Additional examples of straight and spiraled TNTs immunostained with fibronect... more Additional file 2. Additional examples of straight and spiraled TNTs immunostained with fibronectin (FN). a Two parallel, tiny and ultra-long FN+ TNTs (arrows), whose continuity is revealed in the FN single channel (b). c, d A typical bridging TNT (arrows) e, f A TNT characterized by an irregular course (arrow), clearly originates from a pericyte (PC). Nuclear counterstaining propidium iodide (PI). Scale bars a, b 50 µm; c–f 25 µm.
Additional file 7. CD105 is a marker of angiogenically activated endothelial tip cells in the fet... more Additional file 7. CD105 is a marker of angiogenically activated endothelial tip cells in the fetal cerebral cortex. a–c Examples of CD105+ activated. d–f Examples of CD105+ endothelial cells, covered by CD146+ pericytes (PC). Nuclear counterstaining TOPRO-3. Scale bar a, b, d 20 µm; c, e, f 10 µm.
International Journal of Gynecology & Obstetrics, 2021
ObjectiveTo describe the characteristics and peripartum outcomes of patients diagnosed with uteri... more ObjectiveTo describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients.MethodsDemographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR.ResultsUterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gest...
Infection, 2019
Purpose To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV follow... more Purpose To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. Methods Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). Results Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p < 0.001). Women who delivered vaginally were younger, more commonly nulliparous, diagnosed with HIV during current pregnancy, and antiretroviral-naïve, but had a slightly longer duration of pregnancy, with significantly higher birthweight of newborns. NECS was associated with adverse pregnancy outcomes. The rate of HIV transmission was minimal (0.4%). There were no differences between vaginal and ECS about delivery complications, while NECS was more commonly associated with complications compared to ECS. Conclusions Vaginal delivery in HIV-infected women with suppressed viral load appears to be safe for mother and children. No cases of HIV transmission were observed. Despite an ongoing significant increase, the rate of vaginal delivery remains relatively low compared to other countries, and further progress is needed to promote this mode of delivery in clinical practice.
Epidemiology and Infection, 2017
SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower tre... more SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women <25 years, with a significant increase over time (2001–2005: 7·0%; 2006–2010: 9·1%; 2011–2016: 12·2%,P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (<25 years: 56·3%; ⩾25 years: 69·0%, OR 0·58, 95% CI 0·41–0·81). During pregnancy, treatment coverage was almost universal in both age groups (98·5%vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcome...
Geburtshilfe Und Frauenheilkunde, Jul 20, 2016
PubMed, Nov 1, 1996
Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography h... more Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.
PubMed, May 7, 1999
Ehlers-Danlos syndrome is a heterogeneous group of diseases, where connective tissue laxity is th... more Ehlers-Danlos syndrome is a heterogeneous group of diseases, where connective tissue laxity is the main feature. Several pregnancy and delivery complications, mainly related to vascular and uterine rupture or to soft tissue tears, are described. A case of a full term pregnancy is reported and the clinical value of obstetrical management is discussed.
Maturitas, Feb 1, 2002
Objecti6e: To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascul... more Objecti6e: To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascular health in menopause, compared with the effects of the hormone replacement therapy (HRT). Methods: 187 healthy asymptomatic postmenopausal women, aged 39-60, were recruited and randomized into three groups: a soy rich diet group, a HRT group, and a control group. Lipid profile, body mass index, blood pressure, endometrial thickness, uterine artery resistance index (RI), were evaluated in all the participants at the baseline, after 6 months, and at the end of the study. Results: After a 6-month intervention period, the lipid profile in the soy rich diet group showed a favourable outcome, similar to that observed in the HRT group, but compliance to the diet was low. Conclusion: Soy products may be used in the prevention of cardiovascular risk in postmenopausal women because of their efficacy in contrasting the negative effects of menopause on the cardiovascular system, but our findings should be confirmed; moreover, suitable strategies to improve the compliance have to be considered.
American Journal Of Obstetrics & Gynecology Mfm, Jul 1, 2023
Journal of Maternal-fetal & Neonatal Medicine, Mar 6, 2022
PubMed, 2000
The interaction between pregnancy, Diabetes Mellitus and thyroid disturbance needs a particular a... more The interaction between pregnancy, Diabetes Mellitus and thyroid disturbance needs a particular attention. The antithyroid antibodies are more frequent in pregnant women with insulin-dependent diabetes mellitus (IDDM) than in normal pregnant women. Beside, an increased prevalence of subclinic ipotyroidism has been described in pregnant diabetic women. The object of this study is to verify if women with insulin-dependent diabetes mellitus have more probability than normal women to develop a thyroid pathology in pregnancy, in an area with sufficient iodine. Twenty-eight women have been studied: 15 with IDDM, with age 20-37 years, and 13 healthy women, with the same age. Patients were evaluated at the following time-intervals: 9-12 and 18-20 weeks' gestation, at delivery and six months after delivery. Diabetic women followed an insulinic therapy optimized for to reach a good metabolic control. All follow the patients had a thyroid ecography to evaluate thyroid volume and possible presence of nodular formation or others pathologic signs. A blood sample to assay FT3, FT4, TSH, of the antibodies Anti-Thyreoperoxidase (Anti-TPO) and Anti-Thyreoglobulin (Anti-TG). A urine specimen taken to evaluate the iodine excretion. No significant difference was observed between diabetic and normal women, for the values of TSH (p < 0.2), FT4(p < 0.7), FT3(p < 0.6). Instead a significant difference was found between the thyroid volume (p < 0.04), in the diabetic patients versus the normal women, at delivery and six months after delivery. The results of this study underline the importance of the screening of the thyroid function and morphology, in all the pregnant women and, particularly, in the diabetic patients, to find the presence of glandular alterations as early as possible.
Clinical Microbiology and Infection
International Journal of Molecular Sciences
Authors investigated the catecholaminergic neurotransmitters (chNs) quantitative modifications in... more Authors investigated the catecholaminergic neurotransmitters (chNs) quantitative modifications in pregnant uterine Lower Uterine Segment (LUS) during prolonged labor (PL) with the fetus in an occiput-posterior position (OPP), in occiput transverse position (OTP) and in fetal head asynclitism, all diagnosed by Intrapartum Ultrasonography (IU). The chNs neurotransmitters, particularly adrenaline (or epinephrine-A) and noradrenaline (or norepinephrine-N), were evaluated in LUS fragments sampled during CS of 34 patients undergoing urgent cesarean section (CS) in PL, compared to chNs fibers in the LUS of 36 women submitted to elective CS. All results were statistically analyzed to understand the differences in neurotransmitters morphological analysis by scanning electronic microscopy examination (SEM). The LUS fragments analysis revealed a reduction of A and N fibers in LUS during PL, compared with the expression of A and N fibers in LUS during elective CS. The PL for OPP, the OTP and as...
XII Congresso Nazionale della Società Italiana di Colposcopia e Patologia Cervico Vaginale, 1997
CIC Edizioni Internazionali, 1999
Additional file 2. Additional examples of straight and spiraled TNTs immunostained with fibronect... more Additional file 2. Additional examples of straight and spiraled TNTs immunostained with fibronectin (FN). a Two parallel, tiny and ultra-long FN+ TNTs (arrows), whose continuity is revealed in the FN single channel (b). c, d A typical bridging TNT (arrows) e, f A TNT characterized by an irregular course (arrow), clearly originates from a pericyte (PC). Nuclear counterstaining propidium iodide (PI). Scale bars a, b 50 µm; c–f 25 µm.
Additional file 7. CD105 is a marker of angiogenically activated endothelial tip cells in the fet... more Additional file 7. CD105 is a marker of angiogenically activated endothelial tip cells in the fetal cerebral cortex. a–c Examples of CD105+ activated. d–f Examples of CD105+ endothelial cells, covered by CD146+ pericytes (PC). Nuclear counterstaining TOPRO-3. Scale bar a, b, d 20 µm; c, e, f 10 µm.
International Journal of Gynecology & Obstetrics, 2021
ObjectiveTo describe the characteristics and peripartum outcomes of patients diagnosed with uteri... more ObjectiveTo describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients.MethodsDemographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR.ResultsUterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gest...
Infection, 2019
Purpose To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV follow... more Purpose To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. Methods Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). Results Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p < 0.001). Women who delivered vaginally were younger, more commonly nulliparous, diagnosed with HIV during current pregnancy, and antiretroviral-naïve, but had a slightly longer duration of pregnancy, with significantly higher birthweight of newborns. NECS was associated with adverse pregnancy outcomes. The rate of HIV transmission was minimal (0.4%). There were no differences between vaginal and ECS about delivery complications, while NECS was more commonly associated with complications compared to ECS. Conclusions Vaginal delivery in HIV-infected women with suppressed viral load appears to be safe for mother and children. No cases of HIV transmission were observed. Despite an ongoing significant increase, the rate of vaginal delivery remains relatively low compared to other countries, and further progress is needed to promote this mode of delivery in clinical practice.
Epidemiology and Infection, 2017
SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower tre... more SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women <25 years, with a significant increase over time (2001–2005: 7·0%; 2006–2010: 9·1%; 2011–2016: 12·2%,P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (<25 years: 56·3%; ⩾25 years: 69·0%, OR 0·58, 95% CI 0·41–0·81). During pregnancy, treatment coverage was almost universal in both age groups (98·5%vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcome...