Evaluation of Borderline Ovarian Tumor Recurrence Rate after Surgery with or without Fertility-Sparing Approach: Results of a Retrospective Analysis.

Borderline ovarian tumors (BOTs) comprise 15-20% of primary ovarian neoplasms and represent an independent disease entity among epithelial ovarian cancers. The present study (Clinical Trial ID: NCT05791838) aimed to report a retrospective analysis of the management and outcomes of 86 consecutive BOTs patients, 54 of which were at a reproductive age. All patients with BOTs undergoing surgical treatment from January 2010 to December 2017 were included. Data were retrospectively reviewed. High levels of Ca-125 were observed in 25.6% of the FIGO stage I patients and 58.3% of the advanced disease patients. Fertility-sparing surgery and comprehensive surgical staging were performed in 36.7% and 49.3% of the patients, respectively. Laparotomy was the most frequent surgical approach (65.1%). The most common diagnosis at frozen sections was serous BOT (50.6%). Serous BOTs have significantly smaller tumor diameters than mucinous BOTs (p < 0.0001). The mean postoperative follow-up was 29.8 months (range 6-87 months). Three patients experienced a recurrence, with an overall recurrence rate of 3.5% (10% considering only the patients who underwent fertility-sparing treatment). BOTs have low recurrence rates, with excellent prognosis. Surgery with proper staging is the main treatment. Conservative surgery is a valid option for women with reproductive potential.

Poor maternal-neonatal outcomes in pregnant patients with confirmed SARS-Cov-2 infection: analysis of 145 cases.

PURPOSE: The coronavirus 2 (SARS-CoV-2) infection has recently spread causing millions of individuals affected globally. The raising mortality rate highlighted the necessity to identify the most susceptible populations, such as pregnant women and their fetuses, in order to protect them. Few studies have been conducted trying to identify maternal-neonatal outcomes among pregnant patients affected by COVID 19. In this scenario, this study aims to analyse poor maternal-neonatal outcomes in pregnant women affected by SARS-CoV-2 infection. METHODS: This was a double-centre, 5 months retrospective analysis conducted in Italy. The study population consisted of pregnant women with confirmed SARS-CoV-2 infection assessed by Time Quantitative Reverse Transcription PCR (qRT-PCR) nasopharyngeal swabs. RESULTS: 145 pregnant women affected by confirmed SARS-CoV-2 infection were included. Among them, 116 (80%) were symptomatic and 29 (20%) were asymptomatic. Up to half of the patients (n = 111; 76.5%) had a past history of respiratory disease. The mean gestational age at delivery was 36 weeks ± 5 days, while the mean maternal age was 31.5 ± 5.63. Reactive C protein (CRP) serum levels were higher than the normal range corresponding to a mean value of 56.93 ± 49.57 mg/L. The mean interval between the diagnosis of maternal COVID-19 infection and the delivery was 8.5 days. With regard to the type of delivery, the percentage of patients who delivered vaginally was higher than those who experienced a caesarean section. (74.4% vs 25.6%). The percentage of term birth was higher than preterm one (62% vs 38%). Finally, the percentages of maternal and neonatal death were found to be 5% and 6%, respectively; similarly, the percentage of the infection vertical transmission was 5%. CONCLUSION: COVID-19 infection in pregnant women seems to negatively affect both maternal and neonatal outcomes. However, it is important to emphasize that most of the cases of maternal death occurred in patients with severe symptoms and highly altered parameters related to SARS-CoV-2 infection. In the future, larger studies are warranted in order to validate these findings.

Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study.

AIM: Evaluate the relationship between neonatal weight and pregnancy-associated plasma protein-A. METHODS: Retrospective study on 2564 singleton pregnancies with healthy term neonates in three groups of women with different values of pregnancy-associated plasma protein-A who underwent the combined test during the first trimester. Non-parametric test and correlation analysis for statistical elaboration were carried out. RESULTS: There exists a correlation between the serum levels of pregnancy-associated plasma protein-A in the first trimester of pregnancy and neonatal weight. Values of pregnancy-associated plasma protein-A lower than the 25th percentile are associated with neonatal weight in a significant way. There was no significant association between pregnancy-associated plasma protein-A values above 1.50 MoM and neonatal weight. CONCLUSION: This study confirms the positive correlation between circulating concentrations of pregnancy-associated plasma protein-A and fetal growth. Low neonatal weight and factors that can cause this could be determined from the first trimester by measuring the concentrations of pregnancy-associated plasma protein-A in maternal serum. Even if the association between the levels of pregnancy-associated plasma protein-A and a low neonatal weight has been demonstrated, however, we have to say that the sensitivity of a such screening method for the prediction of low birth weight and perinatal complications seems to be rather low. The variations of pregnancy-associated plasma protein-A during the first trimester cannot be used as a marker of excessive fetal growth.