Vertical transmission of Human papillomavirus: experience from a center of southern Italy.

BACKGROUND: Human papillomavirus (HPV) represents a group of DNA viruses, sexually transmitted, and widely accepted as a cause of invasive squamous cell carcinomas. The virus prevalence is critical worldwide. However, the possibility of perinatal transmission during pregnancy is not well understood as well as the risks for the newborn. METHODS: Our study analyzed pregnant women referred to the obstetric outpatient room of the Department of Gynecology and Obstetrics of Sant'Anna and San Sebastiano University Hospital in Caserta, Italy. Cervicovaginal samples were achieved from patients during the first trimester and tested for HPV. The specimen was repeated during the third trimester for HPV-positive patients. After the birth, we took a placenta sample and an eye, pharyngeal, mouth, and genital samples in children from HPV positive mothers, at 36-48 hours after birth and three and six months. RESULTS: We found out a high prevalence of HPV infections in the recruited patients: 71 participants were positive at the HPV test in the first trimester (45%), and 17 (14%) showed a positivity in the placental samples. However, there was a low prevalence of viral infection in newborns, and six newborns were positive for HPV at birth (9%). CONCLUSIONS: HPV vertical transmission represents a critical obstetric topic, and the transplacental passage of the virus represents a possible cause. However, further studies are necessary to deepen the pathological mechanism and assess the risks for the newborn.

First trimester fetal anatomy study and identification of major anomalies using 10 standardized scans.

OBJECTIVE: to validate the use of the first trimester scan not just as a screening tool for chromosomal anomalies, but also as a method to identify the major anatomic anomalies using 10 standardized scans. METHODS: five years of prospective study analyzing the fetal anatomy of 5924 patients with a singleton pregnancy during the first trimester screening for chromosomopathies. A check list of 10 predetermined scans had been used. The follow up consisted of two more scans in the second and third trimester, according to the local protocol, and a final evaluation of neonatal outcome at birth. RESULTS: in the 5924 examined patients, the percentage of major malformations is 0.74%, most of all discovered in the first trimester (47.7%). The Detection Rate for the malformations related to the nervous system is about 50% and for the malformations of the abdomen, heart and skeleton is slightly lower (43.5%). CONCLUSIONS: first trimester ultrasound using 10 standardized scans is a valid screening method for chromosomopathies and also an effective method to identify many of the major fetal anato - mical anomalies.

Sonographic diagnosis of fetal cardiac rhabdomyomas and cerebral tubers: a case report of prenatal Tuberous Sclerosis.

UNLABELLED: The rhabdomyoma constitutes more than 60% of all cardiac tumors that are diagnosed in the prenatal and postnatal age. In more than 50% of cases, it is the first clinical manifestation of tuberous sclerosis (TS), autosomal dominant genetic condition and multisystem involvement. METHODS: we report a case of cardiac rabdomyomatosis in twin pregnancy bicorial biamniotic, with suspicion for tuberous sclerosis, diagnosed at our hospital. For the diagnosis of cardiac rhabdomyomas we used the two-dimensional ultrasound, and 3D echocardiography. For the diagnosis of intracranial subependymal nodules an ultrasound and RMN were used. Cesarean section was performed at 34 weeks. The diagnosis of tuberous sclerosis was confirmed at birth by genetic testing. RESULTS: at birth, instrumental examinations have confirmed the ultrasonographic findings and genetic testing for the detection of tuberous sclerosis confirmed the suspected diagnosis. The cardiac lesions regressed spontaneously and the brain showed no progression. CONCLUSION: the study of the fetal heart ultrasound has allowed an early prenatal diagnosis of cardiac neoplasms, allowing control of their development and their association with other lesions which then actually appeared in the suspicion of a genetic disease much more complex than the Tuberous Sclerosis.