Growth retardation, size at birth and perinatal mortality in twin pregnancy.

The records of 194 consecutive pairs of twins were reviewed. Univariate and multivariate analyses of relative risks (RR) of perinatal death were performed. Perinatal mortality rate was higher in small-for-gestational-age twins and in fetuses with discordancy in size at birth more than 20% and 25%. The RR of perinatal death for small-for-gestational-age twins was 4.8 (2.74-8.42 95% CI). For intertwin birth-weight percent differences of 20% and 25%, the RR was 5.48 (3.2-9.38 95% CI) and 7.2 (3.87-13.42 95% CI). Population mortality attributable risk in the two populations (10.36% and 14.5%, respectively) demonstrates the importance of the prenatal assessment of the respective size of twins in preventing perinatal death.

Assessment of peri-neonatal mortality and morbidity risk in twin pregnancy.

A case control study on peri-neonatal mortality and morbidity rates in 154 twin pregnancies has been performed. The mortality rates along with main neonatal morbidity factors were evaluated in relation to the birth weight and gestational age. The risk of death in peri-neonatal period was 17 times greater (relative risk 17.30) (p less than .00005) in newborns weighing less than 2000 g and about 15 times (r.r. 14.53) (p less than .00005) in twins born before 34th week of gestational age with respect to the controls. The Apgar score of the 2nd twin was lower than that of the 1st, both at 1' (p less than .05) and 5' (p less than .025). The development of HMD was strongly influenced by the gestational age when less than 34th week (r.r. 15.89) (p less than .00005). No difference in incidence was found between the newborns with gestational age between 34-37 weeks and those at term. The potential implications of these findings on obstetric and neonatologic treatment of LBW and VLBW twins was discussed.

The significance of ponderal index as a prognostic factor in a low-birth-weight population.

Neonatal prognostic significance of some biometric parameters in a population study of 331 low-birth-weight newborns was investigated. Multiple logistic regression analysis demonstrates that length, head size and weight are the best predictors of neonatal outcome in small for gestational age (SGA) newborns. In the population of SGA newborns biometric parameters more affected by growth failure were thoracic circumference, weight, head circumference and length, in that order. It seems that the best parameters for the sonographic diagnosis of growth failure are the poorest predictors of neonatal outcome. The possible role of ponderal index as an expression of fetal and neonatal well-being is discussed.

Microinvasive carcinoma of the vulva.

A case of microcarcinoma of the vulva (depth of invasion less than 5 mm) with an unexpected natural history is reported. The 338 cases, up today, reported in literature are reviewed and therapeutical protocols discussed.

[Risk factors in maternal-fetal infections. Research conducted in 93 cases]. / Fattori di rischio nell'ambito dell'infezione materno fetale (IMF). Indagine condotta su 93 casi.

The results of microbiologic cultures from 186 vaginal samples obtained from 93 labouring women have been compared with the results of the microbiologic cultures from meconium of their newborns, to test possible risk-factors for IMF. The high frequency of positive cultures from vaginal samples (83.3%), constantly with strong bacterial charge, and the proved direct mother to foetus transmission for many potential pathogens (23.6%), cause various interpretative problems and require further studies.

[On the possibility of correlation between an IUD and endometriosis]. / Sulla possibilità di correlazione tra IUD ed endometriosi.

PIP: 2 women, wearers of IUD for 3 and 5 years, without antecedent bynecological pathology were examined for dysmenorrhea, pain, and galactorrhea in one case. Celioscopy revealed the presence of ovarian endometriosis in both cases. Both patients were treated with danazol at 800 mg per diem for 6 months; prolactin, follicle stimulating hormone and luteinizing hormone values were controlled at beginning of treatment and at every 2 months. Both patients were completely cured at 6 and at 8 months after beginning of treatment. It is suggested that a relationship exists between IUD presence and the development of endometriosis, since an IUD may influence all immunity through changes in the hormonal situation; both cases presented here had increased prolactin levels. Danazol, a synthetic derivative of androgen with antigonadotropic action, produces regression of endometriosis by completely suppressing ovarian activity.^ieng