Voluntary termination of pregnancy: An opportunity for Measles, Mumps and Rubella vaccination in an Italian healthcare local unit.

In Italy, the National Plan for the Elimination of Measles and Congenital Rubella 2010-15 suggests offering Measles, Mumps and Rubella (MMR) vaccination to susceptible women who underwent voluntary termination of pregnancy (VTP) In Rome, S. Eugenio Hospital is one of the structures where VTP is practised in an Operative Unit called "Family Planning" The primary goal of this study was to estimate the prevalence of susceptibility to rubella, using IgG and IgM immunoassays, among women accessing VTP and to offering MMR vaccination to susceptible women. Secondarily, this study evaluated acceptance of the vaccination offer From 2013 to 2015, data were collected from 1513 voluntary termination of pregnancy (VTP) cases The results show a significant increase of 5 percent in susceptibility prevalence in the target group from 13.6% in 2013 and 2014 to 18.4% in 2015 The association between rubella susceptibility and age was statistically significant (p<0.01) Throughout the entire period, acceptance of the vaccine proposal was 19% (45/232) among susceptible women; 58% (135/232) refused the vaccine and 23% (52/232) took time to think about it This study shows an increase of 5 percent in the prevalence of rubella susceptibility over two years. This result is worrying, even considering the short span of the data collection The rate of acceptance of vaccination is unsatisfactory considering the possibility of future pregnancies This issue deserves continued action, which, going forward, might transform a "project" into a shared strategy as part of a wider network with the goal of aligning Italy with international recommendations.

[Serum beta hCG levels and transvaginal echography in the early phases of pregnancy]. / Beta hCG plasmatica ed ecografia transvaginale nelle fasi precoci di gravidanza.

One hundred thirty two patients at an early gestational age were monitored every other day to establish beta hCG levels at which the gestational sac, the yolk sac and fetal heart motion can be sonographically detected. These structures were observed at significantly lower beta hCG levels by means of the vaginal probe in comparison with the abdominal one. In normal pregnancy a gestational sac of 1-3 mm was detected at a mean hCG level of 1150 UI/l (range 800-1500); the yolk sac was detected at a mean hCG level of 6000 UI/l (range 4500-7500); fetal hart motion was visible at a mean hCG level of 10,425 UI/l (range 8650-12,200). The yolk sac and fetal heart motion were always detected when the gestational sac was greater than 11 and 17 mm respectively. A practical method to evaluate early first trimester pregnancy is suggested.

[Umbilical flowmetry: effect of measurement sites on the results]. / Flussimetria ombelicale: influenza del sito di misurazione sui risultati ottenuti.

Pulsed Doppler duplex sonography was performed longitudinally on 11 uncomplicated singleton pregnancies from 20 to 41 week's gestation (87 measurements). Blood flow velocities were recorded at 3 locations: abdominal insertion site (O), in the free floating part (C), placental insertion site (PL). The objective of the study was to determine whether the C site S/D ratio, the quickest and easiest to perform, relates to the other sites. The S/D ratio measurements fell from the near abdomen (O) to the free floating part (C) to the placental insertion site (PL) between 25-35 week's gestation. Statistical analysis, including analysis of variance for repeated measures and student t test, showed no significant difference in S/D ratio among the locations before 25 and after 35 week's gestation. The S/D ratio at the O site was significantly higher than at the PL site between 25-35 week's gestation; the C site was not significantly different from the PL site.