[Fetal bradycardia during the second stage of labor. Study of 72 cases]. / Bradicardia fetale durante il secondo stadio del travaglio. Studio condotto su 72 casi.

The Authors analyse cardiotocographic patterns characterized by a constant frequency level below 120 beats/minute during the second stage of labour. Some aspects of "terminal bradycardia" (length, amplitude of oscillations, fetal heart rate in the 30 minutes preceding the onset of bradycardia) are related with the condition of the newborn (1st and 5th minute Apgar-score). Terminal bradycardia (Fischer 3, Melchior 2, 3 and 4, 2nd and 4th of Thiery) seems to have an unfavourable prognostic value especially when prolonged (more than 20 minutes), associated with low base-line variability and when cardiotocographic pattern previous to the fall of frequency is characterized by variable and late decelerations.

[Prediction of EPH gestosis by means of the roll-over test. Clinical contribution]. / Predizione della gestosi EPH mediante roll-over test. Contributo clinico.

Roll-over test (ROT) was performed on 128 selected nulliparous women between 28 and 32 weeks of gestation. Considering the high frequency of true-positive (81.5%) and true-negative results (88.1%), ROT seems to show, in clinical practice, a good sensitivity (64.7%) and an excellent specificity (94.7%). The and an excellent specificity (94.7%). The results of this study confirm that ROT is a true predictor of pregnant women at risk for future development of EPH gestosis.

[Functional evaluation of the perineum in pregnancy. Hypertonia of the levator ani muscles]. / Valutazione funzionale del perineo in gravidanza. L'ipertonia dei muscoli elevatori dell'ano.

In this study, the role of "levator ani muscles hypertonia" among pathogenetic factors of perineal obstetric injuries is analysed. For this purpose, clinical data of 142 pregnant women, who underwent functional evaluation of perineum during pregnancy and 30 days after delivery were examined. Data here reported are not sufficient to confirm the importance of this factor within the pathogenesis of postpartum perineal deficiency. Levator ani hypertonia on one hand seems to be able to obstruct fetal progression, on the other hand it presumably constitutes, as an expression of a good voluntary control of perineal muscles, a favourable prognostic factor.

[Functional evaluation of the perineum in pregnancy. Inversion of control]. / Valutazione funzionale del perineo in gravidanza. L'inversione del comando.

This study concerns clinical data of 142 women, who were subjected to functional evaluation of perineum during the last part of pregnancy. The 16 cases characterized by synergic activation, during the examination of perineal muscles ("perineal testing"), of antagonist muscles ("inverted control"), were examined taking into account data regarding evolution of labour and perineal outcome. "Inverted control" seems to influence, in this study, length of the second stage and frequency of operative deliveries whereas we can't confirm the importance of this disorder within pathogenesis of perineal obstetric complications.

[Monitoring of protracted pregnancy. Comparison of two methods]. / Monitoraggio della gravidanza protratta. Due metodiche a confronto.

Antepartum cardiotocographic patterns (NsT:Nonstress Test) and echographic assessments of amniotic fluid pockets were retrospectively analysed in 63 postdate pregnancies. The results of NsT (Fisher-score) and ecographic examinations were correlated with obstetric outcome (5 minutes Apgar-score). Ecographic assessments of amniotic volumes seem more effective than NsT for the lower frequency of false-positive results. Anyhow, considering the low sensibility of NsT and Echography separatedly considered, the Authors suggest a simultaneous valuation of the two tests.

[Oligoamnios in protracted pregnancy. Cardiotocographic aspects]. / L'oligoamnios nella gravidanza oltre il termine. Aspetti del cardiotocogramma.

Ecographic assessments of amniotic fluid volumes and their relationship to ante-partum cardiotocographic patterns were retrospectively analyzed in 59 postdate pregnancies. Sonographic evidence of oligoamnios is significantly related with absence of sporadic accelerations and rarity of fetal movements.

[Therapeutic proposals in vulvar dystrophy and burning vulva]. / Proposte terapeutiche nella distrofia vulvare e nella "burning vulva".

The paper reports the results of 80 cases of vulvar dystrophy and 11 cases of burning vulva. The Authors put forward a protocol for therapy which also aims to provide the basis for a comparative study of this pathology about which little is known from a clinical and research point of view.

Our experience with direct intraperitoneal insemination (DIPI) as a treatment for infertile couples.

The therapeutic value of Direct Intraperitoneal Insemination (DIPI) is of particular interest in cases of unexplained infertility and failed AID. The same technique is less likely to be successful where functional or morphological semen abnormalities or multifactorial infertility exist. The Authors report their own experience with DIPI as a treatment on 76 couples with a long-standing infertility.

[Static anomalies of the pelvis caused by labor. Maternal weight increase during pregnancy as a risk factor]. / Le anomalie della statica pelvica conseguenti al parto. L'incremento ponderale gravidico materno quale fattore di rischio.

In this retrospective study, the role of Gravidic Maternal Ponderal Increase (GMPI) within pathogenetic factors of perineal obstetric injuries, is analysed. TO this purpose, clinical data of 58 puerperae, who underwent a functional evaluation of perineum 30 days after delivery, were examined. The results of this study seem to indicate an autonomous pathogenetic role of GMPI, besides the indirect relation deriving from the association with other risk factors (age, parity, diabetes, fetal megalosomia, ecc).

Use of GnRH depot analogue in the treatment of uterine fibroids.

Twelve patients with symptomatic uterine fibroid were treated with Goserelin acetate, a depot Gn-RH analogue administered s.c. in a dosage of 3.6 mg every 28 days for a 6 month period. Mean age of the patients was 39 (26-47). A menopausal-like state, evidenced by hot flushes, depression, vaginal dryness, hysteroscopic endometrial atrophy, and hormonal values (FSH, LH, E2), was seen in all patients. After only two months of treatment, a significant reduction was noted in the size of the fibroid, being even greater than that in the following four months. Only one patient in the series underwent surgery. General tolerability of the drug was optimal. These data suggest the efficiency of this type of treatment in obtaining a significant reduction of fibroid volume as well as subjective symptomatology. The cost-benefit ratio is optimal, allowing postponement of surgery and the possibility of vaginal, as opposed to abdominal, hysterectomy and affronting problems of anaesthesiology and post-operative recovery for patients "at risk".