Browsing by Author "Lagana, Antonio Simone"

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The Influence of Advanced Age and Obesity on Pregnancy Course and Outcome in Patients With Diabetes Mellitus
(Termedia Publishing House Ltd, 2022) Bapayeva, Gauri; Terzic, Sanja; Dotlic, Jelena; Togyzbayeva, Karlygash; Bugibaeva, Ulzhan; Mustafinova, Madina; Lagana, Antonio Simone
Introduction: Older women are at greater risk of suffering from a series of comorbidities such as obe-sity, diabetes, and hypertension that could negatively affect pregnancy course and outcomes. This study aims to investigate the impact of maternal age and pre-pregnancy body mass index (BMI) on pregnancy outcomes of women with diabetes mellitus (DM).Material and methods: The study included 323 diabetic pregnant women. All complications throughout pregnancy and the early neonatal period were noted. The women were divided into groups according to age decade and BMI.Results: 84.8% of women reported pregnancy complications, with a higher prevalence in obese women (p = 0.003). However, most children had a good outcome with few early neonatal complications (36.85%). Old and obese women with DM often showed complications, and their newborns had higher birth weight (p = 0.003) and more neonatal complications (p = 0.041). Maternal BMI (p = 0.016; OR = 1.064), but not age (p = 0.801), was found to be a significant predictor of pregnancy complications.Conclusions: Pregnant women with DM should be considered as high-risk patients. Advanced age and increased BMI prior to pregnancy are risk factors for pregnancy complications. Maternal obesity is the most important predictor of pregnancy complications in women with DM. Pregnancy outcome can be good for both mothers and children with a timely and adequate approach.
Management of Women Affected by Endometriosis: Are We Stepping Forward
(Sage Publications Ltd, 2019) Di Guardo, Federica; Shah, Mohsin; Cerana, Maria Cecilia; Biondi, Antonio; Karaman, Erbil; Torok, Peter; Lagana, Antonio Simone
Endometriosis is an estrogen-dependent chronic disease defined by the presence of endometrial-like tissue, glands and stroma in ectopic areas. Among all the pathogenic theories proposed to explain the origin of the disease, a pivotal role for immune, hormonal, and epigenetic disbalances have been hypothesized. Endometriosis affects up to 10%-15% of women in reproductive age and represents one of the most common gynecological causes of severe pelvic pain. The main symptoms reported by patients are dysmenorrhea and deep dyspareunia. Although the histological confirmation has been commonly considered mandatory, to date the possibility offered by the improvement in imagining techniques allows to make a proper diagnosis of the disease in most of the cases. Medical therapy represents only a symptomatic treatment and not the definitive solution. The aim of the hormonal therapy is to abolish the menstrual flow using progestin, oral contraceptives, and gonadotropin-releasing hormone agonists to reduce pelvic pain. Surgical treatment consisting of laparoscopy has the goal of abolishing pain and may be conservative or radical in nature depending on the patients' desire of spontaneous conception in the future. Radical surgery seems to be associated with a higher percentage of pain relief as well as higher recurrence rates. Due to the worldwide acceptance and the ongoing evolution of minimally invasive surgery to treat both benign and malignant diseases, future investigations may be conducted to consider this approach to save the function of all the organs involved by the disease and to reduce post-operative discomfort and psychological impact.