@article {8081, title = {New lenses to look at preeclampsia.}, journal = {Gynecol Endocrinol}, year = {2015}, month = {2015 Nov 25}, pages = {1-4}, issn = {1473-0766}, doi = {10.3109/09513590.2015.1115833}, author = {Zullino, Sara and Di Martino, Daniela and Stampalija, Tamara and Ferrazzi, Enrico} } @article {3545, title = {Assessment of coupling between trans-abdominally acquired fetal ECG and uterine activity by bivariate phase-rectified signal averaging analysis.}, journal = {PLoS One}, volume = {9}, year = {2014}, month = {2014}, pages = {e94557}, abstract = {

UNLABELLED: Couplings between uterine contractions (UC) and fetal heart rate (fHR) provide important information on fetal condition during labor. At present, couplings between UC and fHR are assessed by visual analysis and interpretation of cardiotocography. The application of computerized approaches is restricted due to the non-stationarity of the signal, missing data and noise, typical for fHR. Herein, we propose a novel approach to assess couplings between UC and fHR, based on a signal-processing algorithm termed bivariate phase-rectified signal averaging (BPRSA).

METHODS: Electrohysterogram (EHG) and fetal electrocardiogram (fECG) were recorded non-invasively by a trans-abdominal device in 73 women at term with uneventful singleton pregnancy during the first stage of labor. Coupling between UC and fHR was analyzed by BPRSA and by conventional cross power spectral density analysis (CPSD). For both methods, degree of coupling was assessed by the maximum coefficient of coherence (CPRSA and CRAW, respectively) in the UC frequency domain. Coherence values greater than 0.50 were consider significant. CPRSA and CRAW were compared by Wilcoxon test.

RESULTS: At visual inspection BPRSA analysis identified coupled periodicities in 86.3\% (63/73) of the cases. 11/73 (15\%) cases were excluded from further analysis because no 30 minutes of fECG recording without signal loss was available for spectral analysis. Significant coupling was found in 90.3\% (56/62) of the cases analyzed by BPRSA, and in 24.2\% (15/62) of the cases analyzed by CPSD, respectively. The difference between median value of CPRSA and CRAW was highly significant (0.79 [IQR 0.69-0.90] and 0.29 [IQR 0.17-0.47], respectively; p<0.0001).

CONCLUSION: BPRSA is a novel computer-based approach that can be reliably applied to trans-abdominally acquired EHG-fECG. It allows the assessment of correlations between UC and fHR patterns in the majority of labors, overcoming the limitations of non-stationarity and artifacts. Compared to standard techniques of cross-correlations, such as CPSD, BPRSA is significantly superior.

}, keywords = {Electrocardiography, Female, Heart Rate, Fetal, Humans, Labor, Obstetric, Pregnancy, Uterine Contraction}, issn = {1932-6203}, doi = {10.1371/journal.pone.0094557}, author = {Casati, Daniela and Stampalija, Tamara and Rizas, Konstantinos and Ferrazzi, Enrico and Mastroianni, Cristina and Rosti, Eleonora and Quadrifoglio, Mariachiara and Bauer, Axel} } @article {3538, title = {A randomized trial of hyperimmune globulin to prevent congenital cytomegalovirus.}, journal = {N Engl J Med}, volume = {370}, year = {2014}, month = {2014 Apr 3}, pages = {1316-26}, abstract = {

BACKGROUND: Congenital infection with human cytomegalovirus (CMV) is a major cause of morbidity and mortality. In an uncontrolled study published in 2005, administration of CMV-specific hyperimmune globulin to pregnant women with primary CMV infection significantly reduced the rate of intrauterine transmission, from 40\% to 16\%.

METHODS: We evaluated the efficacy of hyperimmune globulin in a phase 2, randomized, placebo-controlled, double-blind study. A total of 124 pregnant women with primary CMV infection at 5 to 26 weeks of gestation were randomly assigned within 6 weeks after the presumed onset of infection to receive hyperimmune globulin or placebo every 4 weeks until 36 weeks of gestation or until detection of CMV in amniotic fluid. The primary end point was congenital infection diagnosed at birth or by means of amniocentesis.

RESULTS: A total of 123 women could be evaluated in the efficacy analysis (1 woman in the placebo group withdrew). The rate of congenital infection was 30\% (18 fetuses or infants of 61 women) in the hyperimmune globulin group and 44\% (27 fetuses or infants of 62 women) in the placebo group (a difference of 14 percentage points; 95\% confidence interval, -3 to 31; P=0.13). There was no significant difference between the two groups or, within each group, between the women who transmitted the virus and those who did not, with respect to levels of virus-specific antibodies, T-cell-mediated immune response, or viral DNA in the blood. The clinical outcome of congenital infection at birth was similar in the two groups. The number of obstetrical adverse events was higher in the hyperimmune globulin group than in the placebo group (13\% vs. 2\%).

CONCLUSIONS: In this study involving 123 women who could be evaluated, treatment with hyperimmune globulin did not significantly modify the course of primary CMV infection during pregnancy. (Funded by Agenzia Italiana del Farmaco; CHIP ClinicalTrials.gov number, NCT00881517; EudraCT no. 2008-006560-11.).

}, keywords = {Adult, Amniocentesis, Cytomegalovirus, Cytomegalovirus Infections, Female, Fetal Diseases, Humans, Immunoglobulins, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious}, issn = {1533-4406}, doi = {10.1056/NEJMoa1310214}, author = {Revello, Maria Grazia and Lazzarotto, Tiziana and Guerra, Brunella and Spinillo, Arsenio and Ferrazzi, Enrico and Kustermann, Alessandra and Guaschino, Secondo and Vergani, Patrizia and Todros, Tullia and Frusca, Tiziana and Arossa, Alessia and Furione, Milena and Rognoni, Vanina and Rizzo, Nicola and Gabrielli, Liliana and Klersy, Catherine and Gerna, Giuseppe} }