The specific effects of gestational diabetes mellitus (GDM) on twin pregnancy outcomes, which are at high risk per se, are unclear. The present study analyzes outcomes of twin pregnancies complicated by GDM (n = 227) by comparing them with GDM singleton pregnancies (n = 1060) and with twin pregnancies without GDM (n = 1008), all followed up at Sant’Anna Hospital, Turin (Italy), between January 2010 and March 2020. The prevalence of GDM among twin pregnancies (n = 1235) was 18.4%. Compared to GDM singletons, GDM twins had higher rates of preeclampsia (aOR 2.0; 95% CI 1.2–3.8), cesarean section (aOR 7.5; 95% CI 5.2–10.8), and neonatal hypoglycemia (aOR 2.5; 95% CI 1.1–5.3). They had a higher incidence of abnormal 2 h OGTT values (aOR 7.1; 95% CI: 3.2–15.7) and were less likely to require insulin therapy (aOR 0.5; 95% CI: 0.3–0.7). In comparison with twin pregnancies without GDM, women with GDM twins were significantly older (35.0 vs. 33.0 years; p < 0.001) and had higher BMI (23.0 versus 22.0 kg/m2; p < 0.001); they had a higher incidence of LGA newborns (aOR 5.3; 95% CI 1.7–14.8), and lower incidence of low APGAR scores (0.5; 95% CI 0.3–0.9). Overall, GDM does not worsen outcomes of twin pregnancy, which is per se at high risk for adverse outcomes.

Adequate re-suspension of only the apex was sufficient to correct other vaginal compartments, even for women with preoperative multi-compartment prolapse higher than POP-Q stage 2. The "simplified" laparoscopic sacropexy was an efficacious intraoperative time-saving technique; it could reduce adverse events caused by deep vaginal dissection up to puborectal muscles and the bladder trigone.

Colorectal cancer (CRC) during pregnancy presents an estimated incidence of 1 : 13,000, and it is associated with diagnostic and therapeutic challenges. Here, we present the case of a 38-year-old woman, 25 weeks and 5 days pregnant, who was transferred to our Obstetrics and Gynecology Department from a local hospital with the diagnosis of intestinal obstruction. Magnetic Resonance Imaging (MRI) showed marked distension with hydroaerial levels of the enterocolic loops upstream of a concentric parietal thickening of the descending colon, stenosing, extended longitudinally for about 4 cm. An exploratory laparotomy was performed with resection of the colon splenic flexure and mechanical end-terminal anastomosis. Histological examination of the operating piece highlighted the presence of moderately differentiated (G2) colon adenocarcinoma (stage pT3N1b). The operation was followed by a single course of oxaliplatin and 5-FU plus leukovorin. The patient had a vaginal delivery at 37   weeks + 2 days of gestational age, following induction of labor and giving birth to a male infant whose weight was 2670 gr with apgar 9/9. We underline the pivotal role of attention to unspecific symptoms, early diagnosis, and active treatment in changing the clinical course of CRC.

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Aim:To assess if fetal fibronectin testing is being performed on the correct patients and how the results of this test is impacting on our management of patients presenting with threatened preterm labour.Method: Retrospective review of 33 charts where a fetal fibronectin test would have been deemed appropriate.Main results: The gestational age ranged from 24 + 3 weeks to 35 + 6 weeks gestation. Patients presented with abdominal pain, tightenings, contractions or backache. All patients were assessed by midwifery and medical staff and of the 33 patients who met the criteria for fetal fibronectin testing, 30 patients has the test. Of the 3 who did not have the test, one discharged herself from hospital before the test could be preformed, 1 patient had a recent negative result and 1 patient was clinically assessed and the test felt not to be appropriate. There were 4 positive results and 26 negative results. All 4 patients with positive results were admitted to hospital with one of those being transferred to another hospital as no cot was available in Antrim Area Hospital. 3 out of the 4 patients had steroids and tocolysis. The 4th patient had recently completed a course of steroids. There was a 50% admission rate for those with a negative result and 15% of those were given steroids. 15% of those admitted with a negative result were treated for a urinary tract infection. There were 6 deliveries before 37 weeks. 4 of these patients had tested negative and 2 had a positive fetal fibronectin test. The earliest delivery was at 34 + 3 weeks, having had a positive fetal fibronectin test at 32 + 3 weeks. The latest delivery was at 36 + 2 weeks, having had a positive fetal fibronectin test at 29 + 6 weeks. Of the 4 patients who delivered with a negative fetal fibronectin test, the gestation ranged from 35 + 5 to 36 + 2 weeks. 2 had spontaneous onset of labour, 1 was induced and 1 had an emergency C/Section for scar pain. All deliveries were in Antrim Area Hospital.Conclusion: Fetal fibronectin can be a useful test if used appropriately. A positive test cannot tell us when labour will occur but allows us to treat these patients as high risk and administer steroids and tocolytics. This was the cases with our patients who had a positive test. A negative result can provide reassurance that preterm labour is unlikely in the next 7-10 days. However in our review we found that 50% patients with a negative test were still being admitted and 15% of these received steroids. Overall management of those with a positive test was excellent but we need to manage those with a negative test better. Current management has financial consequences with possible un-necessary admissions plus timing of steroid administration may not be optimal.http://dx.(O. Ami).Purpose: 3D reconstruction of birthcanal and fetus was obtained from imaging performed with 1 T open field MRI before and during childbirth on 10 patients. Fetal head molding and birthcanal changes are fully described in 3D vectorial meshes.Method and materials: 10 women were enrolled in th...