Endometriosis is defined as the presence of endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. Deep infiltrating endometriosis (DIE) is considered the most aggressive presentation of the disease, penetrating more than 5 mm in affected tissues, and it is reported in approximately 20% of all women with endometriosis. DIE can cause a complete distortion of the pelvic anatomy and it mainly involves uterosacral ligaments, bladder, rectovaginal septum, rectum, and rectosigmoid colon. This review describes the state of the art in laparoscopic approach for DIE with a special interest in intestinal involvement, according to recent literature findings. Our attention has been focused particularly on full-thickness excision versus shaving technique in deep endometriosis intestinal involvement. Particularly, the aim of this paper is clarifying from the clinical and methodological points of view the best surgical treatment of deep intestinal endometriosis, since there is no standard of care in the literature and in different surgical settings. Indeed, this review tries to suggest when it is advisable to manage the full-thickness excision or the shaving technique, also analyzing perioperative management, main complications, and surgical outcomes.

Placenta is the crucial organ for embryo and fetus development and plays a critical role in the development of fetal growth restriction (FGR). There are increasing evidences on the role of microRNAs (miRNAs) in a variety of pregnancy-related complications such as preeclampsia and FGR. More than 1880 miRNAs have been reported in humans and most of them are expressed in placenta. In this paper, we aimed to review the current evidence about the topic. According to retrieved data, controversial results about placental expression of miRNAs could be due (at least in part) to the different experimental methods used by different groups. Despite the fact that several authors have demonstrated a relatively easy and feasible detection of some miRNAs in maternal whole peripheral blood, costs of these tests should be reduced in order to increase cohorts and have stronger evidence. In this regard, we take the opportunity to solicit future studies on large cohort and adequate statistical power, in order to identify a panel of biomarkers on maternal peripheral blood for early diagnosis of FGR.

Polycystic ovary syndrome (PCOS) is characterized by chronical anovulation and hyperandrogenism which may be present in a different degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome and the failure of inositol-mediated signaling may concur to them. Myo (MI) and D-chiro-inositol (DCI), the most studied inositol isoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan and MI-phosphoglycan control key enzymes were involved in glucose and lipid metabolism. In form of phosphoinositides, they play an important role as second messengers in several cellular biological functions. Considering the key role played by insulin-resistance and androgen excess in PCOS patients, the insulin-sensitizing effects of both MI and DCI were tested in order to ameliorate symptoms and signs of this syndrome, including the possibility to restore patients’ fertility. Accumulating evidence suggests that both isoforms of inositol are effective in improving ovarian function and metabolism in patients with PCOS, although MI showed the most marked effect on the metabolic profile, whereas DCI reduced hyperandrogenism better. The purpose of this review is to provide an update on inositol signaling and correlate data on biological functions of these multifaceted molecules, in view of a rational use for the therapy in women with PCOS.

To assess the risk of the association of single umbilical artery and aneuploidies. In a general unselected obstetric population of 12,672 singleton pregnant women from January 1998 to December 2002, we detected 61 fetuses (prevalence, 0.48%) with single umbilical artery (SUA) on prenatal ultrasound at 16 to 23 menstrual weeks. Among the 61 fetuses with 2-vessel cord, 39 (64%) had SUA as an isolated finding, and 22 (36%) had additional findings, either minor or major. One (2.56%) of the 39 fetuses with SUA as an isolated finding had aneuploidy (trisomy 21 at maternal age of 32 years), whereas 5 (41.6%) of the 12 fetuses with SUA concomitant with major anomalies were aneuploid. None of the 10 fetuses with SUA and minor anomalies had aneuploidy. Among the 12,611 women with 3-vessel cord, we instead found 8 cases of trisomy 21 (0.06%), 1 case of translocation 14-21 (0.007%), 5 cases of trisomy 18 (0.04%), 1 case of trisomy 13 (0.007%), 1 case of 47,XXX (0.007%), and 2 cases of monosomy X (0.01%). In an unselected population, second trimester sonographic detection of SUA and major fetal anomalies indicate increased risk for fetal aneuploidy. However, even if this study is based on a large population, the only 1 case of trisomy 21 among the fetuses with SUA as an isolated finding is not sufficient to draw a conclusion, and larger studies are needed to confirm or infirm this single case.