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Hammouri I, Hilail IA, Zalloum J, Alamlih L, Nasereddin M, Rajabi M, Shalalfeh S, Natsheh Z, Elessi K, Jayyab MA, Astal M, Al-Dahdouh M, Salameh AE, Ayyad A, Dawod N, Alsaid H, Matar I, Hassan M, Bakeer M, Malasah M, Abuhashem S, Salem M, Lunca S, Dimofte MG, Morarasu S, Musina AM, Roata CE, Velenciuc N, Butyrskii A, Bozhko M, Ametov A, Chowdhury S, Bagazi D, Domenech J, Rosello-Añon A, Monis A, Chiappe C, Cuneo B, Clemente-Navarro P, Febre J, Sanz-Romera J, Lopez-Vega M, Miranda I, Valverde-Vazquez R, Garcia S, Sanguesa MJ, Balciscueta Z, Ruiz E, Marco E, Talavera E, Farre J, Bacariza L, Duart M, Ureña V, Carre X, Hamid HKS, Abd-Albain MA, Galal-Eldin S, Sarih M, Adam E, Ismail S, Azhari M, Hassan T, Salaheldein M, Abdalla Z, Ahmed W, Alhassan M, Mohamed A, Suliman HMA, Eltayeb MOM, Ahmed RAA, Babekir EMA, Khairy MAT, Mukhtar MMA, Ali RAH, Al-Shambaty YBA, Yousif FI, Mohammed HMH, Osher L, Osher L, Abdelbast M, Yassin M, Moawia N, Abdalsadeg R, Husein A, Elhassan B, Abdelbagi AY, Adam MA, Ali EM, Mohammed IAB, Mohamed M, Abdulaziz M, Akasha M, Hassan M, Hilal N, Mohamed NAA, Abubaker N, Mohammed O, Mohamed S, Osman W, Mustafa F, Salih AA, Ali D, Almakki DMA, Mohamed HE, Elmubark A, Hassan M, Alnour A, Elaagib A, Abdelrahman A, Abdelkhalig M, Eldaim KN, Babiker A, Ahmed E, Ali M, Hussain E, Wedatalla M, Ahmed A, Hamza AA, Mohammed M, Osman O, Ibrahim R, Ahmed R, Ahmed R, Yasir R, Awadallah S, Mohmmed S, Hassan S, Shaban W, Hussein A, Rafea R, Abdalla A, Ahmed A, Mohamed K, Mohammed M, Altahir M, Adam M, Mohamed O, Abdullah W, Fadlalmola H, Abdalla AY, Omer AA, Mustafa AA, Elhadi REH, Banaga EEA, Osman F, Abdalla MGA, Taha HAM, Abdalmahmoud NE, Nafie RH, Jamal S, Ahmed S, Ali RA, Aladna A, Aljoumaa A, Nawfal H, Jamali S, Khouja F, Niazi A, Al Rawashdeh T, Kechiche N, Gara M, Nasr M, Baccar M, Benamor O, Chakroun S, Sanli AN, Yildiz A, Demirkiran MA, Atadag YB, Tandogan YI, Ozkan E, Ozer Y, Ozkan E, Oncel MM, Kalkan S, Gover T, Manoglu B, Oksak I, Kurt I, Rifaioglu K, Sokmen S, Bisgin T, Yildirim Y, Keskin AY, Dogan T, Sahin Bİ, Aydin C, Benek DE, Tiras HN, Arslangilay M, Aslangilay M, Yaytokgil M, Capar MA, Yazgan Y, Bektas S, Alagoz AC, Dagsali AE, Izgis A, Uzel K, Soytas M, Cakir N, Askin AE, Azboy I, Sabuncu K, Aslan M, Sahin M, Oncel M, Okkabaz N, Sivrikaya RK, Saylar A, Saylar A, Yasar M, Erginoz E, Bozkir HO, Zengin K, Ozcelik MF, Uludag SS, Ozdemir Z, Sibic O, Telci H, Bozkurt MA, Kara Y, Tepe MD, Gündoğdu A, Akın B, Pehlivan D, Guner A, Baysallar D, Yıldız B, Cepe H, Reis ME, Yuzgec AN, Kıralı N, Kodalak TA, Ulusahin M, Selim K, Kale A, Gecici ME, Ozbilen M, Düzyol Z, Gemici A, Korkmaz E, Şen E, Taşcı ME, Camkıran E, Elieyioğlu G, Kayabaş İ, Uprak TK, Aral C, Saraçoğlu A, Uğurlu MÜ, Baltacı ZH, Akkaya EN, Fergar C, Tabak EZ, Kocyigit GZ, Kayilioglu I, Polat S, Çolak E, Kara ME, Candan M, Uyanık MS, Sarı AC, Ulkucu A, Certel AT, Dindar A, Durdu B, Bayram C, Kaya E, Akdere H, Cakcak IE, Yavuz I, Omur M, Ajredini M, Aydoğdu EO, Şenödeyici E, Koksoy UC, Kazbek BK, Korkmaz DS, Yavuz D, Yilmaz H, Cetınkaya ZS, Durmus E, Tuzuner F, Hokelekli F, Mutlu M, Akbuz SO, Kus ZC, Kus ZC, Farrell M, Craig-Lucas A, Painter M, Titan A, Narayan A, Fariyike B, Knowlton L, Yue T, Benham E, Nimeri A, Werenski H, Kaiser N, Reinke C. Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries. Br J Surg 2024; 111:znad421. [PMID: 38207169 PMCID: PMC10783642 DOI: 10.1093/bjs/znad421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. METHODS This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. RESULTS The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not. CONCLUSION Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely.
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Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MDLAA, Aguilar Galán EV, López YC, De León Luis JA, Hernández IC, Herraiz I, Villalain C, Venturella R, Rizzo G, Mappa I, Gerosolima G, Hellmeyer L, Königbauer J, Ameli G, Frusca T, Volpe N, Luca Schera GB, Fieni S, Esposito E, Simonazzi G, Di Donna G, Youssef A, Della Gatta AN, Di Donna MC, Chiantera V, Buono N, Sozzi G, Greco P, Morano D, Bianchi B, Lombana Marino MG, Laraud F, Ramone A, Cagnacci A, Barra F, Gustavino C, Ferrero S, Ghezzi F, Cromi A, Laganà AS, Laurita Longo V, Stollagli F, Sirico A, Lanzone A, Driul L, Cecchini D F, Xodo S, Rodriguez B, Mercado-Olivares F, Elkafrawi D, Sisti G, Esposito R, Coviello A, Cerbone M, Morlando M, Schiattarella A, Colacurci N, De Franciscis P, Cataneo I, Lenzi M, Sandri F, Buscemi R, Gattei G, Sala FD, Valori E, Rovellotti MC, Done E, Faron G, Gucciardo L, Esposito V, Vena F, Giancotti A, Brunelli R, Muzii L, Nappi L, Sorrentino F, Vasciaveo L, Liberati M, Buca D, Leombroni M, Di Sebastiano F, Di Tizio L, Gazzolo D, Franchi M, Ianniciello QC, Garzon S, Petriglia G, Borrello L, Nieto-Calvache AJ, Burgos-Luna JM, Kadji C, Carlin A, Bevilacqua E, Moucho M, Pinto PV, Figueiredo R, Morales Roselló J, Loscalzo G, Martinez-Varea A, Diago V, Jimenez Lopez JS, Aykanat AY, Cosma S, Carosso A, Benedetto C, Bermejo A, May Feuerschuette OH, Uyaniklar O, Ocakouglu SR, Atak Z, Gündüz R, Haberal ET, Froessler B, Parange A, Palm P, Samardjiski I, Taccaliti C, Okuyan E, Daskalakis G, Moreira de Sa RA, Pittaro A, Gonzalez-Duran ML, Guisan AC, Genç ŞÖ, Zlatohlávková B, Piqueras AL, Oliva DE, Cil AP, Api O, Antsaklis P, Ples L, Kyvernitakis I, Maul H, Malan M, Lila A, Granese R, Ercoli A, Zoccali G, Villasco A, Biglia N, Madalina C, Costa E, Daelemans C, Pintiaux A, Cueto E, Hadar E, Dollinger S, Brzezinski Sinai NA, Huertas E, Arango P, Sanchez A, Schvartzman JA, Cojocaru L, Turan S, Turan O, Di Dedda MC, Molpeceres RG, Zdjelar S, Premru-Srsen T, Cerar LK, Druškovič M, De Robertis V, Stefanovic V, Nupponen I, Nelskylä K, Khodjaeva Z, Gorina KA, Sukhikh GT, Maruotti GM, Visentin S, Cosmi E, Ferrari J, Gatti A, Luvero D, Angioli R, Puri L, Palumbo M, D'Urso G, Colaleo F, Chiara Rapisarda AM, Carbone IF, Mollo A, Nazzaro G, Locci M, Guida M, Di Spiezio Sardo A, Panici PB, Berghella V, Flacco ME, Manzoli L, Bifulco G, Scambia G, Zullo F, D'Antonio F. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. J Perinat Med 2020; 48:950-958. [PMID: 32975205 DOI: 10.1515/jpm-2020-0355] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.
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Affiliation(s)
- Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Cihat Sen
- Perinatal Medicine Foundation and Department of Perinatal Medicine, Memorial Hospital, Istanbul, Turkey
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Alberto Galindo
- Fetal Medicine Unit, Maternal and Child Health and Development Network, University Hospital 12 de Octubre, Complutense University of MadridDepartment of Obstetrics and Gynaecology, Madrid, Spain
| | - Amos Grünebaum
- Department of Obstetrics and Gynaecology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jun Yoshimatsu
- Department of Perinatology and Gynaecology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Milan Stanojevic
- Department of Obstetrics and Gynaecology, Medical School University of Zagreb, Sveti Duh University Hospital, Zagreb, Croatia
| | - Asım Kurjak
- Department of Obstetrics and Gynaecology, Medical School University of Zagreb, Sveti Duh University Hospital, Zagreb, Croatia
| | - Frank Chervenak
- Department of Obstetrics and Gynaecology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | | | - María de Los Angeles Anaya Baz
- Department of Obstetrics and Gynaecology, Ciudad Real University General Hospital, Ciudad Real, Spain
- University of Castilla-La Mancha, Ciudad Real, Spain
| | - Esther Vanessa Aguilar Galán
- Department of Obstetrics and Gynaecology, Ciudad Real University General Hospital, Ciudad Real, Spain
- University of Castilla-La Mancha, Ciudad Real, Spain
| | - Yolanda Cuñarro López
- Fetal Medicine Unit, Maternal and Child Health anad Development Network, Gregorio Marañón Hospital, Complutense University of Madrid, Department of Obstetrics and Gynaecology, Madrid, Spain
| | - Juan Antonio De León Luis
- Fetal Medicine Unit, Maternal and Child Health anad Development Network, Gregorio Marañón Hospital, Complutense University of Madrid, Department of Obstetrics and Gynaecology, Madrid, Spain
| | - Ignacio Cueto Hernández
- Fetal Medicine Unit, Maternal and Child Health anad Development Network, Gregorio Marañón Hospital, Complutense University of Madrid, Department of Obstetrics and Gynaecology, Madrid, Spain
| | - Ignacio Herraiz
- Fetal Medicine Unit, Maternal and Child Health and Development Network, University Hospital 12 de Octubre, Complutense University of MadridDepartment of Obstetrics and Gynaecology, Madrid, Spain
| | - Cecilia Villalain
- Fetal Medicine Unit, Maternal and Child Health and Development Network, University Hospital 12 de Octubre, Complutense University of MadridDepartment of Obstetrics and Gynaecology, Madrid, Spain
| | - Roberta Venturella
- Department of Obstetrics and Gynaecology, School of Medicin, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Rizzo
- University of Roma Tor Vergata, Division of Maternal Fetal Medicine, Ospedale Cristo Re Roma, Rome, Italy
- Department of Obstetrics and Gynaecology The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Ilenia Mappa
- University of Roma Tor Vergata, Division of Maternal Fetal Medicine, Ospedale Cristo Re Roma, Rome, Italy
| | - Giovanni Gerosolima
- Department of Obstetrics and Gynaecology, Ospedale AOSG Moscati, Avellino, Italy
| | - Lars Hellmeyer
- Department of Gynaecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Josefine Königbauer
- Department of Gynaecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Giada Ameli
- Department of Gynaecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Tiziana Frusca
- Department of Obstetrics and Gynaecology, University of Parma, Parma, Italy
| | - Nicola Volpe
- Department of Obstetrics and Gynaecology, University of Parma, Parma, Italy
| | | | - Stefania Fieni
- Department of Obstetrics and Gynaecology, University of Parma, Parma, Italy
| | - Eutalia Esposito
- Department of Obstetrics and Gynaecology, Ospedale di San Leonardo, Castellammare di Stabia, Italy
| | - Giuliana Simonazzi
- Department of Obstetrics and Gynaecology, University of Bologna, Sant'Orsola- Malpighi University Hospital, Bologna, Italy
| | - Gaetana Di Donna
- Department of Obstetrics and Gynaecology, University of Bologna, Sant'Orsola- Malpighi University Hospital, Bologna, Italy
| | - Aly Youssef
- Department of Obstetrics and Gynaecology, University of Bologna, Sant'Orsola- Malpighi University Hospital, Bologna, Italy
| | - Anna Nunzia Della Gatta
- Department of Obstetrics and Gynaecology, University of Bologna, Sant'Orsola- Malpighi University Hospital, Bologna, Italy
| | | | - Vito Chiantera
- Department of Gynaecologic Oncology, University of Palermo, Palermo, Sicilia, Italy
| | - Natalina Buono
- Department of Gynaecologic Oncology, University of Palermo, Palermo, Sicilia, Italy
| | - Giulio Sozzi
- Department of Gynaecologic Oncology, University of Palermo, Palermo, Sicilia, Italy
| | - Pantaleo Greco
- Department of Medical Sciences, Section of Obstetrics and Gynaecology, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy
| | - Danila Morano
- Department of Medical Sciences, Section of Obstetrics and Gynaecology, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy
| | - Beatrice Bianchi
- Department of Medical Sciences, Section of Obstetrics and Gynaecology, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Lombana Marino
- Department of Medical Sciences, Section of Obstetrics and Gynaecology, Azienda Ospedaliera-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy
| | - Federica Laraud
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Arianna Ramone
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Angelo Cagnacci
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Claudio Gustavino
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospita University of Insubria, Varese, Italy
| | - Antonella Cromi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospita University of Insubria, Varese, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospita University of Insubria, Varese, Italy
| | - Valentina Laurita Longo
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
- Queen Margaret University,Institute for Global Health and Development, Edinburgh, UK
| | - Francesca Stollagli
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Sirico
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Lanzone
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenza Driul
- Clinic of Obstetrics and Gynaecology, University of Udine, Udine, Italy
| | | | - Serena Xodo
- Clinic of Obstetrics and Gynaecology, University of Udine, Udine, Italy
| | - Brian Rodriguez
- Department of Obstetrics and Gynaecology, New York Health and Hospitals/Lincoln Bronx, The Bronx, NY, USA
| | - Felipe Mercado-Olivares
- Department of Obstetrics and Gynaecology, New York Health and Hospitals/Lincoln Bronx, The Bronx, NY, USA
| | - Deena Elkafrawi
- Department of Obstetrics and Gynaecology, New York Health and Hospitals/Lincoln Bronx, The Bronx, NY, USA
| | - Giovanni Sisti
- Department of Obstetrics and Gynaecology, New York Health and Hospitals/Lincoln Bronx, The Bronx, NY, USA
| | - Rosanna Esposito
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Coviello
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marco Cerbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ilaria Cataneo
- Unit of Obstetrics and Gynaecology, Ospedale Maggiore, Bologna, Italy
| | - Marinella Lenzi
- Unit of Obstetrics and Gynaecology, Ospedale Maggiore, Bologna, Italy
| | - Fabrizio Sandri
- Unit of Obstetrics and Gynaecology, Ospedale Maggiore, Bologna, Italy
| | - Riccardo Buscemi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Giorgia Gattei
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Francesca Della Sala
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Eleonora Valori
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
- Hospital Castelli, Verbania, Italy
| | | | - Elisa Done
- UZ Brussel, Universitair Ziekenhuis, Brussel, Belgium
| | - Gilles Faron
- UZ Brussel, Universitair Ziekenhuis, Brussel, Belgium
| | | | | | - Flaminia Vena
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Luigi Nappi
- Department of Obstetrics and Gynaecology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Felice Sorrentino
- Department of Obstetrics and Gynaecology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lorenzo Vasciaveo
- Department of Obstetrics and Gynaecology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Marco Liberati
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
| | - Danilo Buca
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
| | - Martina Leombroni
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
| | - Francesca Di Sebastiano
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
| | - Luciano Di Tizio
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, University of Chieti, ChietiItaly
| | - Massimo Franchi
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | | | - Simone Garzon
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Giuliano Petriglia
- Maternal and Child Health Department, Santa Maria Hospital, Terni, Italy
| | - Leonardo Borrello
- Maternal and Child Health Department, Santa Maria Hospital, Terni, Italy
| | - Albaro Josè Nieto-Calvache
- Fundación Valle del Lili,Tertiary Obstetric Unit, Cali, Colombia
- Postgraduate Department, Universidad Icesi, Cali, Colombia
| | - Juan Manuel Burgos-Luna
- Fundación Valle del Lili,Tertiary Obstetric Unit, Cali, Colombia
- Postgraduate Department, Universidad Icesi, Cali, Colombia
| | - Caroline Kadji
- Department of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Andrew Carlin
- Department of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Bevilacqua
- Department of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Marina Moucho
- Department of Obstetrics and Gynaecology, Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Pedro Viana Pinto
- Department of Obstetrics and Gynaecology, Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Rita Figueiredo
- Department of Obstetrics and Gynaecology, Centro Hospitalar e Universitário São João, Porto, Portugal
| | - José Morales Roselló
- Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Gabriela Loscalzo
- Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Alicia Martinez-Varea
- Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vincente Diago
- Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Alicia Yeliz Aykanat
- Department of Obstetrics and Gynaecology, Istanbul University-Cerrahpasa Medical School, Istanbul, Turkey
| | - Stefano Cosma
- Department of Obstetrics and Gynaecology, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - Andrea Carosso
- Department of Obstetrics and Gynaecology, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Department of Obstetrics and Gynaecology, Sant'Anna Hospital, University of Turin, Turin, Italy
| | | | | | | | | | | | - Reyhan Gündüz
- Department of Obstetrics and Gynaecology, University of Dicle, Diyarbakır, Turkey
| | | | - Bernd Froessler
- Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, Australia
| | - Anupam Parange
- Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, Australia
| | - Peter Palm
- Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, Australia
| | - Igor Samardjiski
- University Clinic of Obstetrics and Gynaecology, Skopje, North Macedonia
| | - Chiara Taccaliti
- Ospedale Generale Regionale "F. Miulli", Acquaviva delle Fonti, Italy
| | - Erhan Okuyan
- Batman Maternity and Child Health Hospital, Batman, Turkey
| | - George Daskalakis
- Alexandra Hospital - National and Kapodistrian, University of Athens, Athens, Greece
| | | | | | | | | | | | - Blanka Zlatohlávková
- Department of Obstetrics and Gynaecology, Division of Neonatology, General Hospital in Prague and First Faculty of Medicine,Charles University, Prague, Czech Republic
| | | | | | | | - Olus Api
- American Hospital, Istanbul, Turkey
| | - Panos Antsaklis
- Alexandra Hospital - National and Kapodistrian, University of Athens, Athens, Greece
| | - Liana Ples
- Department of Obstetrics and Gynaecology, Saint John Hospital, UMF Carol Davila, Bucharest, Romania
| | | | - Holger Maul
- Asklepios Hospital Barmbek, Hamburg, Germany
| | | | - Albert Lila
- Regional Hospital Gjakova, Kosovo, Republic of Kosovo
| | - Roberta Granese
- Department of Obstetrics and Gynaecology, University of Messina, Messina, Italy
| | - Alfredo Ercoli
- Department of Obstetrics and Gynaecology, University of Messina, Messina, Italy
| | - Giuseppe Zoccali
- Department of Obstetrics and Gynaecology, University of Messina, Messina, Italy
| | - Andrea Villasco
- Academic Division of Obstetrics and Gynaecolog, Mauriziano Umberto I Hospital, University of Turin, Turin, Italy
| | - Nicoletta Biglia
- Academic Division of Obstetrics and Gynaecolog, Mauriziano Umberto I Hospital, University of Turin, Turin, Italy
| | - Ciuhodaru Madalina
- Universitatea de Medicină și Farmacie Grigore T. Popa Iași, Iasi, Romania
| | - Elena Costa
- Department of Obstetrics and Gynaecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium
| | - Caroline Daelemans
- Department of Obstetrics and Gynaecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium
| | - Axelle Pintiaux
- Department of Obstetrics and Gynaecology, Hospital Erasme, Cliniques Universitaires de Bruxells, Brussels, Belgium
| | | | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sarah Dollinger
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Noa A Brzezinski Sinai
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Pedro Arango
- Instituto Nacional Materno Perinatal, Lima, Peru
| | | | | | - Liviu Cojocaru
- Department of Obstetrics, Gynaecology and Reproductive Science, University of Maryland Medical Center, Baltimore, MD, USA
| | - Sifa Turan
- Department of Obstetrics, Gynaecology and Reproductive Science, University of Maryland Medical Center, Baltimore, MD, USA
| | - Ozhan Turan
- Department of Obstetrics, Gynaecology and Reproductive Science, University of Maryland Medical Center, Baltimore, MD, USA
| | | | | | | | - Tanja Premru-Srsen
- Department of Perinatology, University Medical Center, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Lilijana Kornhauser Cerar
- Department of Perinatology, University Medical Center, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Mirjam Druškovič
- Department of Perinatology, University Medical Center, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Vedran Stefanovic
- Department of Obstetrics and Gynaecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Irmeli Nupponen
- Department of Obstetrics and Gynaecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaisa Nelskylä
- Department of Obstetrics and Gynaecology, Neonatology and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Zulfiya Khodjaeva
- National Medical Research Center for Obstetrics, Gynaecology and Perinatology, Moscow, Russia
| | - Ksenia A Gorina
- National Medical Research Center for Obstetrics, Gynaecology and Perinatology, Moscow, Russia
| | - Gennady T Sukhikh
- National Medical Research Center for Obstetrics, Gynaecology and Perinatology, Moscow, Russia
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Silvia Visentin
- Department of Woman' and Child's Health, University of Padova, Padova, Italy
| | - Erich Cosmi
- Department of Woman' and Child's Health, University of Padova, Padova, Italy
| | - Jacopo Ferrari
- Department of Woman' and Child's Health, University of Padova, Padova, Italy
| | | | | | | | - Ludovica Puri
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giusella D'Urso
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Francesco Colaleo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | | | | | - Giovanni Nazzaro
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Attilio Di Spiezio Sardo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Berghella
- Maternal Fetal Medicine Division, Sidney Kimmel Medical College at Thomas Jefferson University, Obstetrics and Gynaecology Department, Philadelphia, PA, USA
| | | | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giuseppe Bifulco
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giovanni Scambia
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco D'Antonio
- Centre for High Risk Pregnancy and Fetal Care, University of Chieti, Department of Obstetrics and Gynaecology, Chieti, Italy
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