Papers by Claudio Celentano
Ultrasound in Obstetrics & Gynecology, 2020
ABSTRACTObjectivesTo assess the role of fetal magnetic resonance imaging (MRI) in detecting assoc... more ABSTRACTObjectivesTo assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain.MethodsThis was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0–11.9 mm) or moderate (ventricular atrial diameter, 12.0–14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra‐CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anom...
Case reports in women's health, 2018
Cardiac tumors are rarely diagnosed in utero. Rhabdomyomas are the most common fetal cardiac tumo... more Cardiac tumors are rarely diagnosed in utero. Rhabdomyomas are the most common fetal cardiac tumors. They are usually diagnosed during the first year of life after obstruction of a valve orifice or a cardiac chamber; but they can be detected by echocardiography as early as the second trimester. Rhabdomyomas are usually small. Fetal hydrops and pericardial effusion are rare. The most important indication of tuberous sclerosis in the prenatal period is cardiac rhabdomyoma. Early diagnosis of cardiac rhabdomyoma is thus important for early diagnosis of tuberous sclerosis. This case report concerns the prenatal diagnosis of both multiple fetal cardiac rhabdomyomas and tuberous sclerosis.
Poster: "ECR 2017 / C-2992 / Diagnostic performance of MRI in the assessment of invasive pla... more Poster: "ECR 2017 / C-2992 / Diagnostic performance of MRI in the assessment of invasive placenta previa: can the reader's experience make the difference?" by: "A. Tavoletta, R. Basilico, A. Delli Pizzi, E. Di Campli, B. Seccia, R. Cianci, C. Celentano, A. R. Cotroneo; Chieti/IT"
Ultrasound in Obstetrics & Gynecology, Sep 1, 2020
In fetuses with a sonographic diagnosis of isolated mild or moderate ventriculomegaly (VM), the i... more In fetuses with a sonographic diagnosis of isolated mild or moderate ventriculomegaly (VM), the incidence of an associated fetal anomaly missed on ultrasound and detected only on fetal magnetic resonance imaging (MRI) is lower than that reported previously in the literature. The large majority of anomalies detected exclusively on MRI involve mainly migration disorders and hemorrhage, which can be difficult to detect on ultrasound and tend to have a later presentation during pregnancy. What are the clinical implications of this work? This is the largest study exploring the role of fetal brain MRI in detecting an associated anomaly not diagnosed on ultrasound in fetuses with mild or moderate VM. The findings of this study support the practice of MRI assessment in every fetus with a prenatal diagnosis of VM, although parents can be reassured of the low risk of an associated anomaly when VM is isolated on neurosonography.
Ultrasound in Obstetrics & Gynecology, Sep 1, 2012
The aim of this study is to introduce an automatic algorithm that identifies abdominal aorta and ... more The aim of this study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aorta intima media thickness (aIMT) from videos recorded during routine third trimester ultrasonographic fetal biometry Methods: aIMT was measured in singleton pregnant women during routine third trimester ultrasonography. In each frame, the algorithm locates and segments the region corresponding to aorta by means of an active contour driven by two different external forces: a static vector field convolution force and a dynamic pressure force. Then, in each frame, the mean diameter of the vessel is computed, to reconstruct the cardiac cycle: in fact, we expect the diameter to have a sinusoidal trend, according to the heart rate. From the obtained sinusoid, we identified the frames corresponding to the end diastole and to the end systole. Finally, in these frames was assessed the aIMT. The correlation between end-diastole and end-systole aIMT automatic and manual measures is 0.90 and 0.84 respectively. Results: The mean aorta diameter (blue line) and the mean aIMT (red line) estimated in 78 subsequent frames are shown: for visual purpose the values of aIMT are scaled to be superimposed to aorta diameter. The videos were acquired with a frame rate of 25 frames per second, thus three seconds of acquisition are shown. The estimated heart rate in coherent with physiological fetal heart rate. The correlation between end-diastole and end-systole aIMT automatic and manual measures was 0.90 and 0.84 respectively. Conclusions: The high values of correlation between manual and automatic results suggest that the proposed algorithm provides a reliable technique to faster the measure of important structures during ultrasonographic fetal biometry, such as aorta diameter and aIMT. Besides, being fully automatic, it allows avoiding the problems of intra-and inter-operator variability, typical of any manually performed measure.
Journal of radiological review, Feb 1, 2018
Ultrasound in Obstetrics & Gynecology, Sep 1, 2014
Short oral presentation abstracts OP08.10 Hemodynamic changes in umbilical vein (UV) and ductus v... more Short oral presentation abstracts OP08.10 Hemodynamic changes in umbilical vein (UV) and ductus venosus (DV) flow induced by uterine contractions during normal labour
European Journal of Obstetrics & Gynecology and Reproductive Biology
American Journal of Obstetrics and Gynecology, 2017
The growth of uncomplicated twin fetuses is infuenced by parental variables and fetal gender and ... more The growth of uncomplicated twin fetuses is infuenced by parental variables and fetal gender and it is reduced in comparison with singletons starting from 26-28 weeks onwards. This reduction is more evident in monochorionic twins.
Ultrasound in Obstetrics & Gynecology, 2019
Oral communication abstracts Methods: The study included 102 patients experiencing pregnancy loss... more Oral communication abstracts Methods: The study included 102 patients experiencing pregnancy loss at < 14 weeks. Blood samples were drawn for genome-wide cfDNA testing. Patients then underwent chorionic villous sampling (CVS) for karyotyping of both short-term and long-term cultures. Quantitative fluorescent PCR was also performed for some chromosomes. The first 50 cases served as a training set to determine appropriate thresholds for making an aneuploidy call. These were used for the entire cohort. Results: The mean gestational age at embryo demise was 9.8 ± 2.1 weeks and the fetal fraction was 5.2 ± 3.7%. A chromosomal anomaly was detected in 68 cases. The rates of chromosomal anomalies were 67%, 74%, 73% and 42% in patients undergoing their 1 st , 2 nd , 3 rd , and ≥4 th losses, respectively. Of the 54 cases with a single autosomal trisomy or monosomy X, the detection rate was 83%. Of the 14 cases with complex abnormalities, monosomy, triploidy or mosaic, only 2 were detected. There were 4 false positive cases. The overall sensitivity of cfDNA-based testing was 69%. Conclusions: We suggest that cfDNA-based testing serve to guide management in RPLs: if cfDNA in the 2nd and subsequent RPL demonstrates aneuploidy, no further action is taken; if cfDNA demonstrates an unbalanced rearrangement, parental karyotypes is recommended; and if no abnormality is detected, then the recommended RPL workup is performed.
Prenatal Diagnosis, 2013
Thepast 15yearswitnessedanendorsement inmagnetic resonance imaging (MRI) techniques in prenatal d... more Thepast 15yearswitnessedanendorsement inmagnetic resonance imaging (MRI) techniques in prenatal diagnosis of central nervous system (CNS) anomalies. Ventriculomegaly (VM) represents the most common finding observed with ultrasound (US) and frequently referred to MRI. The practice of medicine requires that every analysis or methodology should be evaluated in terms of performance, quality control, effectiveness, and usefulness. After reading the paper by Parazzini et al. suggesting that in mild VM without further anomalies or risk factors, MRI should not be indicated in the prenatal imaging protocol, we came up with the following considerations. Albeit the common use of MRI when VM is severe and/or not isolated, the general trend of performing MRI in mild/moderate VM without other signs is currently debated. Parazzini et al. described a quite large population using strictly retrospective selection criteria (156pregnantwomen). Even though 35 patients (19.5%) presented additional findings comparedwith US, only two cases had clear malformative pictures (1.1%). Besides this small improvement on the clinical point of view, the result section described an increase of the ventricular size in five fetuses (2.7%), albeit the time elapsed between US and MRI examinations was within 8days in the whole population. On the opposite side, the authors did not considered the fetuses in which ventricular size was within regular range at MRI and reverted to normal. We suggest a more accurate description of the six cases in which was demonstrated a linear subependymal T2-weighted hypointensity considering as peculiar sign gestational age dependent related to neural migration. Furthermore, the other four cases had abnormal outcomes. Two out of four (1.1%) due to extra-CNS anomalies, whereas one case had craniofacial anomalies such as choanal atresia and coloboma and the second had bilateral lamina subependymal heterotopia determined postnatally (1.1%). Both cases related toCNS could be recalculated as false negative at the first diagnostic reading of MRI. Reading the paper by Parazzini et al. ‘from the middle to the end’ nine fetuses had clinically relevant findings at MRI evaluation (5%). We should mention the nine cases in which ventricular atria diameter reverted to less than 10mm at MRI, and hence were considered normal (5%). Most medical decisions are based on a process that combines clinical findings, laboratory tests, and imaging techniques to make a diagnosis as reliable as possible, where single steps should be considered as a means, and not an end goal. Not to mention medico-legal problems that might arise because of the choice whether or not to terminate a pregnancy on the basis of uncertain or incomplete diagnostic process. For all those reasons, we still believe that the value of MRI in prenatal diagnostic tools formild/moderate VM should be continued. In the interest of patients, and physicians, we suggest that improving skills inUS/MRIareneeded in referringcentersas recently confirmed.
Ultrasound in Obstetrics and Gynecology, 2004
Lateral facial clefting may occur as an isolated phenomenon or in association with other disorder... more Lateral facial clefting may occur as an isolated phenomenon or in association with other disorders. It may originate from a failed penetration of ectomesenchyme between the developing maxillary and mandibular prominences, but disruptive factors may also occur in a proportion of cases. The frequency of this abnormality is estimated as 1 in 50 000-175 000 live births. We describe a case of isolated symmetrical lateral facial cleft (number 7 according to the Tessier classification) diagnosed prenatally on ultrasound examination at 26 weeks of gestation.
Journal of Diabetes Research, 2018
Gestational diabetes mellitus (GDM) can be considered a silent risk for out-of-pregnancy diabetes... more Gestational diabetes mellitus (GDM) can be considered a silent risk for out-of-pregnancy diabetes mellitus (DM) and cardiovascular disease (CVD) later in life. We aimed to assess the predictive role of 3rd trimester lipid profile during pregnancy for the susceptibility to markers of subclinical atherosclerosis (CVD susceptibility) at 3 years in a cohort of women with history of GDM. A secondary aim is to evaluate the usefulness of novel nutrigenetic markers, in addition to traditional parameters, for predicting early subclinical atherosclerosis in such women in order to plan adequate early prevention interventions. We assessed 28 consecutive GDM women in whom we collected socio-demographic characteristics and clinical and anthropometric parameters at the 3rd trimester of pregnancy. In a single blood sample, from each patient, we assessed 9 single nucleotide polymorphisms (SNPs) from 9 genes related to nutrients and metabolism, which were genotyped by High Resolution Melting analysis...
The Journal of Maternal-Fetal & Neonatal Medicine, 2018
Abstract Objective: To identify the effects of different dietary inositol stereoisomers on insuli... more Abstract Objective: To identify the effects of different dietary inositol stereoisomers on insulin resistance and the development of gestational diabetes mellitus (GDM) in women at high risk for this disorder. Design: A preliminary, prospective, randomized, placebo controlled clinical trial. Participants: Nonobese singleton pregnant women with an elevated fasting glucose in the first or early second trimester were studied throughout pregnancy. Intervention: Supplementation with myo-inositol, d-chiro-inositol, combined myo- and d-chiro-inositol or placebo. Main outcome measure: Development of GDM on a 75 grams oral glucose tolerance test at 24–28 weeks’ gestation. Secondary outcome measures were increase in BMI, need for maternal insulin therapy, macrosomia, polyhydramnios, neonatal birthweight and hypoglycemia. Results: The group of women allocated to receive myo-inositol alone had a lower incidence of abnormal oral glucose tolerance test (OGTT). Nine women in the control group (C), one of the myo-inositol (MI), five in d-chiro-inositol (DCI), three in the myo-inositol/D-chiro-inositol group (MI/DCI) required insulin (p = .134). Basal, 1-hour, and 2 hours glycemic controls were significantly lower in exposed groups (p < .001, .011, and .037, respectively). The relative risk reduction related to primary outcome was 0.083, 0.559, and 0.621 for MI, DCI, and MI/DCI groups. Conclusions: This study compared the different inositol stereoisomers in pregnancy to prevent GDM. Noninferiority analysis demonstrated the largest benefit in the myo-inositol group. The relevance of our findings is mainly related to the possibility of an effective approach in GDM. Our study confirmed the efficacy of inositol supplementation in pregnant women at risk for GDM.
Ultrasound in Obstetrics & Gynecology, 2011
Poster abstracts Methods: A retrospective review of fetal MRIs obtained at our institution from J... more Poster abstracts Methods: A retrospective review of fetal MRIs obtained at our institution from January 2004 to December 2010 was performed. Results: The MR appearance of various genitourinary abnormalities will be presented and correlated with their embryologic development. Abnormalities include horseshoe kidney, renal agenesis, multicystic dysplastic kidney, renal duplication with ectopic ureterocele, UPJ and UVJ obstruction, and cloacal exstrophy. Conclusions: Prenatal MRI serves as a complementary study to prenatal ultrasound in depicting various genitourinary abnormalities. It can allow for a more accurate diagnosis, and assist in prenatal and postnatal management.
International Journal of Gynecology & Obstetrics, 2009
Acta Obstetricia et Gynecologica Scandinavica, 1999
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Papers by Claudio Celentano