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The presence of uterine myomas during pregnancy is considered a risk factor for gestation and delivery. In literature, myomas are related to spontaneous abortion, bleeding, PPROM, preterm delivery, placenta previa, placental abruption, fetal malpresentations, mechanical dystocia and high incidence of cesarean section. Laparotomic myomectomy done during pregnancy is indicated when symptoms related to uterine myomas, as acute pelvic pain or gastroenteric or urinary symptoms, persist despite the pharmacological therapy. The purpose of this study is to show a successful surgical management of uterine myomas at 15.5 weeks of pregnancy, which allowed the continuation of gestation and a delivery without major complications.

Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervical and oral cancer. We show the case of a woman affected by HPV-related cervical disease and oropharyngeal squamous cell carcinoma (OPSCC). A 41-year-old woman arrived at our Colposcopy Center following an abnormal Pap smear result (ASC-H) and a diagnosis of moderate cervical dysplasia obtained by a cervical biopsy. She underwent a colposcopy that showed a cervical abnormal transformation zone grade 2. A laser conization was performed in November 2010. Histology reported a moderate/severe dysplasia. The cone resection margins were free. Follow-up colposcopy and cytology were negative. The HPV testing showed an infection by HPV 16. In October 2012, the patient presented to the Head-Neck ER after episodes of hemoptysis; a lesion was found in the left tonsillar lodge. A biopsy was performed with a result of squamous cell carcinoma with low-grade differentiation. The HPV testing detected a high-risk HPV and the immunohistochemical analysis was positive for p16. She was treated by chemotherapy and brachytherapy. She was followed at the head-neck center with monthly visits with oral visual inspection that showed complete absence of mucosal abnormalities. HPV-related OPSCC and cervical precancerous/cancerous lesions have significant similarities in terms of pathogenesis. They are both caused largely by HPV 16, as in the present case. In conclusion, because of this association found in literature and in our case, we think that women with HPV cervical lesions should have regular surveillance for oropharyngeal cancer, whereas women with OPSCC should be encouraged to have diligent cervical screening.

The goal of our study was to describe the age-specific distribution of HPV genotypes and related disease among females under the age of 25 years. A prospective cohort study was carried out. We enrolled 85 young females aged 16 -25 years (30 aged 16 -19 and 55 aged 20 -25 years) referred to our colposcopic unit after a repeated abnormal Pap smear result. Every patient underwent an HPV DNA testing, a colposcopy and eventually a cervical biopsy. Participants were proposed to follow-up or treatment on request. Treatment was performed by destructive or excisional laser CO 2 therapy. Data were analyzed by Fisher's Exact test. The overall prevalence of low-risk HPV amounted to 80% among 16 -19-year-old girls, while the overall prevalence of high-risk HPV was 85.5% among 20 -25-year-old patients. The univariate analysis of chosen characteristics of HPV-disease demonstrates the statistically significative difference of this infection between the two groups of age (P < 0.005). We observed a particular age-specific stratification of HPV genotypes and related disease, which appeared to be characterized by a cut-off at the age of 20 years. According to our data, cervical screening program in Italy seems to start later than the beginning of HPV-related pathology.

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Early diagnosis of congenital heart defect (CHD) increased in the last two decades, following technological evolution. A recent meta‐analysis (Yu, 2020), on diagnostic accuracy in ultrasound detection of major CHD in the first trimester of pregnancy, reported an overall sensitivity of 75%. Ultrasound imaging of this case refers to a tricuspid valve dysplasia with right atriomegaly and pulmonary valve atresia diagnosed in a 13‐week gestational‐age fetus with low risk for chromosomal abnormalities. To our knowledge, this is the first case describing such features in the first trimester. We believe the precocity and severity of onset make this a case of diagnostic interest.

Background: Patients with FIGO (International Federation of Gynaecologists and Obstetricians) stage IA1 cervical squamous carcinoma can be treated conservatively with conization only as alternative to a hysterectomy. The aim of this study was to evaluate the efficacy of laser CO 2 excision as therapeutical method for stage IA1 cervical squamous carcinoma. Methods: Sixty patients were submitted to CO 2 laser conization with histologic diagnosis of squamous carcinoma stage FIGO IA1 and then submitted to follow-up with PAP smear, colposcopy and biopsy. Prognostic risk factors for relapse were evaluated with univariate analysis. Results: Conservative management with laser therapy was effective in more than 90% of the patients. When disease persistence was detected (7%), patients underwent repeated laser CO 2 conization and followed-up without demolitive intervention. The risk of disease progression in the case series was 1.8%. Univariate analysis revealed that only depth of stromal invasion was a significant risk factor for relapse (P<0.04). Moreover, depth of stromal invasion between 1-3 mm was the only prognostic factor for relapse with specificity 78%, sensitivity 75% and likelihood positive ratio 3,47. Conclusion: Laser CO 2 conization alone appeared to be an effective and safe treatment for patients with Cervical Cancer Stage FIGO IA1 if careful post-treatment follow-up was guaranteed. The deph of stromal invasion has been confirmed as the most important risk and prognostic factor to be evaluated for disease relapse.