The Experts below are selected from a list of 33 Experts worldwide ranked by ideXlab platform

Berghella Vincenzo - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second degree immune-mediated atrioventricular block (AVB). MATERIAL AND METHODS: Studies reporting the outcome of fetuses with immune-mediated second degree AVB diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome was the overall progression of AVB to either continuous or intermittent third degree AVB at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: 5 studies (71 fetuses) were included. The progression rate to AVB at birth in fetuses treated with Steroids was 52% (95% CI 23-79) while in fetuses not receiving Steroid therapy was 73% (95% CI 39-94). The overall rate of regression to either first degree, intermittent first/second degree or sinus rhythm in fetuses treated with Steroids was 25% (95% CI 12-41) compared to 23% (95% CI 8-44) of those not treated. Stable (constant) second degree AVB at birth was present in 11% (95% CI 2-27) of cases in the treated group and in none of the new-borns in the untreated group, while complete regression to sinus rhythm occurred in 21% (95% CI 6-42) of fetuses receiving Steroids versus 9% (95% CI 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second degree immune-mediated AVB

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Magro-malosso, Elena R., Berghella Vincenzo
    Abstract:

    INTRODUCTION: The aim of this study was to explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. MATERIAL AND METHODS: Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with Steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving Steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with Steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving Steroids vs. 9% (95% confidence interval 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block

  • Maternal Steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis
    'Informa UK Limited', 2017
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Saccone Gabriele, Radolec Mackenzy, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome observed was the regression of CAVB; secondary outcomes were: need for pacemaker insertion overall mortality, defined as the occurrence of either intrauterine (IUD) or neonatal (NND) death, IUD, NND, termination of pregnancy (TOP). Furthermore, we assessed the occurrence of all outcomes in fetuses with compared to those without hydrops at diagnosis. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used to combine data. RESULTS: Eight studies (162 fetuses) were included. The rate of regression was 3.0% (95% CI 0.2-9.1) in fetuses treated and 4.3% (95% CI 0.4-11.8) in those not treated, with no difference between the two groups (odds ratio (OR): 0.9, 95% CI 0.1-15.1). Pacemaker at birth was required in 71.5% (95% CI 56.0-84.7) of fetuses treated and 57.8% (95% CI 40.3-74.3) of those not treated (OR: 9, 95% CI 0.4-3.4). There was no difference in the overall mortality rate (OR: 0.5, 95% CI 0.9-2.7) between the two groups; in hydropic fetuses, mortality occurred in 76.2% (95% CI 48.0-95.5) of the treated and in 23.8% (95% CI 1.2-62.3) of the untreated group, while in those with hydrops the corresponding figures were 8.9% (95% CI 2.0-+20.3) and 12% (95% CI 8.7-42.2) respectively. Improvement or resolution of hydrops during pregnancy occurred in 76.2% (95% CI 48.0-95.5) of cases treated and in 23.3% (95% CI 1.2-62.3) of those nontreated with Fluorinated Steroids. CONCLUSIONS: The findings from this systematic review do not suggest a potential positive contribution of antenatal Steroid therapy in improving the outcome of fetuses with immune CAVB

Ciardulli Andrea - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second degree immune-mediated atrioventricular block (AVB). MATERIAL AND METHODS: Studies reporting the outcome of fetuses with immune-mediated second degree AVB diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome was the overall progression of AVB to either continuous or intermittent third degree AVB at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: 5 studies (71 fetuses) were included. The progression rate to AVB at birth in fetuses treated with Steroids was 52% (95% CI 23-79) while in fetuses not receiving Steroid therapy was 73% (95% CI 39-94). The overall rate of regression to either first degree, intermittent first/second degree or sinus rhythm in fetuses treated with Steroids was 25% (95% CI 12-41) compared to 23% (95% CI 8-44) of those not treated. Stable (constant) second degree AVB at birth was present in 11% (95% CI 2-27) of cases in the treated group and in none of the new-borns in the untreated group, while complete regression to sinus rhythm occurred in 21% (95% CI 6-42) of fetuses receiving Steroids versus 9% (95% CI 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second degree immune-mediated AVB

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Magro-malosso, Elena R., Berghella Vincenzo
    Abstract:

    INTRODUCTION: The aim of this study was to explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. MATERIAL AND METHODS: Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with Steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving Steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with Steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving Steroids vs. 9% (95% confidence interval 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block

  • Maternal Steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis
    'Informa UK Limited', 2017
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Saccone Gabriele, Radolec Mackenzy, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome observed was the regression of CAVB; secondary outcomes were: need for pacemaker insertion overall mortality, defined as the occurrence of either intrauterine (IUD) or neonatal (NND) death, IUD, NND, termination of pregnancy (TOP). Furthermore, we assessed the occurrence of all outcomes in fetuses with compared to those without hydrops at diagnosis. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used to combine data. RESULTS: Eight studies (162 fetuses) were included. The rate of regression was 3.0% (95% CI 0.2-9.1) in fetuses treated and 4.3% (95% CI 0.4-11.8) in those not treated, with no difference between the two groups (odds ratio (OR): 0.9, 95% CI 0.1-15.1). Pacemaker at birth was required in 71.5% (95% CI 56.0-84.7) of fetuses treated and 57.8% (95% CI 40.3-74.3) of those not treated (OR: 9, 95% CI 0.4-3.4). There was no difference in the overall mortality rate (OR: 0.5, 95% CI 0.9-2.7) between the two groups; in hydropic fetuses, mortality occurred in 76.2% (95% CI 48.0-95.5) of the treated and in 23.8% (95% CI 1.2-62.3) of the untreated group, while in those with hydrops the corresponding figures were 8.9% (95% CI 2.0-+20.3) and 12% (95% CI 8.7-42.2) respectively. Improvement or resolution of hydrops during pregnancy occurred in 76.2% (95% CI 48.0-95.5) of cases treated and in 23.3% (95% CI 1.2-62.3) of those nontreated with Fluorinated Steroids. CONCLUSIONS: The findings from this systematic review do not suggest a potential positive contribution of antenatal Steroid therapy in improving the outcome of fetuses with immune CAVB

D'antonio Francesco - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second degree immune-mediated atrioventricular block (AVB). MATERIAL AND METHODS: Studies reporting the outcome of fetuses with immune-mediated second degree AVB diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome was the overall progression of AVB to either continuous or intermittent third degree AVB at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: 5 studies (71 fetuses) were included. The progression rate to AVB at birth in fetuses treated with Steroids was 52% (95% CI 23-79) while in fetuses not receiving Steroid therapy was 73% (95% CI 39-94). The overall rate of regression to either first degree, intermittent first/second degree or sinus rhythm in fetuses treated with Steroids was 25% (95% CI 12-41) compared to 23% (95% CI 8-44) of those not treated. Stable (constant) second degree AVB at birth was present in 11% (95% CI 2-27) of cases in the treated group and in none of the new-borns in the untreated group, while complete regression to sinus rhythm occurred in 21% (95% CI 6-42) of fetuses receiving Steroids versus 9% (95% CI 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second degree immune-mediated AVB

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Magro-malosso, Elena R., Berghella Vincenzo
    Abstract:

    INTRODUCTION: The aim of this study was to explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. MATERIAL AND METHODS: Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with Steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving Steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with Steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving Steroids vs. 9% (95% confidence interval 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block

  • Maternal Steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis
    'Informa UK Limited', 2017
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Saccone Gabriele, Radolec Mackenzy, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome observed was the regression of CAVB; secondary outcomes were: need for pacemaker insertion overall mortality, defined as the occurrence of either intrauterine (IUD) or neonatal (NND) death, IUD, NND, termination of pregnancy (TOP). Furthermore, we assessed the occurrence of all outcomes in fetuses with compared to those without hydrops at diagnosis. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used to combine data. RESULTS: Eight studies (162 fetuses) were included. The rate of regression was 3.0% (95% CI 0.2-9.1) in fetuses treated and 4.3% (95% CI 0.4-11.8) in those not treated, with no difference between the two groups (odds ratio (OR): 0.9, 95% CI 0.1-15.1). Pacemaker at birth was required in 71.5% (95% CI 56.0-84.7) of fetuses treated and 57.8% (95% CI 40.3-74.3) of those not treated (OR: 9, 95% CI 0.4-3.4). There was no difference in the overall mortality rate (OR: 0.5, 95% CI 0.9-2.7) between the two groups; in hydropic fetuses, mortality occurred in 76.2% (95% CI 48.0-95.5) of the treated and in 23.8% (95% CI 1.2-62.3) of the untreated group, while in those with hydrops the corresponding figures were 8.9% (95% CI 2.0-+20.3) and 12% (95% CI 8.7-42.2) respectively. Improvement or resolution of hydrops during pregnancy occurred in 76.2% (95% CI 48.0-95.5) of cases treated and in 23.3% (95% CI 1.2-62.3) of those nontreated with Fluorinated Steroids. CONCLUSIONS: The findings from this systematic review do not suggest a potential positive contribution of antenatal Steroid therapy in improving the outcome of fetuses with immune CAVB

Manzoli Lamberto - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second degree immune-mediated atrioventricular block (AVB). MATERIAL AND METHODS: Studies reporting the outcome of fetuses with immune-mediated second degree AVB diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome was the overall progression of AVB to either continuous or intermittent third degree AVB at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: 5 studies (71 fetuses) were included. The progression rate to AVB at birth in fetuses treated with Steroids was 52% (95% CI 23-79) while in fetuses not receiving Steroid therapy was 73% (95% CI 39-94). The overall rate of regression to either first degree, intermittent first/second degree or sinus rhythm in fetuses treated with Steroids was 25% (95% CI 12-41) compared to 23% (95% CI 8-44) of those not treated. Stable (constant) second degree AVB at birth was present in 11% (95% CI 2-27) of cases in the treated group and in none of the new-borns in the untreated group, while complete regression to sinus rhythm occurred in 21% (95% CI 6-42) of fetuses receiving Steroids versus 9% (95% CI 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second degree immune-mediated AVB

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Magro-malosso, Elena R., Berghella Vincenzo
    Abstract:

    INTRODUCTION: The aim of this study was to explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. MATERIAL AND METHODS: Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with Steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving Steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with Steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving Steroids vs. 9% (95% confidence interval 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block

  • Maternal Steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis
    'Informa UK Limited', 2017
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Saccone Gabriele, Radolec Mackenzy, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome observed was the regression of CAVB; secondary outcomes were: need for pacemaker insertion overall mortality, defined as the occurrence of either intrauterine (IUD) or neonatal (NND) death, IUD, NND, termination of pregnancy (TOP). Furthermore, we assessed the occurrence of all outcomes in fetuses with compared to those without hydrops at diagnosis. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used to combine data. RESULTS: Eight studies (162 fetuses) were included. The rate of regression was 3.0% (95% CI 0.2-9.1) in fetuses treated and 4.3% (95% CI 0.4-11.8) in those not treated, with no difference between the two groups (odds ratio (OR): 0.9, 95% CI 0.1-15.1). Pacemaker at birth was required in 71.5% (95% CI 56.0-84.7) of fetuses treated and 57.8% (95% CI 40.3-74.3) of those not treated (OR: 9, 95% CI 0.4-3.4). There was no difference in the overall mortality rate (OR: 0.5, 95% CI 0.9-2.7) between the two groups; in hydropic fetuses, mortality occurred in 76.2% (95% CI 48.0-95.5) of the treated and in 23.8% (95% CI 1.2-62.3) of the untreated group, while in those with hydrops the corresponding figures were 8.9% (95% CI 2.0-+20.3) and 12% (95% CI 8.7-42.2) respectively. Improvement or resolution of hydrops during pregnancy occurred in 76.2% (95% CI 48.0-95.5) of cases treated and in 23.3% (95% CI 1.2-62.3) of those nontreated with Fluorinated Steroids. CONCLUSIONS: The findings from this systematic review do not suggest a potential positive contribution of antenatal Steroid therapy in improving the outcome of fetuses with immune CAVB

Saccone Gabriele - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second degree immune-mediated atrioventricular block (AVB). MATERIAL AND METHODS: Studies reporting the outcome of fetuses with immune-mediated second degree AVB diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome was the overall progression of AVB to either continuous or intermittent third degree AVB at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: 5 studies (71 fetuses) were included. The progression rate to AVB at birth in fetuses treated with Steroids was 52% (95% CI 23-79) while in fetuses not receiving Steroid therapy was 73% (95% CI 39-94). The overall rate of regression to either first degree, intermittent first/second degree or sinus rhythm in fetuses treated with Steroids was 25% (95% CI 12-41) compared to 23% (95% CI 8-44) of those not treated. Stable (constant) second degree AVB at birth was present in 11% (95% CI 2-27) of cases in the treated group and in none of the new-borns in the untreated group, while complete regression to sinus rhythm occurred in 21% (95% CI 6-42) of fetuses receiving Steroids versus 9% (95% CI 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second degree immune-mediated AVB

  • Maternal Steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis
    'Wiley', 2018
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Manzoli Lamberto, Anisman Paul, Saccone Gabriele, Magro-malosso, Elena R., Berghella Vincenzo
    Abstract:

    INTRODUCTION: The aim of this study was to explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. MATERIAL AND METHODS: Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with Fluorinated Steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. RESULTS: Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with Steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving Steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with Steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving Steroids vs. 9% (95% confidence interval 0-41) of those untreated. CONCLUSIONS: There is still limited evidence as to the benefit of administered Fluorinated Steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block

  • Maternal Steroid therapy for fetuses with immune-mediated complete atrioventricular block: a systematic review and meta-analysis
    'Informa UK Limited', 2017
    Co-Authors: Ciardulli Andrea, D'antonio Francesco, Magro-malosso, Elena Rita, Manzoli Lamberto, Saccone Gabriele, Radolec Mackenzy, Berghella Vincenzo
    Abstract:

    INTRODUCTION: To explore the effect of maternal Fluorinated Steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with Fluorinated Steroids compared to those not treated were included. The primary outcome observed was the regression of CAVB; secondary outcomes were: need for pacemaker insertion overall mortality, defined as the occurrence of either intrauterine (IUD) or neonatal (NND) death, IUD, NND, termination of pregnancy (TOP). Furthermore, we assessed the occurrence of all outcomes in fetuses with compared to those without hydrops at diagnosis. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used to combine data. RESULTS: Eight studies (162 fetuses) were included. The rate of regression was 3.0% (95% CI 0.2-9.1) in fetuses treated and 4.3% (95% CI 0.4-11.8) in those not treated, with no difference between the two groups (odds ratio (OR): 0.9, 95% CI 0.1-15.1). Pacemaker at birth was required in 71.5% (95% CI 56.0-84.7) of fetuses treated and 57.8% (95% CI 40.3-74.3) of those not treated (OR: 9, 95% CI 0.4-3.4). There was no difference in the overall mortality rate (OR: 0.5, 95% CI 0.9-2.7) between the two groups; in hydropic fetuses, mortality occurred in 76.2% (95% CI 48.0-95.5) of the treated and in 23.8% (95% CI 1.2-62.3) of the untreated group, while in those with hydrops the corresponding figures were 8.9% (95% CI 2.0-+20.3) and 12% (95% CI 8.7-42.2) respectively. Improvement or resolution of hydrops during pregnancy occurred in 76.2% (95% CI 48.0-95.5) of cases treated and in 23.3% (95% CI 1.2-62.3) of those nontreated with Fluorinated Steroids. CONCLUSIONS: The findings from this systematic review do not suggest a potential positive contribution of antenatal Steroid therapy in improving the outcome of fetuses with immune CAVB