Felice Petraglia

University of Florence | UNIFI · Experimental and Clinical Biomedical Sciences "Mario Serio"

Background It is estimated that over 2 million cases of fetal death occur worldwide every year, but, despite the high incidence, several basic and clinical characteristics of this disorder are still unclear. Placenta is suggested to play a central role in fetal death. Placenta produces hormones, cytokines and growth factors that modulate functions...

STUDY QUESTION Does linzagolix administered orally once daily for up to 3 months at a dose of 75 mg alone or 200 mg in combination with add-back therapy (ABT) (1.0 mg estradiol; 0.5 mg norethindrone acetate, also known as norethisterone acetate [NETA]) demonstrate better efficacy than placebo in the management of endometriosis-related dysmenorrhea...

Over 60% of women with endometriosis experience abdominopelvic pain alongside pain in other areas of the body, such as chronic back pain, fibromyalgia and chronic fatigue, vulvodynia, and migraine. Although the imbalance of proinflammatory mediators, including the complement component C5a, has been implicated in endometriosis-associated pain sympto...

Background Dienogest (DNG) improves endometriosis-associated pain (EAP) and patients’ quality of life; however, the modern cornerstone of the management of endometriosis is the long-term adherence of the patient to medical treatment. Objective To evaluate DNG as a long-term treatment of endometriosis, focusing on patients’ compliance and side effe...

Iron deficiency (ID) and iron deficiency anemia (IDA) are very common in women during their reproductive life, but often these conditions remain unrecognized and left untreated. Heavy menstrual bleeding (HMB) and pregnancy are associated with ID/IDA, influencing health and the physical and social lives of these individuals. Cross discipline expert...

The prevalence of infertility in women with endometriosis is very high and the disease is one of the main causes of female infertility. The coexistence with gynecological (uterine fibroids, adenomyosis, and polycystic ovary syndrome) and systemic comorbidities (autoimmune diseases, inflammatory diseases, mental health disorders, and migraine) contr...

Endometriosis is a complex and chronic gynaecological disorder that affects millions of women worldwide, leading to significant morbidity and impacting reproductive health. This condition affects up to 10% of women of reproductive age and is characterised by the presence of endometrial-like tissue outside the uterus, potentially leading to symptoms...

Open access: https://www.jmig.org/article/S1553-4650(24)00073-6/fulltext or click the DOI above. // Endometriosis research has not progressed at a pace in proportion to disease severity and the negative impact on women’s quality of life. Furthermore, advancement in our understanding of this condition requires a quantum shift based on new theories o...

Endometriosis is a chronic gynecological syndrome characterized by endometrial cell invasion of the extra‐uterine milieu, pelvic pain and infertility. Treatment relies on either symptomatic drugs or hormonal therapies, even though the mechanism involved in the onset of endometriosis is yet to be elucidated. The signaling of sphingolipid sphingosine...

Simple Summary The rate of concurrent endometrial cancer (EC) in women with atypical endometrial hyperplasia (AEH) is not negligible. Furthermore, among women with EC, about 12% may have a high-risk disease requiring lymph node status assessment. Given that endometrial sampling cannot exclude EC in women with AEH, knowing variables that increase th...

The present narrative review aims to discuss the available data on the incidence and the risk factors of uterine fibroids (UFs) recurrence after different types of conservative surgical or radiologic procedures in women wishing to preserve their uterus. UFs are the most common benign tumors in women all over the world. Clinical presentation, includ...

Background Sexual health is a major concern in women with endometriosis, however only a few controlled studies have examined this with validated instruments. The effect of hormonal treatments on sexual function in endometriosis is also an underrated topic. The aim of this study was to investigate sexual function of patients with endometriosis by a...

BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during th...

Early onset fetal growth restriction (FGR) is one of the main adverse pregnancy conditions, often associated with poor neonatal outcomes. Frequently, early onset FGR is associated with early onset hypertensive disorders of pregnancy (HDP), and in particular preeclampsia (PE). However, to date, it is still an open question whether pregnancies compli...

Objective In the 24-week, phase 3 LIBERTY 1 (L1) and LIBERTY 2 (L2) trials, relugolix combination therapy (relugolix-CT (relugolix 40 mg, estradiol 1 mg, norethisterone acetate 0.5 mg)) reduced uterine fibroid (UF)-associated symptoms. This post hoc analysis assessed safety and efficacy of relugolix-CT in European women from L1/L2. Methods Premeno...

Purpose Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy’s physiological changes in body shape through reduced calorie intake or increased physical activity. Methods In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the...

Chagas disease is an endemic parasitosis in Latin America where the main route of transmission is vectorial. In Europe, due to migration phenomena, Chagas disease cases are increasing and the main way of transmission is mother-to-child, perpetuating the infection from one generation to the other. Congenital Chagas disease is in most cases asymptoma...

Endometriosis is a chronic gynecological disease affecting ~10% women in the reproductive age characterized by the growth of endometrial glands and stroma outside the uterine cavity. The inflammatory process has a key role in the initiation and progression of the disorder. Currently, there are no available early diagnostic tests and therapy relies...

Background Menstrual cycle has a significant impact on women’s health from different perspectives, both physically and psychologically. The assessment of menstrual-related distress is of pivotal clinical interest, especially in women with chronic exposure to abnormal bleeding or pain. The Menstrual Distress Questionnaire (MEDI-Q) is a new tool orig...

Study question Does once-daily linzagolix for up to 6 months reduce the pain symptoms in women with endometriosis? Summary answer Once-daily oral use of the GnRH agonist linzagolix alone or in combination with combined hormonal add-back therapy (ABT) for 24 weeks improved endometriosis-associated pain symptoms. What is known already Linzagolix is...

SUMMARY: ESHRE has recommended that laparoscopy is now only recommended for patients with negative imaging results and where empirical treatment is unsuccessful or inappropriate. This change in the diagnostic approach offers a non-invasive way to diagnose ovarian and infiltrating endometriosis. Moreover, novel non-invasive biomarker-based tests are...

Purpose: Data on the role of prolactin (PRL) in the physiologic range in the female sexual response are scanty. We aimed at investigating the association between PRL and sexual function as assessed by the Female Sexual Function Index (FSFI). We explored the presence of a cut-off level of PRL able to identify Hypoactive Sexual Desire Disorder (HSDD...

Objective We aimed to evaluate pregnancy and postnatal outcomes of fetuses with NT between 95th and 99th percentile at first trimester and whether they could benefit from further investigations rather that routine scans. Methods Multicenter retrospective observational study which involved all cases with NT between 95th and 99th percentile from Jan...

Research question: Women with endometriosis are frequently affected by headache. How many of these have a clear diagnosis of migraine? Are the different forms of migraine related to the phenotypes and/or characteristics of endometriosis? Design: This was a prospective nested case-control study. A consecutive series of 131 women with endometriosi...

Research question: Is the hypusinated form of the eukaryotic translation initiation factor 5A (EIF5A) present in human myometrium, leiomyoma and leiomyosarcoma, and does it regulate cell proliferation and fibrosis? Design: The hypusination status of eIF5A in myometrial and leiomyoma patient-matched tissues was evaluated by immunohistochemistry a...

Introduction The quality of sexual life plays an important role in the overall quality of life,¹ representing a primary care priority.² Sexual health is defined, according to the World Health Organization, as a state of physical, emotional, mental, and social well-being in relation to sexuality.³ Sexual function is a complex phenomenon driven by so...

Endometriosis is a benign gynecological disease affecting ∼10% of reproductive-aged women and is defined as the presence of endometrial glands and stroma outside the uterine cavity. Endometriosis can cause a variety of health problems, from pelvic discomfort to catamenial pneumothorax, but it's mainly linked with severe and chronic pelvic pain, dys...

Background and purpose: To evaluate the usefulness of urinary estradiol (E2) assay for the management of patients with precocious puberty. Methods: This was a retrospective cohort study performed in the Obstetrics and Gynaecology Clinic, Careggi Hospital, University of Florence, Florence, Italy. We collected data from medical records of patients w...

Introduction: Endometriosis is an estrogen-dependent disease on the background of progesterone resistance. Increased estrogen production, low estrogen metabolization, and altered estrogen receptors (ERs) expression contribute to the hyperestrogenic milieu within endometriotic lesions. Since estrogens play a crucial role in the pathogenesis of the...

Uterine fibroids (UFs) are the most common benign tumors in women of reproductive age, frequently associated with pain symptoms and heavy menstrual bleeding (HMB), leading to impaired quality of life. Thus, the aim of the study was to evaluate the global perception of stress and the menstrual distress in patients with UFs. A cross-sectional observa...

In the past, the primary approach for the treatment of endometriosis was represented by surgery; however, after the introduction of non-invasive diagnosis of endometriosis with the development of imaging technologies, medical treatment became the preferred approach, particularly in young patients. Hormonal drugs, by blocking menstruation, are the m...

(Abstracted from Lancet 2022;400:896–907) Uterine fibroids occur in 50% to 60% of women and are symptomatic in 30% of patients by causing abnormal uterine bleeding and pelvic pressure. Treatment of uterine fibroids involves surgical and radiological interventions, as well as progestogens and other medical therapies.

Background: Currently, there is little evidence to guide clinical management of pregnancies after stillbirth. Our study aims to evaluate the pregnancy outcome in pregnant women with a previous stillbirth, by applying a standardized protocol for etiologic investigations and subsequent treatment of the underlying etiology. Methods: A retrospective co...

Objectives Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Our aim was to investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Involv...

Endometriosis is a chronic inflammatory condition affecting women of reproductive age. A relevant feature of endometriosis is the presence of fibrotic tissue inside and around the lesions, thus contributing to the classic endometriosis-related symptoms, pain, and infertility. The molecular mechanisms responsible for the development of fibrosis in e...

Estrogen dependence and progesterone resistance play a crucial role in the origin and development of endometriosis. Therefore, hormonal therapies are currently the most effective treatment. Progestins are considered the first-line approach, especially for a long-term management. Progestins are synthetic compounds that mimic the effects of progester...

The endocrine and neuroendocrine system in pregnancy involves highly complex maternal, fetal and placental mechanisms, which are critical for the maintenance of pregnancy, the timing of parturition, for fetal growth and protection from adverse fetal programming. This timely book summarizes the different endocrine aspects related to pregnant women,...

The endocrine and neuroendocrine system in pregnancy involves highly complex maternal, fetal and placental mechanisms, which are critical for the maintenance of pregnancy, the timing of parturition, for fetal growth and protection from adverse fetal programming. This timely book summarizes the different endocrine aspects related to pregnant women,...

MicroRNAs (miRNAs) are small single-stranded non-coding RNA molecules that play a role in regulating gene expression in a tissue-specific manner. Placental miRNAs expression pattern dynamically changes during pregnancy influencing cell proliferation, differentiation and apoptosis. Changes of specific miRNA levels have been described in pregnancies...

Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent among women across their life span, especially during the reproductive age. An iron-deficient state has been associated with a number of adverse health consequences, affecting all aspects of the physical and emotional well-being of women. Heavy menstrual bleeding, pregnancy...

Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score

Objectives To evaluate pregnancy and postnatal outcomes of fetuses with NT between 95th and 99th percentile and whether they could benefit from further investigations rather that routine scans. Design Retrospective multicenter observational study. Setting Two Italian Fetal Medicine centre Population All cases with NT between 95th and 99th percentil...

Menstruation is defined as monthly uterine bleeding, regarded as a sign of reproductive health. When characterized by excessive bleeding (heavy menstrual bleeding [HMB]), it may act as a useful clinical marker for diagnosis of reproductive diseases. Endometrial and myometrial mechanisms underlying abnormal uterine bleeding (AUB), which includes HMB...

Background Uterine fibroids are common non-cancerous neoplasm that cause heavy menstrual bleeding and other signs. Linzagolix is an oral gonadotropin-releasing hormone receptor antagonist taken once per day that dose-dependently suppresses gonadal steroids and might reduce uterine-fibroid-associated signs. Two phase 3 trials were conducted to confi...

Purpose The aim of the study is to compare maternal hemodynamic adaptations in gestational diabetes (GDM) versus healthy pregnancies. Methods A prospective case–control study was conducted, comparing 69 singleton pregnancies with GDM and 128 controls, recruited between September 2018 and April 2019 in Maternal–Fetal Medicine Unit, Careggi Universi...

Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion including placenta accreta, increta and percreta and is a major cause of maternal morbidity and mortality. Recently, a conservative surgical technique has been proposed as a valid alternative to peri-partum hysterectomy to reduce the short- and long-term risks for the mot...

Objectives: Endometriosis is an inflammatory disease characterized by a frequent association with gynecologic and systemic comorbidities. Our aim was to evaluate which gynecologic and systemic comorbidities occur in women affected by endometriosis and their impact on quality of life and global health. Mechanism: A literature search of the PubMed, C...

Objective: To investigate the clinical and surgical predictors of urinary tract endometriosis (UTE) relapse DESIGN: Retrospective single-institutional study SETTING: Italian multidisciplinary referral center for endometriosis PATIENTS: Consecutive patients affected by with urinary tract endometriosis (UTE) and surgically treated between January 20...

Endometriosis is a benign uterine disorder characterized by menstrual pain and infertility, deeply affecting women’s health. It is a chronic disease and requires a long term management. Hormonal drugs are currently the most used for the medical treatment and are based on the endocrine pathogenetic aspects. Estrogen-dependency and progesterone-resis...

Purpose of the Review The purpose of this review is to provide a synopsis of all the mechanisms involved in the pathogenesis of adenomyosis. It will summarize recent advances in the field, discussing current controversies, and considering potential future directions. Recent Findings Adenomyosis pathogenesis is still a topic under investigation, ho...

Introduction Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Objective To investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regul...

Introduction Preclinical studies show that, in the clitoris, testosterone (T) is necessary to maintain a functional contractile and relaxant machinery, which represents the underlying mechanism of the peripheral arousal response. Although there is clinical evidence suggesting that T treatment significantly improves multiple domains of sexual functi...

Introduction The human vagina is extremely sensitive to hormonal changes occurring during the woman's lifetime, in particular the decline in estrogens that characterizes the menopause is known to induce a range of genital and sexual symptoms (dryness, burning, irritation, lack of lubrication, discomfort, pain), known as “genitourinary syndrome of m...

Objective: To establish pregnancy-specific reference ranges for fasting and postprandial total serum bile acids (TSBA) concentrations. Design: Cross-sectional study. Setting: Tertiary care university hospital. Population: Healthy pregnant women at term admitted to the Obstetrics Department over one year. Exclusion criteria were an establishe...

Research question Is sphingosine 1-phosphate (S1P) pathway involved in the process of fibrosis in adenomyosis? Design RNA was extracted from paraffin embedded slices collected from the ectopic endometrium of patients with nodular adenomyosis (n=27) and eutopic endometrium of healthy controls women (n=29). Expression of genes involved in the metabo...

Purpose: Pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have a higher risk of hospitalization, admission to intensive care unit (ICU) and invasive ventilation, and of acute respiratory distress syndrome (ARDS). In case of ARDS and critical severe coronavirus disease 2019 (COVID-19), the use of extracorpo...

Objective: To evaluate the different effects of a progestin-only contraceptive with desogestrel (DSG) vs combined oral contraceptives (COCs) for a first line long-term treatment of endometriosis-related pain among patients seeking hormonal contraception. Methods: An observational retrospective cohort study was conducted in collaboration with a l...

Objective To establish pregnancy-specific reference ranges for fasting and postprandial total serum bile acids (TSBA) levels. Design Cross-sectional study. Setting Tertiary care university hospital. Population Healthy pregnant women at term admitted to the Obstetrics Department over one year. Exclusion criteria were an established diagnosis of intr...

Background: In women with rheumatic diseases (RDs) menstruation-related disorders have never been investigated. The aim of this study was to evaluate gynecological symptoms/disorders in fertile age women with RDs. Materials and methods: All patients (n = 200) filled up a self-administered questionnaire on their gynecological history, menstrual cycl...

Undifferentiated connective tissue disease (UCTD) is characterized by signs and symptoms suggestive of a connective tissue disease (CTD), but not fulfilling criteria for a specific CTD. Although UCTD is probably the most common rheumatic disease diagnosed in pregnant women, data about disease course during pregnancy and perinatal outcomes are very...

To investigate the impact of uterine adenomyosis on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) clinical outcomes and also to evaluate the impact of gonadotropin-releasing hormone agonist (GnRHa) and surgical treatments. Infertile women with adenomyosis undergoing conventional IVF or ICSI were compared with women without ad...

Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 201...

Background: The purpose of the present study was to compare the effectiveness of intrathecal injection of morphine, inserted in the protocols of multimodal analgesia, versus intravenous morphine in the control of postoperative pain and course in women undergoing gynecological surgery. Methods: An observational, single-center, retrospective and c...

There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality.

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.