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BIRTH PATH
HOW TO CONTACT WITH THE OB SURGERY?
The woman with a positive pregnancy test, without necessarily having a request from her family doctor, schedules an appointment at our dedicated surgeries or by phone, choosing the Gynecologist from which to be followed throughout the pregnancy.
WHEN MAY I SCHEDULE THE FIRST EXAMINATION DURING PREGNACY?
The first examination should be performed between 7-8 weeks of gestation. It is strongly recommended to take folic acid about 3 months before conception.
During the first examination, trans-vaginal ultrasound is performed to highlight the location of the gestational chamber, its morphology and its upgradeability.
The physician also prescribes the general examinations to determine the state of health of the mother and the examinations of the TORCH group.
Usually the obstetric examination is scheduled every 4-5 weeks, as well as blood tests and urine tests at the same interval. The tests to be performed are defined by the attending gynecologist from time to time, depending on the time of pregnancy, according to the guidelines of scientific societies and protocols in use on the ward.
HOW MANY ULTRASOUND EXAMINATIONS MUST I UNDERGO?
The WHO, the World Health Organization, recommends that the first ultrasound is performed at 12 weeks of gestation, which is necessary for dating the pregnancy, and the second examination must be completed between 20-21 weeks of gestation to screen for fetal malformations and the third one must be carried out between 30-32 weeks of gestation to assess fetal growth, fetal presentation and position of the placenta. By the 20th week of pregnancy onwards, it is good to perform cervicometry, an ultrasound examination of the cervix performed by trans-vaginal way, which allows to identify pregnancies at risk of preterm delivery.
ARE THE ULTRASOUND EXAMINATIONS DANGEROUS?
The literature has widely documented that the use of ultrasound does not cause damage to the tissues and organs of the fetuses subjected to ultrasound.
MAY THE MOISTURIZERS FOR THE BODY INTERFERE WITH THE ULTRASOUND DISPLAY OF THE CHILD?
It's recommended not to apply creams on the skin of the abdomen 4-5 days prior to the execution of the obstetric ultrasound because the gel used frequently interferes with the picture on the screen, limiting the diagnostic value of ultrasound vision.
WHAT IS THE LOAD CURVE OF GLUCOSE?
ostetriciaeginecologia en birth-path 001The load curve is a survey that shows women with gestational diabetes. The screening test is carried out between 24-28 weeks of gestation. You run a blood test on an empty stomach, and the following two samples within an hour after taking, by mouth, 75 mg of anhydrous glucose. During this examination, it is recommended to stay close to the department without eating, while you can drink plain water only if necessary.
According to recent International Classifications, it is sufficient that only one data has been altered to be defined as suffering from gestational diabetes.
In the event of a positive test, you will be prescribed a low-calorie and low sugar diet and you must perform checks at the Anti-Diabetic Centre (CAD).
In most cases, a controlled diet and modest physical activity are sufficient to keep the problem under control.
WHAT IS THE OPTIMUM WEIGHT GAIN IN PREGNANCY?
ostetriciaeginecologia en birth-path 002ostetriciaeginecologia en birth-path 003During pregnancy, the ideal weight gain would be about 1 kg per month. However, the majority of women have a weight increase of 12-13 kg, which can be considered the standard increase in pregnancy.
It's a good idea to monitor the blood pressure every month, even if there are no risk factors.
WHAT IS THE PURPOSE OF THE VAGINAL AND RECTAL SWAB?
At 36 weeks of gestation, a vaginal and rectal swab is performed for detecting the presence of beta-hemolytic streptococcus. The positivity of the swab indicates that you need to perform antibiotic therapy at the beginning of labor or there will be a premature rupture of the membranes.
IN THE CASE OF DELAYED LABOR, DURING WHICH WEEK DOES THE INDUCTION OF LABOUR START?
As per our protocol, widely distributed across the Emilia-Romagna region, it is recommended to start the procedures to induce labor at 41 +3 weeks of gestation. Every indication is increasingly widely shared and discussed with the woman.
CAN THE PARTNER (OR A PERSON OF TRUST) STAY WITH THE WOMAN DURING LABOR AND DELIVERY?
ostetriciaeginecologia en birth-path 004The woman can easily choose who can accompany her during labor and childbirth. The partner is the person who normally we recommend, but the woman is free to choose a person of her confidence along the way that will lead her to childbirth.
ARE HAIR REMOVAL, ENEMA AND EPISIOTOMY REQUIRED?
None of these procedures today is absolutely mandatory. For example, the removal of the genitals hair is no longer performed, as well as the enema. The episiotomy is instead performed only if strictly necessary in an emergency situation, if it takes therapeutic character for the completion of the fetus. Also, the timing compliance of the labor severely limits the execution of the episiotomy.
CAN THE WOMAN TAKE CARE OF HER BABY DURING HER HOSPITAL STAY?
The baby will be entrusted to the care of his/her mother, under the guidance of experienced skilled midwives and nurses (roaming in). The promotion and support of breastfeeding are one of the peculiarities of our department.
CAN THE RELATIVES AND FRIENDS OF THE WOMAN COME TO THE DEPARTMENT?
Ample spaces have been identified. Herenew mothers can receive visits from relatives and friends. It is recommended to respect the privacy of other women and the tranquility of children. The partner can stay with the mother and child throughout the day.

The first few days are extremely important for the success of breastfeeding and mother-infant attachment, so it is essential to ensure a quiet and peaceful environment. For this reason, it is recommended that in the early days the visit of relatives and friends are limited as much as possible.
WHEN CAN THE WOMAN RETURN TO HER HOME?
The new family will normally have to return home after three days from the birth. At discharge, the baby is visited by the pediatrician that provides all the information for breastfeeding and infant care.
The mother is visited at discharge from the gynecologist who provides her the guidelines for the functional recovery of the perineum. The new mother will have to perform a check after 30-40 days after delivery at the surgeries on the third floor.
CAN THE WOMAN TAKE A BIRTH CONTROL MEDICINE DURING BREASTFEEDING?
During the nursing period, it may be taken with a progestin-only contraceptive. The literature has amply demonstrated that the treatment in question does not create any disturbance to the baby and does not adversely affect breastfeeding.
It's possible to insert, as an alternative to the pill, an intrauterine device (IUD or coil), when the uterus has returned to its normal size.
The couple's life can be resumed after performing the postpartum checkup.
FURTHER READING TOPIC

For further reading on the subject, evaluation of cases, vision of events or consultation of scientific articles, please refer to the specific sections COMMUNICATIONS, COURSES AND CONFERENCES, SCIENTIFIC PRODUCTION and EVENT.
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News

TRAINING INTERNSHIP OF A GROUP OF DOCTORS FROM PORTUGAL
On June 20-21 2023 a group of Doctors from Latvia conducted a training interns read more
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TRAINING INTERNSHIP OF TWO GREAT BRAZILIAN FRIENDS
On 26-28 June 2023 two great friends from Brazil undertook a training course at read more
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THE EFFICACY AND FEASIBILITY OF FRACTIONAL CO2 LASER THERAPY FOR THE TREATMENT OF URINARY INCONTINENCE: A MULTICENTRIC CASE–CONTROL STUDY
Article by the LARA group on 'Efficacy and feasibility of fractional co2 las read more
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TRAINING INTERNSHIP OF A GROUP OF DOCTORS FROM LATVIA
On June 20-21 2023 a group of Doctors from Latvia conducted a training interns read more
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2023.05.29 SPECIALIZATION THESIS ON 10 YEARS OF MONNALISA TOUCH LASER TREATMENTS IN THE REPUBLIC OF SAN MARINO
On Monday 29 May 2023 in the lecture hall of the Secretariat of the University read more
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A QUALITATIVE AND QUANTITATIVE STUDY TO EVALUATE THE EFFECTIVENESS AND SAFETY OF MAGNETIC STIMULATION IN WOMEN WITH URINARY INCONTINENCE SYMPTOMS AND PELVIC FLOOR DISORDERS
Article published in the MDPI Medicine journal evaluating the efficacy and safet read more
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2023.04.13 REPORT FROM THE DEKA ACADEMY TO BRAZILIAN DOCTORS
On 04.13.2023 Dr. Filippini held a course on the new laser and electromagnetic t read more
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TRAINING INTERNSHIP OF A GROUP OF DOCTORS FROM SLOVENIA AND CROATIA
From 21 to 21 March 2023 a group of Doctors from Slovenia and Croatia carried o read more
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TRAINING INTERNSHIP OF A GROUP OF DOCTORS FROM PORTUGAL
In the days from 06 to 07 December 2022 a group of Doctors from Portugal carrie read more
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TRAINING INTERNSHIP OF A GROUP OF DOCTORS FROM TURKEY
From 29 to 30 November 2022 a group of Doctors from Turkey carried out a traini read more
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TRAINING INTERNSHIP DR.SSA CARMEN LETICIA BARBOSA DE AZEVEDO
From 10 to 14 October 2022 Dr. Carmen Barbosa De Azevedo carried out a training read more
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ANTI–MULLERIAN HORMONE (AMH) AND ADENOMYOSIS: MINI–REVIEW OF LITERATURE OF THE LAST 5 YEARS
Article published in the journal Frontiers in Endocrinology to evaluate the corr read more
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2022.08.03 VISIT OF A FRIEND: THE MEXICAN ANTONIO POSADA
2022.08.03 Visit to our ward of our Mexican colleague Antonio Posada Jefe de Un read more
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PRESS REVIEW ABOUT THE NEW ELECTROMAGNETIC DEVICE DR. ARNOLD
Press review of the San Marino newspapers on the occasion of the donation by th read more
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RESULT OF A FIVE–YEAR EXPERIENCE IN FIRST TRIMESTER PREECLAMPSIA
Article published in the Journal of Clinical Medicine about a monocentric study read more
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2022.05.31 VISIT OF A FRIEND: THE COLOMBIAN PABLO GONZALEZ ISAZA
Visit of Colombian friend Pablo Gonzalez Isaza specialist in Minimally Invasive read more
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INTERVIEW ABOUT THE NEW DUOGLIDE LASER SYSTEM
Press article published in the newspaper L'INFORMAZIONE DI SAN MARINO on the read more
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CO2–LASER THERAPY AND GENITOURINARY SYNDROME OF MENOPAUSE: A SYSTEMATIC REVIEW AND META–ANALYSIS
Article by Dr. Maurizio Filippini published in The Journal of Sexual Medicine in read more
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EFFECTS OF FRACTIONAL CO2 LASER TREATMENT ON PATIENTS AFFECTED BY VULVAR LICHEN SCLEROSUS: A PROSPECTIVE STUDY
Article by Dott. Maurizio Filippini published in the journal Photomedicine and L read more
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SATISFACTION WITH PROPHYLACTIC RISK–REDUCING SALPINGO–OOPHORECTOMY IN BRCA MUTATION CARRIERS
Article by Dr. Margaret Sammarini published in Menopause The Journal of The Nor read more
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THE BENEFICIAL EFFECTS OF FRACTIONAL CO2 LASER TREATMENT ON PERINEAL CHANGES DURING PUERPERIUM
Multicenter retrospective study (State Hospital of the Republic of San Marino C read more
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VIDEO ILLUSTRATING THE EFFICIENCY OF LASER MONNALISA TOUCH TREATMENT IN VARIOUS GENITAL PATHOLOGIES
In the "VIDEO" section there are some videos illustrating the advantag read more
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CURRENT INDICATIONS FOR LASER TREATMENT ACCORDING TO THE SCIENTIFIC EVIDENCES PRESENT IN LITERATURE
The main indications about the use of the MonnaLisa Touch laser treatment on som read more
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UROGYNAECOLOGY COURSES ON THE TECHNIQUE OF ENTERING THE SLING SUBURETHRAL IN–OUT
Periodically at our facilities we are organized theoretical and practical course read more
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MONNALISA TOUCH: MORE THAN 3100 TREATMENTS
The authorized center of the Republic of San Marino was among the first centers read more
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MONNALISA TOUCH THE LASER TREATMENT RESULTS OF 2018/09/30
Look at the statistics of MonnaLisa Touch treatment performed in the vagina̴ read more
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BEFORE THE MASTER THESIS MONNALISA TOUCH
Wednesday January 21 2015 to complete the Masters in Aesthetic Surgery of the read more
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DATES AND TIMES OF PREPARATION COURSES AT BIRTH
In the attached brochure lists the dates and times of meetings in preparation fo read more
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NEW ROSA PARKS
After several years of demand by our Unit Complex were finally established the read more
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FIRST THESIS ON MONNALISA TOUCH
Tuesday July 22 2014 in the classroom of the Secretariat of the University of read more
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AUTHORIZED TREATMENT CENTER TOUCH MONNALISA
Since the beginning of 2013 the State Hospital of the Republic of San Marino ha read more
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COURSES OF LASER TECHNOLOGY
Intensive theoretical and practical courses individuals or small groups on the read more
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REHABILITATION AND FITNESS CLASSES PERINEAL IPOPRESSIV
They are active courses Rehabilitation of the pelvic floor and Gymnastics Ipopre read more
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CHILDBIRTH PREPARATION COURSES IN THE POOL
They are active courses Rehabilitation of the pelvic floor and Gymnastics Ipopre read more
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