OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic in the years 2007-2015. DESIGN: Prospective epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2015. RESULTS: Cesarean section rate progressively increased from 24.1% in the year 2007 up to 30.8% in the year 2013 and up to year 2015 decreased to 30.2%. Vacuum-extraction frequency was 1.3% in the year 2007 and to the year 2015 increased up to 1.6%. Forceps frequency was the same in the year 2007 and 2015: 0.6%. In the years 2008-2015 frequency of perineal tears 3th and 4th degree increased from 0.44% to 0.68% and frequency of episiotomies decreased from 74.7% to 57.2%. In the years 2012-2015 incidence of total severe acute maternal morbidity per 1,000 births was 5.85, peripartum hysterectomy 0.78, severe postpartum bleeding 2.03, transport to anaesthesiology department/intensive care unit 1.26, eclampsia 0.2, HELLP syndrome 0.6, abnormal placental invasion 0.38, uterine rupture 0.45, severe sepsis in pregnancy and puerperium 0.14 and frequency of nonfatal amniotic fluid embolism was 2/100,000 maternities. Total maternal mortality ratio in this period was 11.5 and pregnancy-related deaths ratio 9.9 per 100,000 live births. CONCLUSION: The highest cesarean section rate in Slovakia, 30.8 %, was in the year 2013, but in the next years slowly decreased. Frequency of episiotomies decreased in followed period too. Incidence of severe acute maternal morbidity was 5.85 per 1,000 births. Maternal mortality ratio in Slovakia was one of the highest in European Union and not corresponding with good level of perinatal mortality. Improving of cesarean section rate and episiotomy, incidence of severe acute maternal morbidity and maternal mortality still need to be improved in Slovak Republic.

• Klíčová slova
• HELLP syndrome, amniotic fluid embolism, cesarean section, eclampsia, episiotomy, forceps, maternal mortality, perineal tears, peripartum hysterectomy, severe acute maternal morbidity, vacuumextraction,
• MeSH
• císařský řez * statistika a číselné údaje   MeSH
• dospělí MeSH
• eklampsie * epidemiologie   MeSH
• epiziotomie statistika a číselné údaje   MeSH
• hysterektomie * statistika a číselné údaje   MeSH
• incidence MeSH
• lidé MeSH
• mateřská mortalita * trendy   MeSH
• morbidita MeSH
• novorozenec MeSH
• perinatální mortalita MeSH
• perineum zranění   MeSH
• poporodní období MeSH
• prospektivní studie MeSH
• ruptura dělohy * epidemiologie   MeSH
• těhotenství MeSH
• vakuová extrakce porodnická statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic (SR) in the years 2007-2012. DESIGN: Epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics School of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2012 from all obstetrics hospitals in the Slovak Republic. RESULTS: Caesarean section rate progressively increased from 24.1% in the year 2007 up to 30.3% in the year 2012. In the year 2012 the frequency of vacuum-extraction was 1.4%, forceps 0.6%, perineal tears 3th and 4th degree 0.49% and episiotomy 65%. Incidence of total severe acute maternal morbidity was 6.34 per 1,000 births. Incidence (per 1,000 births) of transport to anaesthesiology department/intensive care unit was 2.32, postpartum hysterectomy 0.72, HELLP syndrome 0.63, eclampsia 0.29, abnormal placental invasion 0.37, uterine rupture 0.27, severe sepsis in pregnancy and puerperium 0.21. In the years 2007-2012 frequency of fatal amniotic fluid embolism was 2.46/100,000 maternities or 2.43/100,000 live-births. Maternal mortality ratio in this period was 14 per 100,000 live births and pregnancy-related deaths ratio was 11.9 per 100,000 live births. CONCLUSION: In the year 2012 Slovakia reached the highest caesarean section rate in her own history - 30.3%. Incidence of severe acute maternal morbidity was 6.34 per 1,000 births. Maternal mortality ratio in Slovakia was one of the highest in European Union. Decreasing of caesarean section rate and episiotomy, incidence of severe acute maternal morbidity and maternal mortality still need to be improved in Slovak Republic.

• Klíčová slova
• abnormal placental invasion, amniotic fluid embolism maternal mortality., caesarean section, eclampsia, episiotomy, perineal tears 3th and 4th degree, postpartum hysterectomy, severe acute maternal morbidity,
• MeSH
• císařský řez statistika a číselné údaje   MeSH
• dospělí MeSH
• eklampsie epidemiologie   MeSH
• embolie plodovou vodou mortalita   MeSH
• epiziotomie statistika a číselné údaje   MeSH
• HELLP syndrom epidemiologie   MeSH
• hysterektomie statistika a číselné údaje   MeSH
• incidence MeSH
• jednotky intenzivní péče statistika a číselné údaje   MeSH
• lidé MeSH
• mateřská mortalita * MeSH
• poporodní období MeSH
• prospektivní studie MeSH
• ruptura dělohy epidemiologie   MeSH
• těhotenství MeSH
• vakuová extrakce porodnická statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

OBJECTIVE: Analysis of maternal morbidity in the Slovak Republic in the years 2012-2018. METHODS: The analysis of selected maternal morbidity data prospectively collected in the years 2012-2018 from all obstetric units in the Slovak Republic. RESULTS: In the years 2012-2018, incidence of severe peripartum bleeding was 2.17, peripartum hysterectomy was 0.89, maternal admission to intensive care units was 1.59, eclampsia was 0.21, HELLP syndrome was 0.73, abnormally invasive placentation was 0.37, uterine rupture was 0.68, severe sepsis in pregnancy and puerperium was 0.18 and nonfatal amniotic fluid embolism was 0.027 per 1,000 births. CONCLUSION: Incidence of total severe acute maternal morbidity in the Slovak Republic was 6.84 per 1,000 births. In Slovak local conditions, there is still room for reduction of severe acute maternal morbidity.

• Klíčová slova
• severe acute maternal morbidity – severe peripartum haemorrhage – peripartum hysterectomy – eclampsia – HELLP syndrome – abnormally invasive placentation – uterine rupture – sepsis – amniotic fluid embolism – sepsis,
• MeSH
• eklampsie * epidemiologie   MeSH
• embolie plodovou vodou * MeSH
• hysterektomie MeSH
• komplikace těhotenství * epidemiologie   MeSH
• lidé MeSH
• poporodní krvácení * epidemiologie   MeSH
• ruptura dělohy * epidemiologie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

• MeSH
• chorobopisy MeSH
• komplikace těhotenství prevence a kontrola   MeSH
• lidé MeSH
• mateřská mortalita * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

OBJECTIVE: Analysis of life-threatening maternal morbidities, the condition of which required subsequent treatment in Intensive Care Units (ICU) in the Slovak Republic in the years 2012-2020. METHODOLOGY: Retrospective analysis of 655 identified cases of mothers admitted to the intensive care units out of 436,136 births. The reasons for the transport were divided into nine categories: peripartum bleeding, hypertensive diseases, thromboembolism, cardiovascular diseases, sepsis/severe infections, metabolic diseases, complications of anaesthesiology, gastroenterological problems and others. RESULTS: The total incidence of admission to the intensive care units in the observed period was 1.5 per 1,000 births, but for mothers of Roma nationality it was 8.8 per 1,000 births. The average age of mothers was 30.7 years, while 29.7% were over 35 years old. Overweight and obesity was present by 70.4% of mothers. The most common reason for transport to the ICU (49.3%) was severe postpartum hemorrhage. The second most common cause (26.0%) was hypertensive diseases (preeclampsia, eclampsia and HELLP syndrome). The third most common cause (4.9%) was sepsis and severe maternal infections. The mortality rate of mothers admitted to the ICU was 2.3% and infant mortality of these mothers was 8.7%. CONCLUSION: The incidence of admission of mothers to the ICU in the monitored years was 1.5 per 1,000 births, which in international comparison ranks Slovakia among countries with a lower incidence.

• Klíčová slova
• mother admission to the intensive care unit, severe acute maternal morbidity,
• MeSH
• dospělí MeSH
• eklampsie * MeSH
• HELLP syndrom * MeSH
• hypertenze * MeSH
• jednotky intenzivní péče MeSH
• kojenec MeSH
• lidé MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

• MeSH
• komplikace porodu prevence a kontrola   MeSH
• komplikace těhotenství prevence a kontrola   MeSH
• lidé MeSH
• mateřská mortalita * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriurie farmakoterapie   MeSH
• infekční komplikace v těhotenství farmakoterapie   MeSH
• komplikace porodu prevence a kontrola   MeSH
• lidé MeSH
• poruchy v puerperiu prevence a kontrola   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky MeSH

OBJECTIVE: To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. DESIGN: Retrospective and observational study. SETTING: Private health service in Vitória, Espírito Santo, Brazil. METHODS: The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates. A descriptive analysis of the data was conducted. Students t-test was performed to compare quantitative variables, and Fishers exact test was performed for categorical variables. RESULTS: A total of 584 patients were evaluated. Of these, 91.8% (536/584) had cesarean sections, while only 8.2% (48/584) had vaginal deliveries. There were no reports of forceps-assisted vaginal deliveries. In 87.49% of the deliveries, the number of gestational weeks was more than 37. In terms of indications for performing cesarean section, 48.5% were for maternal causes, 30.41% were for fetal causes, and 17.17% were elective. Maternal re-hospitalization due to puerperal complications was necessary in 10.42% of the vaginal deliveries and in 0.93% of the cesarean deliveries (p<0.001). Complications were observed in 18.75% of the vaginally delivered newborns and in 17.16% of those delivered by cesarean section. Of the newborns with complications at birth, 40.59% (41/101) had to be admitted to the neonatal intensive care unit. There were no cases of maternal death. There were seven cases of fetal/neonatal death. CONCLUSION: We observed that the vast majority of deliveries in the private sector are performed by cesarean section, without labor, and by the patients obstetrician. We found no serious maternal complications or increased neonatal morbidity rates associated with cesarean section.

• Klíčová slova
• Brazil, cesarean section, maternal complications neonatal morbidity.,
• MeSH
• císařský řez škodlivé účinky   statistika a číselné údaje   MeSH
• dospělí MeSH
• fetální úmrtnost MeSH
• gestační stáří MeSH
• incidence MeSH
• lidé MeSH
• mateřská mortalita MeSH
• mladý dospělý MeSH
• nemoci novorozenců epidemiologie   MeSH
• novorozenec MeSH
• perinatální mortalita MeSH
• pooperační komplikace epidemiologie   etiologie   MeSH
• poruchy v puerperiu epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• soukromý sektor statistika a číselné údaje   MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   statistika a číselné údaje   MeSH
• znovupřijetí pacienta statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Brazílie epidemiologie   MeSH

• MeSH
• chorobopisy * MeSH
• kojenecká mortalita MeSH
• komplikace těhotenství prevence a kontrola   MeSH
• lidé MeSH
• mateřská mortalita * MeSH
• novorozenec MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

• MeSH
• komplikace těhotenství diagnóza   mortalita   prevence a kontrola   MeSH
• lidé MeSH
• těhotenství MeSH
• ultrasonografie * MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH