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Povzetek: General anaesthesia is typically recommended for category 1 emergency caesarean delivery (CD). For categories 2-4 emergencies, either regional and general anaesthesia could be used. However, the factors influencing the choice of anaesthetic technique in these categories remain poorly understood. We analysed the association between the type of labour analgesia and subsequent anaesthetic techniques employed for intrapartum categories 2 and 3 CD. A prospective longitudinal cohort study was conducted at the University Medical Centre Ljubljana. A total of 300 women who underwent emergency CD between March and October 2021 were consecutively enrolled and categorised according to Lucas's classification of CD urgency. Parturients with category 1 and category 4 emergency CD were excluded from the analysis. Demographic, obstetric, and anaesthetic data were recorded. The techniques of anaesthesia (general, spinal, and epidural anaesthesia) employed for CD were analysed with respect to labour analgesia methods (remifentanil patient-controlled analgesia [remifentanil-PCA], epidural analgesia, and nitrous oxide). Of the participants, 124 (41.3%) had category 2, and 96 (32%) had category 3 emergency CD. Epidural analgesia was the most frequent analgesic option (43.8%), followed by remifentanil-PCA (20.7%) anditrous oxide (5.1%), while 30.4% of parturient women received no analgesia. All anaesthetic methods showed a significant relationship with analgesic modalities (P < 0.001). Remifentanil-PCA was associated with a higher incidence of general anaesthesia. Contraindication to epidural analgesia was the primary factor related to the transition from remifentanil-PCA to general anaesthesia. Most parturients who received epidural analgesia were successfully converted to epidural anaesthesia. Spinal anaesthesia was the most common technique in women using N2O and those without labour analgesia. General anaesthesia was associated with lower 5 min Apgar scores. The method of labour analgesia was associated with the anaesthesia technique employed for categories 2 and 3 CD. This finding may guide patient counselling and intrapartum anaesthetic planning. However, the analysis should be cautiously interpreted as the selection of anaesthesia is a complex decision influenced by several clinical considerations.
Ključne besede: emergency caesarean delivery, labour analgesia, remifentanil-PCA, epidural analgesia, general anaesthesia, obstetric anaesthesia, neonatal outcome
Objavljeno v DiRROS: 04.06.2026; Ogledov: 207; Prenosov: 173
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Povzetek: Objectives: The SARS-CoV-2 pandemic was declared by World Health Organisation (WHO) in March 2020, causing health and economic disruptions and millions of deaths. Pregnant women represent a vulnerable group, as COVID-19 during pregnancy increases the risk of preterm birth, preeclampsia, and severe maternal illness. Nutritional status, such as vitamin D deficiency, may influence these outcomes, yet data on its status in the cohort of SARS-CoV-2 positive pregnant women as well as its association with inflammatory and angiogenic markers is scarce. The aim of this study was to evaluate the levels of vitamin D in the cohort of SARSCoV- 2 positive pregnant women and its association with inflammatory and angiogenic markers. Methods: Prospective cohort study at Ljubljana Maternity Hospital (Oct 1, 2020–Mar 30, 2021) enrolled singleton pregnancies with PCR-confirmed SARS-CoV-2 within the last 14 days, delivering at our institution. Results: Among 235 SARS-CoV-2-positive pregnant women 62.1% had adequate and 21.3% insufficient level of vitamin D and 13.6%were vitaminDdeficient. Statistical analysis revealed no significant correlations between 25-OH-vitamin D and Creactive protein (CRP), procalcitonin (PCT), leukocyte count, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), the sFlt-1/PlGF ratio, or body mass index (BMI). Conclusions: Our prospective cohort study revealed that high proportion of pregnant women has inadequate levels of vitamin D. Although maternal insufficiency is linked to adverse outcomes, its association with inflammatory and angiogenic markers remains unclear. Rigorous studies in pregnancy are essential to clarify vitamin D’s role in COVID-19 complications in pregnancy.
Ključne besede: COVID-19, pandemic, pregnancy, SARS-CoV-2, vitamin D deficiency, inflammation
Objavljeno v DiRROS: 19.03.2026; Ogledov: 427; Prenosov: 323
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Povzetek: Objectives: Understanding the clinical factors influencing the SARS-CoV-2 antibody response during and after pregnancy is critical for optimizingmaternal care and vaccination strategies. This prospective cohort study aimed to evaluate associations between maternal clinical characteristics and SARS-CoV-2-specific IgG and IgA antibody levels at delivery and 42 days postpartum in unvaccinated pregnant women. Methods: A total of 387 pregnant women with confirmed SARS-CoV-2 infection during pregnancy were included. SARSCoV- 2 infectionwas confirmed using real-time RT-PCR. Clinical data, including age, body mass index (BMI), smoking status, pre-existing morbidities, and obstetric complications, were recorded. SARS-CoV-2-specific IgG and IgA antibodies were quantified using ELISA at delivery and 42 days postpartum. Results: Higher preconception BMI significantly correlated with increased odds of detecting IgG and IgA antibodies at both delivery and postpartum assessments (p<0.05), independently ofmaternal age and chronic diseases.Women without chronic systemic diseases exhibited lower antibody levels at delivery, whereas smokers had significantly lower odds of IgG antibody presence at delivery. Additionally, preexisting cardiovascular diseases were associated with reduced antibody presence at six weeks postpartum. Other clinical parameters did not show significant associations. Conclusions: Preconception BMI and pre-existing systemic diseases may modulate SARS-CoV-2 antibody responses in pregnant women. These clinical factors should inform assessments of maternal and neonatal infection risks and guide vaccination strategies in pregnant populations. Further research is needed to elucidate the mechanisms underlying these associations.
Ključne besede: SARS-CoV-2, IgG antibodies, IgA antibodies, pregnancy, body mass index, comorbidity, postpartum period
Objavljeno v DiRROS: 18.03.2026; Ogledov: 391; Prenosov: 268
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Povzetek: Bisphenol A (BPA) is a high-production-volume industrial chemical and component of commonly used plastic products. However, it is also an endocrine-disrupting chemical that can negatively affect human health. It is not yet known whether it is associated with the development of epithelial ovarian cancer (EOC), a severe and highly fatal human disease. Therefore, the purpose of this study was to determine the concentrations of BPA in the urine of women with EOC or epithelial borderline ovarian tumors (EBOTs) using gas chromatography tandem mass spectrometry (GC-MS/MS) and find their possible associations with kidney function at the molecular level, urine and blood biochemical parameters related to metabolism, anti-Müllerian hormone (AMH) (a marker of ovarian reserve/fertility), and lifestyle habits determined via a questionnaire in comparison to healthy controls. The results suggest that the unadjusted or urine-specific-gravity-adjusted BPA levels were significantly increased in women with EOC/EBOT. The unadjusted BPA was significantly positively associated with urinary creatinine (p = 0.007) in all women with EOC/EBOT after adjustment for age, body mass index, and pregnancy using multiple linear regression analysis. This may be related to kidney injury. However, no association was found between urinary BPA and serum AMH levels in women. Women with ovarian malignancies were more exposed to plastic products for storing foods and drinks. Some lifestyle habits, including refilling plastic bottles, correlate with higher urinary BPA levels across the entire cohort of women. When considering EOC or EBOT, it is necessary to consider the potential higher exposure of women to BPA, as reflected in their urine and lifestyle habits.
Ključne besede: anti-Müllerian hormone, kidney function, lifestyle habits, ovarian cancer, thrombocytes, urine, female exposure
Objavljeno v DiRROS: 03.12.2025; Ogledov: 1191; Prenosov: 370
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Povzetek: Background/Objectives: The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. Methods: This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries. Three DDI phases were assessed for each anesthetic modality: transfer time (decision for cesarean section to admission in the operation room), anesthetic time (admission to incision), and delivery time (incision to delivery of the neonate). The surgical procedure time (incision to closure), neonatal (5 min Apgar score, umbilical artery pH/base excess, neonatal intensive care unit (NICU) admission) and maternal (blood loss, surgical and postoperative complications) outcomes were also analyzed for each group. Results: There were 215 women (122 category 2 and 93 category 3) included. The use of epidural and general anesthesia was associated with significantly shortened DDI compared to spinal anesthesia (p < 0.001). This difference was due prolonged transfer (p < 0.05) and anesthetic times (p < 0.001), respectively. No cases of umbilical artery pH below 7 were observed in any group. No significant differences were observed in the incidence of umbilical artery pH between 7 and 7.10 or in base excess below -12 nmol/L (p = 0.416 and p = 0.865, respectively). NICU admission was higher with both general and spinal anesthesia (p = 0.021), but mainly due to a higher proportion of preterm births, both before the 32nd week (p = 0.033) and between the 32nd and 37th week of pregnancy (p < 0.001). General anesthesia was associated with higher maternal blood loss (p = 0.026) and a higher rate of postoperative complications (p = 0.006). Conclusions: In category 2 and 3 cesarean deliveries, general and epidural anesthesia were associated with shorter DDI compared to spinal anesthesia with no differences in neonatal outcomes. General anesthesia was associated with a higher risk of maternal complications compared to neuraxial anesthetic techniques.
Ključne besede: cesarean delivery anesthesia, decision-to-delivery interval, epidural anesthesia, general anesthesia, maternal outcomes, neonatal outcomes, spinal anesthesia
Objavljeno v DiRROS: 01.12.2025; Ogledov: 652; Prenosov: 387
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