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Povzetek: Objectives: The study aimed to evaluate the magnitude and duration of the effect of antenatal betamethasone on fetal heart rate short-term variability (STV) in growth-restricted (FGR) fetuses in comparison with appropriate-for-gestational age (AGA) fetuses. Methods: A prospective observational study was conducted at the UMC Ljubljana between June 2023 and June 2024, including 21 FGR and 20 AGA fetuses. We measured STV before applying betamethasone and at regular intervals for seven days after the first application or until delivery. Confounding variables were fetal and maternal demographic and clinical characteristics. Analysis was done using linear regression, paired-sample t-tests and one-way and two-way analysis of variance. Results: The increase in STV 6-12 h after the first application was significant compared to baseline in both groups (p < 0.001). STV remained significantly elevated the first 24 h after the first application in the FGR group (p=0.018) but not in the AGA group. There was no significant difference in STV between baseline and 48 and 72 h after the first application in either group. When adjusted for gestational age, STV was significantly lower in the group of FGR compared to AGA fetuses at all times of cCTG recordings (p=0.031). Conclusions: Following the initial increase in STV after the first dose of betamethasone, STV declines and returns to levels that doesn't differ significantly from baseline after 24 h in AGA and 48 h in FGR fetuses. Longer-lasting response of FGR fetuses to betamethasone merits further investigation.
Ključne besede: antenatal betamethasone, computerized cardiotocography, fetal growth restriction, fetus, heart rate short-term variability
Objavljeno v DiRROS: 15.04.2026; Ogledov: 27; Prenosov: 16
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Povzetek: Purpose: Retained products of conception (RPOC) are a common complication following pregnancy. Office hysteroscopy (OH) is increasingly used for diagnostics and management due to its minimally invasive nature. However, incidence of incomplete OH removal and procedures in which no RPOC are identified despite prior suspicion remains a concern. This study aimed to identify factors associated with these outcomes to improve patient selection and procedural success. Methods: A retrospective study was conducted on patients referred for OH for presumed RPOC between August 2015 and April 2023 at the Department of Gynecology and Obstetrics, University Medical Centre Ljubljana, Slovenia. Inclusion criteria included hemodynamically stable patients with prolonged bleeding and/or suspicious ultrasound (US) findings post-pregnancy. Patients with RPOC thickness of more than 30 mm or strong tissue vascularization on US were excluded. Data on patient demographics, US features, and procedural outcomes were analyzed. Results: Out of the 468 patients, RPOC removal was performed in 333 cases (71.2%), of which 225 (67.6%) were successfully completed, while in 135 cases (28.8%), the procedure was only diagnostic due to the absence of RPOC. Regarding procedural success, neither the pregnancy outcome, i.e., termination of pregnancy (TOP) vs delivery, nor gestational age significantly correlated with it. Longer time from pregnancy end to OH significantly improved procedural success in both groups, after TOP (p = 0.025) and in cases of large RPOC after delivery (p < 0.001). Parity significantly altered procedural success only in the delivery group (p < 0.007). The success rate of the procedure was significantly higher in cases when only small RPOC were observed (p < 0.001). Absence of RPOC occurred more frequently following TOP than after delivery (p < 0.001). Procedures in which no RPOC were confirmed were significantly associated with a longer interval between pregnancy end and OH in both TOP (p = 0.013) and delivery group (p = 0.003). Gestational age significantly correlated with the absence of RPOC only in the delivery group (p = 0.003). The likelihood of not confirming RPOC was higher where US thickness and length were lower (p = 0.007 and p = 0.011, respectively). Conclusion: OH is effective for managing RPOC with a high success rate, but the absence of RPOC in a considerable number of OH-treated patients stresses the need for better diagnostic criteria and patient selection to minimize overtreatments. Further prospective studies are needed to optimize the timing and indications for OH.
Ključne besede: minimally invasive surgery, office hysteroscopy, retained products of conception, uterine diseases
Objavljeno v DiRROS: 09.04.2026; Ogledov: 51; Prenosov: 25
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Povzetek: Introduction: Regular physical activity during pregnancy is associated with several maternal and neonatal health benefits. However, most studies focus on specific forms of exercise in low-risk populations, limiting generalizability. Objective: To investigate associations between regular physical activity during singleton pregnancy and perinatal outcomes using a national perinatal registry. Methods: A population-based cohort study was conducted using data from the Slovenian National Perinatal Information System (2013–2022), which included 190,331 singleton pregnancies. Regular physical activity was defined as any form of physical activity at least twice weekly throughout pregnancy. The outcomes analyzed included preterm birth (<37 and <32 weeks), preeclampsia, gestational hypertension, gestational diabetes mellitus (GDM), pelvic girdle pain, small-for-gestational-age (SGA) and large-for-gestational-age (LGA) neonates, cesarean delivery, urinary incontinence postpartum, and Apgar scores < 7 at 5 minutes. Multivariate logistic regression adjusted for parity, maternal age, BMI, prepregnancy hypertension and diabetes, and gestational weight gain. Results: Regular physical activity during pregnancy was reported by 69 % of the women. It was significantly associated with reduced odds of preterm birth (<37 weeks, aOR 0.658; <32 weeks, aOR 0.393), preeclampsia (aOR 0.719), gestational hypertension (aOR 0.708), pelvic girdle pain (aOR 0.808), SGA (aOR 0.903), LGA (aOR 0.902) and low Apgar scores (aOR 0.638). Physically active women with GDM were less likely to require insulin (aOR 0.768). No significant associations were found with cesarean delivery or urinary incontinence. Conclusion: Regular physical activity during pregnancy, regardless of specific type, was associated with improved perinatal outcomes without safety concerns. These findings highlight the potential benefits of encouraging physical activity during pregnancy in diverse populations.
Ključne besede: pregnancy, physical activity, perinatal outcome
Objavljeno v DiRROS: 27.02.2026; Ogledov: 233; Prenosov: 108
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Povzetek: Introduction: The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth. Methods: A prospective observational case-control study was carried out in Ljubljana Maternity Hospital in the period May - August 2013. The sample comprised 497 labouring women; 154 who attended the midwife led and 343 who attended in the obstetric unit, both matching the same inclusion criteria: low risk primiparous; singleton term pregnancies, normal foetal heart beat, cephalic presentation; spontaneous onset of labour. The primary outcome was the caesarean section rate. Chi-square test was used to compare medical interventions and birth outcomes. Results: Women in the midwife led unit had statistically significant higher spontaneous vaginal births (p < 0.001), less augmentation with oxytocin (p < 0.001), less use of analgesia (p < 0.001), less operative vaginal deliveries (p < 0.001) and less caesarean sections (p < 0.001), lower rates of episiotomy (p < 0.001) and more exclusively breastfed (p = 0.002). Discussion and conclusion: These significant findings showed that in the midwife led unit fewer medical interventions were used. For generalisation of the findings more similar studies in Slovenia are needed.
Ključne besede: low risk, labour, medical interventions, perinatal outcomes
Objavljeno v DiRROS: 28.01.2026; Ogledov: 266; Prenosov: 100
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Povzetek: Objective Cerebral palsy (CP) is a group of neurological disorders with profound implications for children’s development. The identification of perinatal risk factors for CP may lead to improved preventive and therapeutic strategies. This study aimed to identify the early predictors of CP using machine learning (ML). Design This is a retrospective case–control study, using data from the two population-based databases, the Slovenian National Perinatal Information System and the Slovenian Registry of Cerebral Palsy. Multiple ML algorithms were evaluated to identify the best model for predicting CP. Setting This is a population-based study of CP and control subjects born into one of Slovenia’s 14 maternity wards. Participants A total of 382CP cases, born between 2002 and 2017, were identified. Controls were selected at a control-to-case ratio of 3:1, with matched gestational age and birth multiplicity. CP cases with congenital anomalies (n=44) were excluded from the analysis. A total of 338CP cases and 1014 controls were included in the study. Exposure 135 variables relating to perinatal and maternal factors. Main outcome measures Receiver operating characteristic (ROC), sensitivity and specificity. Results The stochastic gradient boosting ML model (271 cases and 812 controls) demonstrated the highest mean ROC value of 0.81 (mean sensitivity=0.46 and mean specificity=0.95). Using this model with the validation dataset (67 cases and 202 controls) resulted in an area under the ROC curve of 0.77 (mean sensitivity=0.27 and mean specificity=0.94). Conclusions Our final ML model using early perinatal factors could not reliably predict CP in our cohort. Future studies should evaluate models with additional factors, such as genetic and neuroimaging data
Ključne besede: early predictors, cerebral palsy
Objavljeno v DiRROS: 10.12.2025; Ogledov: 456; Prenosov: 228
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