OBJECTIVE: To examine the population-based trend for cesarean births in twin pregnancies for the last 13 years in Slovenia, and to find correlates for thistrend. METHODS: We evaluated data from the Slovenian national perinatal information system (NPIS) of all twin pairs born at Ž24 weeks during the period 1997-2009 (n=3916 pairs). RESULTS: We noted a significant and steady increase of about 1.1% cesarean births/year, concomitant with significant increased birth rates at 34-36 weeks, but with a significant decrease over time in neonatal mortality. These trends were neither associated with any particular maternal characteristic nor with increased neonatal morbidity. CONCLUSIONS: An association exists between an increased cesarean birth rate, increased preterm births at 33-36 weeks and concomitant significantly reduced neonatal mortality in twins.
COBISS.SI-ID: 336300
Objective: To evaluate associated factors for preeclampsia in twin gestations and to compare incidences of pregnancy complications among twin pregnancies with vs. without preeclampsia. Patients and methods: We performed a case-control study using a population dataset of twin pregnancies delivered after 24 weeks of gestation, in Slovenia, between 1997 and 2009. Cases were twin gestations complicated by preeclampsia and controls were cases matched bygestational age, parity, and chorionicity. Results: We identified 181 cases(4.7%) of preeclampsia among 3885 twins and 542 matched controls. High pre-pregnancy body mass index (BMI) and gestational diabetes were significantly associated with preeclampsia [odds ratio (OR) 1.8, 95% CI 1.26, 2.77 for overweight (BMI 25.0-29.9); OR 4.72, 95% CI 2.83, 7.89 for obese (BMIŽ30), and OR 2.19, 95% CI 1.03, 4.68 for gestational diabetes]. The association was not significant for preexisting hypertension, maternal age, smoking, and pregnancy following assisted reproduction. Placental complications (previa, abruption, or adherent placenta) were more common, and low birth weight less common in the preeclampsia group (P=0.03 and P=0.01, respectively). Conclusions: High pre-pregnancy BMI carries an especially highrisk for the development of preeclampsia and its complications in twin gestation.
COBISS.SI-ID: 335788
Objective: To calculate a population-based prospective risk of fetal death in monochorionic-diamniotic twins. Study design: We evaluated 387 monochorionic-diamniotic twin pregnancies that were followed and delivered after 24 weeks in Slovenia during the period 1997–2007. Surveillance was not standardized. The prospective risk of fetal death was calculated as the total number of deaths after the beginning of the gestational period divided by the number of continuing pregnancies at or beyond that period. Results: Fetal death rate was 32 of 774 fetuses (4.1%; 95%confidence interval (CI), 3.0%–5.9%); the prospective risk of stillbirth per pregnancy after 33 weeks of gestation was 6.2% (95% CI, 4.2%–9.1%). Conclusion: The Slovenian population-based prospective riskof fetal death in monochorionic-diamniotic pregnancies that remained undelivered after 33 weeks' gestation is higher than previously reported from hospital-based studies.
COBISS.SI-ID: 27570137
A retrospective matched-control study to evaluate the effect of uterine anomalies on pregnancy rates after 2481 embryo transfers in conventionally stimulated IVF/intracytoplasmic sperm injection (ICSI) cycles. The study groupof 289 embryo transfers before and 538 embryo transfers following hysteroscopic resection of a uterine septum was compared with two consecutive embryo transfers in the control group. Groups were matched for age, body mass index, ovarian stimulation, embryo quality, IVF or ICSI and infertility aetiologies. Number of embryos transferred, embryo quality and absence of uterine anomalies significantly predicted the pregnancy rates in the study group: odds ratios (OR) 1.7, 2.6 and 2.5, respectively (P ( 0.001). Pregnancy rates after embryo transfer before hysteroscopic metroplasty were significantly lower, both in women with subseptate and septate uterus and in women with arcuate uterus compared with controls. If two or three embryos withat least one best-quality embryo were transferred, the differences were 9.6% versus 43.6%, OR 7.3 (P ( 0.001) and 20.9% versus 35.5%, OR 2.1 (P ( 0.03), respectively. Differences in terms of live birth rates were even more evident: 1.9% versus 38.6%, OR 32 (P ( 0.001) and 3.0% versus 30.4%, OR 14 (P ( 0.001). After surgery, the differences disappeared.
COBISS.SI-ID: 27355609
Method: In this 24-month prospective, randomized, controlled study with 125 women in early menopause, those in the study group (n = 64) attended oral presentations on menopause and HT whereas those in the control group (n = 63) did not. Data were collected from 2 questionnaires, one completed before starting HT and the other during follow-up visits after 3, 6, 12, and 24 months. The results were analyzed according to the intention-to-treat principle. Results: In the second year, an improved quality of life and friends critical of HT negatively affected adherence to HT. After 24 months, 47% of the participants in the study group and 32% in the control group were still using HT. The difference between the 2 groups in the rates of participants who discontinued HT was the same in the first than and in the last 12 months of the study (49 [76.6%] vs 15 [23.4%]). Conclusion: Since there were no changes in discontinuation rates between the groups from one study period to the other, and a total of 15 women in each group stopped using HT in the second year of the study, the effect of the educational presentations on HT adherence was long-term rather than temporary.
COBISS.SI-ID: 512101688