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Copyright of Czecho-Slovak Pediatrics / Česko-Slovenská Pediatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Czecho-Slovak Pediatrics / Česko-Slovenská Pediatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Czecho-Slovak Pediatrics / Česko-Slovenská Pediatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate validity of biochemical diagnostic methods of fetal hypoxia., Design: A case-control study., Setting: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic., Methods: We included 67 patients, and they were retrospectively divided into group of controls (n=36), and studied group (n=31) according to pH in umbilical artery (UA) <7.15. Acid-base parameters were assessed with Rapidlab 248, Bayer Healthcare LLC, East Walpole, USA. We determined criterion for metabolic acidosis (MAC) as pH UA <7.15, resp. base deficit (BD) UA >12 mmol/l. Postpartal lactate concentration in umbilical vein (UV) and UA was determined with lactatemeter Accutrend Lactate, Roche Diagnostics, Switzerland. Quantitative assessment of fetal human protein S100B was provided with ELISA (Sangtec 100 ELISA, DiaSorin Inc., Stillwater, Minnesota, USA). Fetal erythropoietin concentration in UV was examined with immunoenzymatic assessment Access EPO (Beckman Coulter, Inc., Fullerton, CA, USA)., Statistics: histograms, Kolmogorov-Smirnov test, Mann-Whitney test, Spearman's rho; statistical significance: p<0.05, Receiver Operating Characteristic curves, Area Under the Curve., Results: The best correlation was between fetal acid-base parameters and lactate in UA (p<0.0005). Significant correlation was between EPO in UV, and protein S100B in UV (p<0.05). EPO in UV significantly correlated with lactate in UA (p<0.05). Correlation between EPO in UV and protein S100B was not significant. According to ROC curves in prediction of fetal hypoxia, we found an excellent accuracy (AUC>0.9) for lactate in UA, good accuracy (AUC>0.7) had EPO in UV. Results for protein S100B were not significant. The highest sensitivity had EPO in UV, while the highest specificity has had lactate in UA., Conclusion: An indisputable evidence of labor management quality is the fetal metabolic status. On the basis of our results, the suitable clinical markers are lactate and EPO, in addition to acid-base parameters.

Objective: To provide health care providers, patients, and the general public the improvements and objective data outcomes in perinatal health care indicators for the Zilina district, northern part of Slovak republic., Setting: Martin perinatology center (Department of Gynecology and Obstetrics, Department of Neonatology, Jessenius Medical Faculty, Commenius University, Martin, Slovak Republic)., Subject and Method: Retrospective analysis of selected main perinatal outcomes for the period of 10 years (last decade) in the Zilina region. The comparison between the regional data and similar ones retrieved for the Slovak republic., Results: During the analyzed period we have observed a significant decrease in perinatal mortality (PM) with lowest rate of 3.1 per thousand in year 2009 with the 4.13 per thousand decade average. The more favorable trend in PM drop was observed when analyzed separately from congenital disorders, which when compared to national rate decreased by 2.9 per thousand and by 1 per thousand when compared to crude PM in Zilina region for the year 2009. Furthermore, the sophisticated clinical management and improved technical equipment led to the decrease in other main perinatal indicators (e.g. decade average of frequency drop in preterm labors to 5.4%; early neonatal mortality to 2.14 per thousand; stillbirth rate drop to 0.327 per thousand, decrease in neonatal asfyxia rate with pH <7.15 to 0.01% in 2009 with decade average of 0.08% and increased proportion of in-utero transports with 5-years average of 90.9%). Contrary to that, there was revealed a doubling effect of cesarean section rate per observed period (15.7% vs. 32.9%)., Conclusions: Our results showed that the symbiosis in organization of health care, basic and applied clinical research together with improved technical equipment and introducing the WHO guidelines into the obstetrical praxis has prepared the clinical background which led to the immense improvement in the perinatal outcomes in the northern part of Slovakia during the last decade.