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Aim Severe acute maternal morbidity (SAMM) is a state of the woman, when she nearly died, but survived. The aim of study was to find out the exact incidence of SAMM in Slovakia, establishment of functional surveillance system and improve quality of health care. Materials and methods The regular annual analyses of SAMM cases in Slovakia from January 1st 2012 to December 31st 2016. Observed SAMM included: peripartum haemorrhage, peripartum hysterectomy, uterine rupture, abnormally invasive placenta, HELLP syndrome, eclampsia, sepsis, transport to intensive care unit or anaesthesiology and non-fatal amniotic fluid embolism. Results The response rate of questionnaires was 84.8 %. The overall confirmed incidence of SAMM was 6.35/1,000 births (95% CI 6.03-6.67). The most often causes of SAMM were: peripartum haemorrhage (2.1/1,000 births), transport to intensive care unit or anaesthesiology (1.46/1,000 births), peripartum hysterectomy (0.84/1,000 births) and HELLP syndrome (0.63/1,000 births). The average age of women with SAMM was 30.3 years (14-46) and average parity was 1.16 (0-15). Conclusion The incidence of SAMM and especially incidence of peripartum haemorrhage and peripartum hysterectomy in Slovakia is one of the highest in Europe. To decrease incidence and improve management and outcome of patients, regular audit of SAMM is needed (Tab. 3, Fig. 2, Ref. 30).

Objective Hemolysis, Elevated Liver Enzymes, Low Platelets syndrome (HELLP syndrome) is one of the actively haunted maternal morbidity through Slovak Obstetric Survey System (SOSS), the organisation for surveillance of severe maternal morbidity and mortality in Slovakia. Methods The questionaires were sent in 55 Obstetric Units in Slovakia. The analyzed and here presented data had been collected cases those happened in the period from 1.1.2012 till 31.12.2014. Controls were women from SR during observed years, who delivered without HELLP syndrome. Results The return rate of questionnaires was 89.67 %, thus covering 146 972 deliveries during the study period in Slovakia. The exact incidence of HELLP syndrome was 0.63/1000 deliveries (CI 95 % 0.51-0.78). Risk factors were age > 30 (OR = 1.63), nuliparous (OR = 2.96), pregnancy after assisted reproduction technology (OR = 8.29) and multiple pregnancy OR = 9.19). The mean gestation age at delivery was 33.8th weeks. Vaginal delivery was by 10 (10.8 %) patients with HELLP syndrome and in the 83 (89.2 %) patients pregnancy was terminated with acute caesarean section. There were reported 45 050 cases (30.7 %) of the caesarean section in the control group throughout the study period. Conclusion The older age, nulliparity, multiple pregnancy and pregnancy after assisted reproduction techniques was identified as a significant risk factors of HELLP syndrome (Tab. 5, Fig. 1, Ref. 21).

OBJECTIVES The aim of this study is to describe demographic, clinical and epidemiological characteristics of cases with laboratory-confirmed pandemic influenza virus A(H1N1)pdm09 reported in Slovakia from May 28, 2009 to December 30, 2009 and analyse the association between risk factors and severe outcome of these cases. BACKGROUND In the spring of 2009, an outbreak of a pandemic influenza virus A(H1N1)pdm09, emerged in Mexico and spread globally. Until December 2009, 1,014 cases were notified in Slovakia. METHODS The data were collected within national influenza surveillance system. Odds ratios (95% CI) were calculated. Associations were found to be significantly associated with the worse outcome (p < 0.05) in the univariate analysis and were adjusted for possible effects of age and sex by using a logistic regression model. RESULTS Out of the total number of 1,014 cases, 131 (12.9 %) cases were hospitalized, and 43 (4.2 %) of those were admitted to intensive care units. During the reporting period, 38 deaths were reported, representing a case fatality rate of 3.75 %. The median age of severe cases (35 years, IQR = 29 y) was significantly higher than the median age of mild cases (24 years, IQR = 19 y; p < 0.001). By using a logistic regression, we found out that chronic obstructive pulmonary disease (COPD) (aOR = 9.2; 95%CI: 1.42-59.98), cardiovascular diseases (aOR = 14.97; 95%CI: 5.49-40.79), malignity (aOR = 7.6; 95%CI: 1.95-29.37) and gravidity (aOR = 55.21; 95% CI: 14.40-211.58) were significantly associated with severe outcomes of the cases. CONCLUSION The fact, that 35% of severely ill patients did not report any risk factor suggests the importance of vaccination as a prevention of influenza (Tab. 2, Fig. 1, Ref. 18). Text in PDF www.elis.sk.