Purpose. To examine the uterine involution period after uncomplicated delivery in primiparous and multiparous women.Methods. Longitudinal prospective study. Repeated parameters were measured and endometrial contents and diastolic notch were observed. Measurements of primiparous and multiparous women were carried out after labour on the 1st, 3rd, 10th, 30th, 42nd, and 60th postpartum days. The analysis was performed using SPSS version 21.Results. The median uterus parameters are bigger in multiparous group in physiological puerperium, but the decreasing trend is the same. The endometrial cavity on the 10th day was significantly wider in multiparous women and mainly echo-negative view of the uterine cavity was observed. The evaluation of the uterine angle deviation changes from an extremely retroverted position to a more anteverted position. RI of the uterine artery in both groups was low immediately after labour and significantly increased one month postpartum. Notching of the uterine artery undergoes changes, but diastolic notch does not appear in all postpartum women even after two months following labour.Conclusions. The puerperium period after normal vaginal delivery depends on parity. The trend of involution in primiparous and multiparous women follows a similar pattern, yet, it lasts longer in the multiparous women. Ultrasound of uterine is certainly a useful tool after labour and may be important in facilitating an early detection of postpartum uterine complications.

Osteogenesis imperfecta (OI), also known as brittle bone disease, belongs to a rare heterogeneous group of inherited connective tissue disorders. In experienced prenatal centers, severe cases of OI can be suspected before birth from the first trimester prenatal ultrasound screening. In this article, we describe a case report of OI suspected at the 26th week of gestation and the patient’s outcomes in infancy one year after birth, as well as compare our case to other prenatally or soon-after-birth suspected and/or diagnosed OI clinical case reports in the literature. This case was managed by a multidisciplinary team. In this clinical case, OI was first suspected when prenatal ultrasound revealed asymmetric intrauterine growth restriction and skeletal dysplasia features. The diagnosis was confirmed after birth using COL1A1 gene variant detection via exome sequencing; the COL1A1 gene variant causes OI types I–IV. The familial history was negative for both pregnancy-related risk factors and genetic diseases. At one year old, the patient’s condition remains severe with bisphosphonate therapy.

Background/Objectives: A wide range of syphilis-related pregnancy complications are encountered in clinical practice. Active surveillance of the epidemiological situation in different countries and a series of retrospective data analyses allow for a comprehensive assessment of the feasible consequences of syphilis infection during pregnancy. The negative effects of infection on reproductive health are also described. Risk-increasing factors (inadequate or late treatment, partner coinfection) and protective factors (timely diagnostics and treatment) are distinguished. The importance of adequate and timely management as well as the accessibility of healthcare and socioeconomic status, which influence health outcomes, are stressed. This article presents a rare case of untreated syphilis infection during pregnancy. The infection was diagnosed during the first antenatal visit; how-ever, treatment was not initiated. At the 33rd week of gestation, the patient was admitted to the hospital because of sparse bloody vaginal discharge. Following sudden fetal hypoxia, an urgent cesarean section was performed at 33 weeks of gestation. A preterm newborn was delivered in critical condition, and congenital syphilis was diagnosed. Methods: We searched the PubMed, Cochrane, and MeSH databases using the key search terms “treponema pallidum”, “sexually transmitted infections”, “pregnancy”, “congenital infection”, “syphilis”, and “congenital syphilis”, as well as their combinations. A total of 28 papers published over a ten-year period were included in the literature review. A clinical case was analyzed. Results: The impact of syphilis on pregnancy is quite evident. Our case showcased one of the most common impacts, i.e., premature birth, of congenital infections with associated bacterial meningitis, respiratory distress syndrome, multiple organ damage, and insufficient weight. Such associations with many adverse pregnancy outcomes as well as congenital syphilis and neonatal defects are often avoidable. Conclusions: Considering the potential consequences of infections, the issue of sexually transmitted diseases remains relevant, and improving diagnostic and treatment opportunities becomes of paramount importance as cases increase.

Background. The effect of COVID-19 disease during pregnancy is still under investigation, however scientific studies have shown that pregnant women with COVID-19 infection are at increased risk for severe illness or complications [1]. Risk factors for severe disease and death in pregnancy include maternal age (especially ≥35 years), obesity, preexisting medical comorbidities (particularly hypertension and diabetes or more than one comorbidity), and being unvaccinated [2]. Many societies of obstetricians and gynecologists recommend that all pregnant patients undergo COVID-19 vaccination [1]. The aim of this study is to observe demographic characteristics, including education, place of residence and type of employment of women who chose to be vaccinated against COVID-19 in Lithuania, as well as to investigate any adverse reactions following the COVID-19 vaccine during pregnancy and compare the results to published scientific data.Materials and methods. An online questionnaire for pregnant women primarily located in Lithuania who received at least one dose of COVID-19 vaccine before giving birth has been launched in July, 2021. Data were entered via Google Forms and analyzed using Microsoft Excel and IBM SPSS Statistics. Literature review was performed on PubMed and Google Scholar search engines on inclusion criteria: publication date 2019–2021, used keywords pregnancy, COVID-19, vaccination, side effects.Results. Data were collected from 227 women vaccinated against COVID-19 during pregnancy. It was observed that the most chosen vaccine was Pfizer-BioNTech BNT162b2 (196 out of 227 individuals (86%)). More pregnant women confirmed having fever after the second dose compared to the first dose (p=0.006). In addition, injection site pain was the most common local side effect after both doses (98%) and more common after the first dose compared to the second (p=0.002). Regarding systemic reactogenicity more women experienced fatigue after the second dose comparing to the first dose (p=0.01). Furthermore, more women were unable to engage in daily activities after the second dose (p=0.03). All other symptoms did not differ after doses 1 and 2.Conclusions. Overall findings of this study did not suggest any obvious safety signals among pregnant individuals who received COVID-19 vaccine and all the side effects were comparable to the general population. Completed literature review indicates that pregnant women vaccinated against COVID-19 experience the same side effects as individuals in general population and no specific postvaccination reactions among pregnant individuals are observed.

Background/Objectives: Acute appendicitis is the most common non-obstetric surgical emergency during pregnancy. Diagnosing appendicitis in the third trimester remains especially challenging due to physiological changes that obscure clinical presentation and limit the utility of imaging modalities. These challenges can lead to diagnostic delays, increasing the risk of severe complications for both mother and fetus. Case presentation: We present a complex case of a 36-year-old pregnant woman at 29 + 4 weeks of gestation who developed acute appendicitis with an atypical clinical course. Her initial symptoms were nonspecific and misattributed to gastrointestinal discomfort related to pregnancy. Her condition progressively worsened, leading to an emergency laparoscopic appendectomy. Intraoperative findings confirmed a perforated, necrotic appendix. Postoperatively, she experienced multiple complications, including ileus, wound dehiscence, and complete eventration of the abdominal wall. These required two additional laparotomies and the application of vacuum-assisted closure (VAC) therapy for effective wound management. Despite the severity of maternal complications and the risk of preterm delivery, a multidisciplinary team provided coordinated care. The patient was delivered vaginally at 34 + 4 weeks using vacuum assistance. The neonate, who developed sepsis, was treated in the neonatal intensive care unit and discharged after 24 days. Both mother and child ultimately recovered. Conclusions: This case highlights the diagnostic complexity of appendicitis in late pregnancy and the potential for severe postoperative complications. Prompt surgical intervention, high clinical suspicion, and a multidisciplinary approach are crucial. Moreover, this report adds to the limited literature on the use of VAC therapy for abdominal eventration in pregnancy, demonstrating its feasibility and safety in selected cases.

Reikšminiai žodžiai: pasitenkinimas gimdymu, gimdymas, cezario pjūvio operacija. Tyrimo tikslas. Nustatyti veiksnius, lemiančius gimdyvių pasitenkinimą gimdymu planinio gimdymo arba planinio cezario pjūvio metu. Metodika. Prospektyvinis anketinis tyrimas atliktas Vilniaus universiteto ligoninės Santariškių klinikų (VUL SK) Akušerijos ir ginekologijos centre 2015 m. sausio–kovo mėnesiais. Dalis anketos pildyta prieš gimdymą, dalis – pirmą parą po gimdymo. Tyrime dalyvavo 59 moterys. Duomenys apdoroti „Excel“, SPSS17 programomis. Rezultatai laikyti statistiškai reikšmingi, kai p < 0,05. Rezultatai. Statiškai reikšmingai nenustatyta, kad labiau pasitenkinusios natūraliu gimdymu moterys tokį būdą rinktųsi ir kito gimdymo metu. Rastas statistiškai patikimas ryšys, kad pasitenkinimas gimdymu netiesiogiai priklauso nuo laikotarpio, po kurio moteris atsikėlė iš lovos (p = 0,046). 44 proc. moterų teigė, kad pasitikėjimas personalu gimdymo metu padidėjo, 46 proc. – išliko toks pat, kaip ir prieš gimdymą, 10 proc. moterų nurodė sumažėjusį pasitikėjimą, tačiau tai nebuvo reikšmingas veiksnys galutiniam pasitenkinimo vertinimui. Moterys, kurios teigė, kad personalas nepakankamai jas informavo apie gimdymo eigą, pasitenkinimą vertino žemesniais balais. Jaučiamas skausmas po gimdymo ar operacijos statistiškai reikšmingai daro įtaką pasitenkinimui gimdymu (p = 0,047). Išvados. Moterys, kurios planavo gimdyti natūraliais takais, tačiau gimdymas pasibaigė CPO, savo pasitenkinimą gimdymu vertino mažesniais balais. Statistiškai patikimos koreliacijos tarp gimdymo būdo ir moters nuomonės, kokiu būdu ji norėtų gimdyti ateityje, negavome. Moterys, kurios teigė, kad personalas nepakankamai jas informavo apie gimdymo eigą, pasitenkinimą vertino žemesniais balais. Atlikus koreliacinę analizę tarp moters išsilavinimo ir baimės gimdyti ar tarp artimųjų dalyvavimo gimdyme bei moters pasitenkinimo statistiškai patikimas ryšys nebuvo nustatytas.