Objective: Analysis of life-threatening maternal morbidities, the condition of which required subsequent treatment in Intensive Care Units (ICU) in the Slovak Republic in the years 2012–2020. Methodology: Retrospective analysis of 655 identified cases of mothers admitted to the intensive care units out of 436,136 births. The reasons for the transport were divided into nine categories: peripartum bleeding, hypertensive diseases, thromboembolism, cardiovascular diseases, sepsis/severe infections, metabolic diseases, complications of anaesthesiology, gastroenterological problems and others. Results: The total incidence of admission to the intensive care units in the observed period was 1.5 per 1,000 births, but for mothers of Roma nationality it was 8.8 per 1,000 births. The average age of mothers was 30.7 years, while 29.7% were over 35 years old. Overweight and obesity was present by 70.4% of mothers. The most common reason for transport to the ICU (49.3%) was severe postpartum hemorrhage. The second most common cause (26.0%) was hypertensive diseases (preeclampsia, eclampsia and HELLP syndrome). The third most common cause (4.9%) was sepsis and severe maternal infections. The mortality rate of mothers admitted to the ICU was 2.3% and infant mortality of these mothers was 8.7%. Conclusion: The incidence of admission of mothers to the ICU in the monitored years was 1.5 per 1,000 births, which in international comparison ranks Slovakia among countries with a lower incidence. Key words: severe acute maternal morbidity – mother admission to the intensive care unit

Objective: Analysis of maternal mortality and identification of risk factors for maternal deaths in Slovakia in the years 2007–2023. Methods: Retrospective population-based descriptive analysis of maternal mortality from 2007 to 2023 based on the International Classification of Diseases—Maternal Mortality 10th edition (ICD-MM). Selected demographic characteristics were analysed, and statistical data from official sources and the enhanced surveillance system were compared. Results: From 2007 to 2023, there were 940 351 live births and 109 maternal deaths in Slovakia, resulting in a maternal mortality ratio (MMR) of 11.6 per 100 000 live births. Indirect causes of maternal deaths predominated (52 deaths, MMR 5.5 per 100 000 live births) over direct causes (45 deaths, MMR 4.8 per 100 000 live births). The most common causes of death were cardiovascular diseases (22.0%), amniotic fluid embolism (11.0%), viral infections (10.1%), obstetrics haemorrhage (8.3%) and hypertensive disorders of pregnancy, childbirth and puerperium (8.3%). Ten (9.2%) of all deaths were coincidental. The lowest MMR was observed in women aged 20–24 years (3.8), and the highest over 35 years (28.7) per 100 000 live births. Vital maternal mortality data were underreported by 69.7% compared to enhanced surveillance system data. Conclusion: The findings highlight the critical importance of improving healthcare infrastructure, access to quality maternal care, and timely interventions to prevent maternal deaths. Addressing the underreporting of maternal deaths and ensuring accurate data collection are crucial to understanding the true scope of the issue and identifying areas for improvement.

Objective: Analysis of maternal mortality in the Slovak Republic in the years 2007–2018. Methods: The analysis of selected maternal mortality data in the years 2007–2018. Results: In the years 2007–2018, 84 women died during pregnancy or within 42 days of the end of pregnancy – maternal mortality ratio was 12.57 per 100,000 live births. Direct maternal mortality ratio in this period was 4.64 (31 maternal deaths), indirect maternal mortality 6.74 (45 maternal deaths) and direct obstetrics death ratio was 11.38 per 100,000 live births. Pregnancyassociated but unrelated maternal death ratio was 1.19 (eight maternal deaths). The Slovak Gynecological and Obstetric Society revealed a 64% underestimation of maternal mortality data in comparison with routine statistical data. Conclusion: Maternal mortality ratio in the Slovak Republic was one of the highest in the European Union and was discordant with a good level of perinatal mortality. In the Slovak Republic, it is necessary to look for ways to reduce maternal mortality and improve data collection. Keys word: maternal mortality – maternal mortality ratio – direct obstetrics deaths – indirect obstetrics deaths – pregnancy-related deaths

Introduction: Gestational trophoblastic neoplasia (GTN) represents the malignant variant of gestational trophoblastic disease (GTD), a rare condition characterized by abnormal trophoblastic cell proliferation. GTN affects mostly women of reproductive age and is characterized by early metastatic progression. The majority of GTN tumors respond well to chemotherapy. The overall cure rate may be as high as 95 to 100 percent. Future pregnancy after treatment is an important issue. The purpose of this study was to analyze reproductive outcomes of GTN patients registered at the Center for GTD of Slovakia. Methods: A retrospective analysis of pregnancy outcomes in GTN patients after treatment. The study included all recorded pregnancies in GTN patients treated with systemic therapy at the Center for GTD of Slovakia in 1993–2024. Results: A total of 94 pregnancies in 51 patients were included. 44 patients (86.3%) were treated with single-agent chemotherapy and 7 (13.7%) with multi-agent chemotherapy. 41 patients (80.4%) had at least one pregnancy resulting in live birth. Of the 94 pregnancies, 61 (64.9%) resulted in live birth and 17 (18.1%) in miscarriage. Women after single-agent chemotherapy had more live births than women after multi-agent chemotherapy (68.7% vs. 36.4%, p = 0.035). Pregnancies conceived ≥ 12 months after finishing treatment resulted in more live births (25 vs 2; p = 0.004) and less pregnancy terminations (2 vs 8; p < 0.001) compared to those conceived earlier. Conclusion: GTN patients can expect a normal course of subsequent pregnancy after treatment with comparable outcomes to the general population.

Objective: Analysis of maternal morbidity in the Slovak Republic in the years 2012–2018. Methods: The analysis of selected maternal morbidity data prospectively collected in the years 2012–2018 from all obstetric units in the Slovak Republic. Results: In the years 2012–2018, incidence of severe peripartum bleeding was 2.17, peripartum hysterectomy was 0.89, maternal admission to intensive care units was 1.59, eclampsia was 0.21, HELLP syndrome was 0.73, abnormally invasive placentation was 0.37, uterine rupture was 0.68, severe sepsis in pregnancy and puerperium was 0.18 and nonfatal amniotic fl uid embolism was 0.027 per 1,000 births. Conclusion: Incidence of total severe acute maternal morbidity in the Slovak Republic was 6.84 per 1,000 births. In Slovak local conditions, there is still room for reduction of severe acute maternal morbidity. Key words: severe acute maternal morbidity – severe peripartum haemorrhage – peripartum hysterectomy – eclampsia – HELLP syndrome – abnormally invasive placentation – uterine rupture – sepsis – amniotic fl uid embolism – sepsis