Lithuanian Obstetrics & Gynecology

POSTPARTUM DEPRESSION AND BIRTH EXPERIENCES: THE ROLE OF DELIVERY MODE AND EPIDURAL ANALGESIA IN THE DEVELOPMENT OF POSTPARTUM DEPRESSION

Danielė Berulė, Liveta Vaitulevičiūtė, Miglė Remeikaitė, Simona Jazdauskienė — Mon, 30 Jun 2025 00:43:50 +0300

Aim of the study. This systematic review aims to assess the impact of delivery mode, interventions, and epidural analgesia on the development of postpartum depression (PPD). Methods. A systematic literature review was conducted using the PubMed, ScienceDirect, and Wiley online library databases. Eight publications were included in the review based on PRISMA selection criteria. Results. Six studies analysed the influence of delivery mode on the development of PPD. All publications consistently agreed that emergency caesarean section (CS) carries the highest risk for PPD, while vaginal delivery without induction reduces this risk. The results for patients who had planned CS were mixed: women without previous psychiatric disorders had an increased risk of PPD after elective CS. In contrast, for those who had been diagnosed with depression or anxiety disorders before delivery, elective CS lowered the risk of PPD. Two studies found that epidural analgesia reduces the risk of PPD. Conclusions. Vaginal delivery without induction or instrument use, along with epidural analgesia for pain relief, is associated with the lowest risk of PPD among women without prie-existant psychiatrical disorders. For women who had been diagnosed with depression before delivery, elective CS is associated with the lowest risk of PPD. Emergency CS poses the highest risk for this mental health disorder.

SHIFTING PREFERANCES IN SEXUALITY EDUCATION AMONG LITHUANIAN YOUTH: A CROSS-SECTIONAL ANALYSIS

Mon, 30 Jun 2025 00:53:36 +0300

Aim of the study. To evaluate changes in access to and preferences for sexuality education among Lithuanian youth aged 14–29 between 2017 and 2023. Methods. An anonymous online questionnaire was distributed via email and Facebook to student councils at 20 universities, 23 colleges, and 517 high schools across Lithuania. Results. A total of 1371 respondents (49.2%) reported receiving sexuality education at school, while 1308 (46.9%) had discussed reproductive health with their parents. Females were significantly more likely than males to report both attending school-based sexuality education and discussing the topic with family members (p < 0.05). The most preferred methods of receiving sexuality education were informative movies (57.8% in 2017 vs. 61.8% in 2023; p = 0.017) and social websites (35.3% in 2017 vs. 50.2% in 2023; p < 0.001). Preferences varied significantly by educational level and gender. However, satisfaction with the quality of school-based sexuality education remained low and did not improve over time. Conclusions. A substantial proportion of Lithuanian youth continue to lack comprehensive sexuality education at both school and home. Digital platforms are increasingly preferred as primary sources of sexual health information.

PREGNANT WOMEN’S KNOWLEDGE ABOUT TRAVEL DURING PREGNANCY AND TRAVEL HABITS

Lina Adomaitienė, Evelina Smailytė — Mon, 30 Jun 2025 00:59:37 +0300

Aim of the study. This study aimed to assess pregnant women’s travel behaviors, their awareness of risks associated with travel during pregnancy. Methods. A quantitative study was conducted using an anonymous questionnaire survey. The study included 103 pregnant women admitted to the Obstetrics Department of LSMU Kaunas Clinics or attending the maternity emergency department. Data were analyzed using SPSS, employing frequency analysis and the chi-square test (p < 0.05). Results. Fifty-two percent of participants reported traveling during pregnancy. Although 82% knew of travel-related risks, 47% consulted a physician before traveling. The primary reasons for travel included leisure and family visits. Despite widespread knowledge of thrombosis prevention, adherence to preventive measures, such as compression stockings and regular leg exercises, was limited. Conclusions. Pregnant women generally recognize travel-related risks, but the application of preventive measures, particularly for thrombosis, remains inconsistent.

DELIVERY OUTCOMES AFTER A SINGLE CESAREAN SECTION: A RETROSPECTIVE ANALYSIS OF RISK FACTORS AND OBSTETRIC OUTCOMES

Rugilė Leščiauskaitė, Viktorija Nemeikšienė, Eglė Savukynė — Mon, 30 Jun 2025 01:04:23 +0300

Aim of the study. To evaluate the delivery outcomes and associated factors in pregnant women after a single cesearean section (CS). Methods. A retrospective study was conducted, including women with one previous CS who delivered from 1 January 2023 to 31 December 2024. The analysis included pregnancy complications, course of labour, delivery-related complications, and neonatal outcomes. Results. A total of 414 cases were analyzed. The first group consisted of 253 (61.1 %) women who had a successful vaginal delivery after one previous CS, whereas the second group included 161women (38.9 %) who underwent repeat CS. Women who had vaginal births before (n = 30 and n = 5, p = 0.002) or after (n = 61 and n = 10, p < 0.001) their previous CS were significantly more likely to deliver successfully via vaginal birth. Neonates in the vaginal delivery group had higher Apgar scores at 1 and 5 compared to the repeat CS group. Conclusions. Successful delivery following a single cesarean is associated with a prior pregnancies and births, a history of vaginal deliveries, and spontaneous onset of labor. Delivery complications occur significantly more often in women requiring an urgent repeat cesarean section.

THE VIEWS OF PREGNANT WOMEN TOWARDS THE USE OF ARTIFICIAL INTELLIGENCE IN THE EVALUATION OF CARDIOTOCOGRAM DURING LABOR

Ana Gorbunova, Gerda Smolskaitė, Miglė Semėnaitė, Justina Kačerauskienė — Mon, 30 Jun 2025 01:10:19 +0300

Aim. To assess pregnant women’s views towards using artificial intelligence (AI) in the evaluation of cardiotocogram (CTG) during labor. Materials and methods. An anonymous questionnaire originally created by the authors, which consisted of 21 questions, was used. The study was conducted on the website www.apklausa.lt, QR codes with an active link to the survey website were created, and printed paper versions of the questionnaire were distributed in the Department of Obstetrics and Gynecology of Kauno klinikos. Results. 358 women participated in the study. Women with higher education and younger pregnant women were statistically significantly more likely to know what AI is and its potential applications in medicine. More than half of the respondents (64,8%, n=232) did not agree that AI would take over doctors’ jobs in the future or that doctors would become dependent on computer systems, which would result in a decline in the quality of care. The majority of surveyed women (78.2%, n=280) agreed to have their CTG evaluated by a physician during labor using AI. A significant level of trust in doctors was observed among the respondents – 88.3% (n = 316) of those surveyed stated that when AI is used to assess CTG data during childbirth, the final decision should be confirmed by a doctor. Conclusions. Younger women and those with higher education are better informed about AI and its potential applications in medicine. Respondents agree that AI is making progress in medicine and that its use in evaluating CTG during labor can make the doctor’s daily work easier. However, they do not believe that AI will take over doctors’ roles in the future. Most pregnant women would agree to have their CTG evaluated by a physician using AI during labor. Similar results were found in other studies – respondents agree that AI is a valuable decision support tool, but the final decision should be made by the doctor.

THIRD- AND FOURTH-DEGREE PERINEAL TEARS AFTER CHILDBIRTH: LONG-TERM CARE AND PELVIC FLOOR MUSCLE FUNCTION RECOVERY

Mon, 30 Jun 2025 01:23:45 +0300

Obstetric anal sphincter injuries (OASIS) of the third and fourth degree are severe childbirth complications that pose significant challenges in clinical practice and long-term maternal care. Two illustrative clinical cases highlight the importance of structured postpartum follow-up and comprehensive pelvic floor rehabilitation. National and international OASIS management guidelines are reviewed, emphasizing early urogynecological and rehabilitative intervention. An interdisciplinary approach is highlighted as essential to reducing long-term complications and improving physical and emotional outcomes for affected women.

MANAGEMENT METHODS FOR POSTPARTUM URINARY INCONTINENCE

Gerda Bučienė, Kristina Jarienė — Mon, 30 Jun 2025 01:29:35 +0300

Postpartum urinary incontinence is a common condition that can affect a woman’s physical and emotional well-being. This article presents a literature review based primarily on publications from 2014 to 2024, with the inclusion of earlier influential sources. Pelvic floor muscle training remains the main conservative treatment; however, evidence indicates that combining it with interventions such as acupressure, acupuncture, biofeedback, or electrostimulation may significantly improve effectiveness. Lifestyle modifications, including healthy nutrition, physical activity, and weight management, also play an important role in symptom control. The role of nurses is highlighted in supporting education, emotional well-being, and individualized treatment planning. Further largescale and long-term studies are needed to strengthen the evidence base.

NEONATAL SEPSIS AND MENINGITIS CAUSED BY PASTEURELLA MULTOCIDA

Laima Tamulienė, Urtė Stankutė, Skaistė Pečiulienė, Arūnas Liubšys — Mon, 30 Jun 2025 01:50:49 +0300

Pasteurella multocida (P. multocida) is the most common cause of localized infections in both adults and children following a domestic animal bite or scratch, which rarely causes meningitis or sepsis. Although this infection is rare in neonates, when sepsis or meningitis occurs, the mortality rate reaches 20%, and among survivors, long-term health complications are often observed. Preventing close contact between infants and domestic animals, as well as maintaining proper hand hygiene at home, can help avoid this infection. For the first time in Lithuania, a case of P. multocida-induced sepsis and meningitis is described in a 17-day-old female neonate following nontraumatic contact with a domestic animal, i.e., without a bite or scratch.

ACUTE PANCREATITIS IN PREGNANCY

Gabija Matuzaitė, Virginija Paliulytė — Mon, 30 Jun 2025 01:54:17 +0300

The article describes a rare case of severe acute biliary pancreatitis in a 35-week pregnant woman. Gallstones and pregnancy caused the pancreatitis. To manage the condition, a cesarean section was performed to deliver the baby, followed by a specialized treatment called endoscopic retrograde cholangiopancreatography (ERCP). The article reviews medical literature on the challenges of treating pregnant patients while minimizing risks to the baby.

PRENATAL DIAGNOSIS AND TREATMENT OF PARVOVIRUS B19. A CLINICAL CASE

Gabija Grežeckaitė, Kotryna Baltutytė, Edita Vabolienė — Mon, 30 Jun 2025 01:57:52 +0300

Parvovirus B19 infection during pregnancy can lead to severe fetal anemia and non-immune hydrops fetalis. Early diagnosis using middle cerebral artery peak systolic velocity (MCA PSV) Doppler screening enables timely detection of anemia and the need for intrauterine transfusion (IUT). In this case, IUT effectively reduced fetal anemia and improved hemodynamic stability. Post-procedure fetal monitoring and induced delivery at term helped prevent complications and ensured a favorable neonatal outcome.

ACUTE HEPATIC PORPHYRIA AND WOMEN’S HEALTH: WHEN TO SUSPECT AND HOW TO TREAT?

Augustina Tumelytė, Paulina Tekoriutė, Limas Kupčinskas — Mon, 30 Jun 2025 01:44:21 +0300

Acute hepatic porphyrias (AHP) are rare, inherited disorders related to impaired heme biosynthesis, most commonly affecting women of reproductive age. Clinical presentation is diverse and non-specific, including severe abdominal pain, neurological, and psychiatric symptoms, which often delays diagnosis. This article reviews key pathophysiological mechanisms, triggering factors, and emphasizes the particular aspects of women’s health and the impact of pregnancy on the disease course. Diagnostic approaches are discussed, highlighting the importance of urinary ALA and PBG testing and the role of genetic confirmation. Treatment strategies include the use of hemin for acute attacks, the preventive role of givosiran, and the importance of lifestyle modifications. Early diagnosis and appropriate treatment significantly improve patient outcomes and quality of life.

HIGH-RISK PULMONARY EMBOLISM IN PREGNANCY: DIAGNOSTIC AND TREATMENT CHALLENGES

Eglė Noreikaitė, Diana Ramašauskaitė — Mon, 30 Jun 2025 01:33:47 +0300

Aim of the study. To review the pathophysiology, diagnosis, risk stratification, and treatment of high-risk pulmonary embolism in pregnancy. Methods. A literature review was conducted by searching scientific publications in the PubMed database. Articles were selected using keywords and their combinations: pulmonary embolism, pregnancy, risk stratification, diagnosis, and management. Preference was given to systematic reviews and meta-analyses published within the last 10 years, although analytical observational studies and narrative literature reviews were included. Older publications were used for epidemiological data and the review of pathophysiology. Results. High-risk pulmonary embolism leads to right ventricular dysfunction and obstructive shock. While CT pulmonary angiography is the diagnostic gold standard, echocardiography is a valuable tool for unstable patients. Pregnant women should be assessed for the risk of premature death based on the same criteria as in the general population. Systemic thrombolysis may be used when haemodynamic instability is present but has a high bleeding risk. Conclusions. High-risk PE in pregnancy demands rapid diagnosis and risk assessment. Due to the lack of high-quality prospective studies, management should be made individually.

EDITORIAL COLUMN

Tomas Biržietis — Sun, 29 Jun 2025 00:00:00 +0300

LITHUANIAN SOCIETY OF OBSTETRICIANS AND GYNAECOLOGISTS ACTIVITIES 2001-2004

Audronė Arlauskienė — Mon, 30 Jun 2025 00:37:01 +0300

THE ROLE OF THE WID®-EASY EPIGENETIC TEST IN THE DIAGNOSIS OF CERVICAL CANCER

LSOG — Mon, 30 Jun 2025 00:00:00 +0300

Congratulations

LSOG — Mon, 30 Jun 2025 02:06:23 +0300