Browsing by Author "Rostoka, Zane"

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    In-Depth Analysis of Caesarean Section Rate in the Largest Secondary Care-Level Maternity Hospital in Latvia
    (2023-10-09) Rācene, Laura; Rostoka, Zane; Ķīse, Līva; Kacerauskiene, Justina; Rezeberga, Dace; Department of Obstetrics and Gynaecology
    There is no surgical intervention without risk. A high rate of caesarean sections (CSs) impacts on maternal and newborn mortality and morbidity. For optimisation of the CS rate, regular monitoring is necessary. In 2015, the World Health Organization recommended the Robson classification as a global standard for assessing, monitoring, and comparing CS rates. We analysed all births in 2019 in the Riga Maternity Hospital-a secondary-level monodisciplinary perinatal care hospital in Latvia-according to the Robson classification, seeking to identify which groups make the biggest contribution to the overall CS rate. In total, 5835 women were included. The overall CS rate was 21.5%. In our study, the largest contributors to the overall CS rate were as follows: Group 5 (33.3%); Group 2 (20.8%); and Group 1 (15.6%). The results of our deeper analysis of individual groups (Group 1 and 5) from our study may help to develop targeted interventions for specific subgroups of the obstetric population, effectively reducing both the overall rate of CS and the number of unnecessary CSs performed. The CS rate reduction strategy should be based on decreasing CSs in Group 1 and encouraging VBAC, thus decreasing the number of women undergoing two or more CSs in future
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    Non-disabled and disabled women sexual health comparison
    (2022-01) Pitkēviča, Ieva; Rostoka, Zane; Saulīte, Gabriela; Rezeberga, Dace; Briedīte, Ieva; Residency Unit; Department of Obstetrics and Gynaecology
    Background: Disabled women constitute approximately 16% of all women in Europe. Regardless of disability level women are interested in maintaining sexual activity. The study aim was to compare, understand if there are sexual health disparities between disabled women and non-disabled women. Methods: A cross-sectional study was conducted in non-governmental associations and the general practitioner's office in Latvia from November 2018 to January 2019. Data were collected from self-filled questionnaires of 34 DW and 34 NDW. Results: The mean age of NDW was 32 years and 43 years for DW. 73.5% of DW and 41.2% of NDW were partially satisfied with their sex life, p=0.009. 47.1% of DW and 32.4% of NDW admitted having an irregular sex life, p=0.002. 58.8% of NDW and 29.4% of DW had last sexual intercourse within 6 days period, p=0.011. 67.6% NDW and 20.6% DW thought their sex life will improve in future, p=0.001. 70.6% of DW was interested in maintaining sexual relations as well as 91.2% of NDW. 20.6% of DW was interested in maintaining sexual relationships but less than before disability. 29.4% of respondents from both groups noted that the level of disability or other health disorders had little impact on their sexual health. 8.8% of disabled women and 2.9% of non-disabled women had severe symptoms of depression. Conclusions: The study demonstrated that NDW had regular sex life and were more satisfied with it than DW. Regardless of the state of health women were interested in maintaining sexual activity.
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    The significance of ultrasound parameters and clinical factors in predicting successful labor induction among nulliparous women
    (2025-01) Rācene, Laura; Ķīse, Līva; Pitkēviča, Ieva; Rostoka, Zane; Sārta, Beāte; Priedniece, Maija; Vecvagare, Agnija; Lapidus, Ļubova; Ķīvīte-Urtāne, Anda; Rezeberga, Dace; Vedmedovska, Natālija; Department of Obstetrics and Gynaecology; Institute of Public Health
    OBJECTIVES: To compare the values of ultrasound and clinical parameters for predicting outcomes of induction of labor (IOL) among healthy nulliparous women with a singleton, term cephalic pregnancy. METHODS: The cervical length, cervical strain elastography, posterior cervical angle, head-perineum distance, Bishop score, and maternal parameters were assessed before IOL with a combined method-Foley catheter and Misoprostol perorally. The main outcome was vaginal delivery. RESULTS: Variation in cervical tissue elasticity, represented by elasticity index (E), was significantly different between outcome groups-vaginal delivery and cesarean section (CS) in internal os, in the anterior lip near the cervical canal and the midpoint of the anterior and posterior lip ( p  < 0.05). The E was higher-softer in the vaginal delivery group. The overall elasticity was significantly higher in the middle part of the cervix in the vaginal delivery group. However, other ultrasound metrics did not differ significantly across the outcome groups. Overall, women who delivered vaginally were taller and had a lower pre-pregnancy BMI ( p  = 0.02 for both variables). Univariate and multivariate analyses showed maternal height was the significant independent predictor of CS (AOR 0.91, 95% CI 0.84-0.98). The prognostic value for vaginal delivery, based on cervical length, maternal height, Bishop score, and parameters of cervical strain elastography, was poor (AUC < 0.7). CONCLUSION: The study underscores the importance of cervical tissue elasticity in predicting vaginal delivery outcomes, while also highlighting that maternal height is a significant independent predictor of cesarean delivery. However, evaluated metrics in the study have limited prognostic value for predicting vaginal delivery. This suggests a need for further research to identify more reliable predictors of delivery outcomes.
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    Ultrasound Simulation for Training Trainees when the Luxury Becomes Essential : Opinion and Evidence Obtained during the Latvian Research Council Project Implementation
    (2022) Vedmedovska, Natālija; Ķīvīte-Urtāne, Anda; Lisovaja, Ija; Rācene, Laura; Ķīse, Līva; Sārta, Beāte; Vaska, Agnija; Rostoka, Zane; Bule, Violeta; Pitkēviča, Ieva; Rezeberga, Dace; Department of Obstetrics and Gynaecology; Institute of Public Health; Department of Public Health and Epidemiology
    Background: Simulation as a proxy tool for conditional clinical training became a powerful technique for introducing trainees to the ultrasound imaging world, allowing them to become a trained sonographer taking into consideration different rates of progress in completing a specific task against the time and ensuring the long-lasting maintenance of the obtained practical skills. Adding a costly, but effective high fidelity simulator to the residency program justified the expense, demonstrating efficiency of training for improving the clinical performance and confidence of trainees. Materials and methods: A pilot study in Riga Maternity Hospital within the framework of the study “Role of metabolome, biomarkers and ultrasound parameters in successful labor induction” (Fundamental and Applied Research Programme lzp-2021/1-0300) was performed between March 1st 2022 and 31st April 2022. A virtual-reality simulator (ScanTrainer, Medaphor™, Cardiff, UK) was used with the teaching module for assessment of the uterine cervix. Five trainees in obstetrics and two young specialists included in the study. None of them had Fetal Medicine Foundation certificate of competence in the assessment of the uterine cervical lenght before. The time used on the simulator, the number of simulations and a mean confidence in cervical length assessment before and after simulation were recorded. Results: The study on assesment of uterine cervical lenght demonstrated statistically significant increase in confidence (p=0.008) and statistically significant decrease in time needed to complete correctly the same tasks for the trainees (p=0.008) that shows a positive learning curve over the time of training on ScanTrainer, Medaphor. Conclusions: The simple task allows to become a certified specialist in uterine cervical assessment in the short period of time. That support the productiveness of the simulation-based education. The training program should be updated taking into consideration simulation curriculum.