Labor analgesia in Czech Republic and Slovakia: a 2015 national survey.

BACKGROUND: The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK). METHODS: All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). RESULTS: The response rate was 71% (70 of 95 departments in CZE, 35 of 54 centers in SVK). Participating centers represented 87.7% of all births in CZE and 66.4% of all births in SVK during the study period. Analgesia for labor, administered by anesthesiologists, was recorded in 12.5% of deliveries (CZE 12.1%, SVK 13.4%). Epidural analgesia was used in most of the cases (CZE 97.2%, SVK 99.1%) whereas spinal (CZE 1.4%, SVK 0.9%) or combined spinal-epidural (CZE 0.5%, SVK 0.0%) and intravenous remifentanil analgesia (CZE 2.4%, SVK 0.0%) were used infrequently. One fifth of the labors with analgesia administered by anesthesiologists (CZE 20.2%, SVK 20.5%) terminated in cesarean section. CONCLUSIONS: Although labor analgesia was available in all Czech and Slovak obstetric centers, only a small proportion of parturients received an effective method of labor pain relief (regional or intravenous analgesia).

[Evaluation of diet in a sample of Czech mothers six months after delivery]. / Zhodnocení stravování vzorku ceských matek v sestém mesíci po porodu.

BACKGROUND: Health care of nursing mothers and their infants is an important priority of primary preventive care. The mother's diet plays an important role in this respect. The objective of the presented investigation was to assess the adequacy of the dietary intake of lactating mothers during the sixth month after delivery. METHODS AND RESULTS: Data on the education, body weight, height of the mother, dietary intake, evaluated from a three-day dietary record, were collected from 131 nursing mothers and compared with the Czech recommended dietary allowances for nursing mothers as well as with data from 265 controls, i.e. women who did no longer breastfeed their babies. From the results ensues a significantly higher calcium intake (937 mg; SD = 415, p < 0.001), vitamin B1 (1.1 mg, SD = 0.5, p < 0.001), total energy (8.7 MJ, SD = 2.6, p < 0.01), protein 75.4 g, SD = 18, p < 0.01), carbohydrates (281 g, SD = 112, p < 0.01) and riboflavin (1.3 mg, SD = 0.5, p < 0.01) in nursing women as compared with those not nursing. The nursing mothers, however, do not meet the Czech recommended dietary allowances as regards total energy, calcium, vitamin C, linoleic acid, vegetable proteins and iron. Other problematic nutrients-magnesium, zinc, folates, pyridoxine, selenium and iodine could not be assessed as they are not listed in the Czech food composition tables. In women with university education the energy and nutrient intake was in the majority more favourable than in women with elementary education. On the other hand no statistical differences were found in weight increments during the period from the beginning of gestation to the sixth month after delivery between nursing and not nursing mothers. CONCLUSIONS: The results of analysis of the dietary intake of nursing mothers indicate that the Czech recommended allowances are not met as regards energy, calcium, linoleic acid, protein and iron. Whether the intake is really inadequate or whether the recommended allowances are excessive remains an open question.