The objective was to assess the effects of prenatal yoga on heart rate variability (HRV) and cardio-respiratory synchronization, used as proxies of autonomic nervous system activity. Sixty-nine healthy pregnant women were included; 33 in a yoga group attending at least one 90-min yoga class weekly throughout pregnancy, and 36 controls not involved in formal pregnancy exercise programs. Measurements of the time domain (SDNN, standard deviation of regular R-R intervals, and RMSSD, square root of mean squared differences of successive R-R intervals) and frequency domain (ln(LF/HF), natural logarithm of low-frequency to high-frequency power) HRV indices, as well as cardio-respiratory synchronization indexes were performed once per trimester before and after yoga or 30-min moderate-intensity walk. A statistical comparison was performed using a three-way analysis of the variance (p < 0.05 significant). Both the time domain and frequency domain HRV indices showed significant shifts towards parasympathetic dominance following yoga when compared to the controls throughout pregnancy (p = 0.002 for SDNN, p < 0.001 for RMSSD, and p = 0.006 for ln(LF/HF), respectively). There was a statistically non-significant trend towards higher synchronization between respiratory frequency and heart rate following yoga vs. controls (p = 0.057). Regular prenatal yoga was associated with enhanced parasympathetic activation persisting throughout pregnancy.

Izhodišče: Joga sodi med najbolj priporočljive oblike telesne dejavnosti nosečnic. Ni povsem jasno, ali so koristi vadbe joge v nosečnosti večje od koristi drugih oblik telesne dejavnosti. Namen članka je predstaviti sistematični pregled randomiziranih raziskav, ki so učinke vadbe joge primerjale z učinki drugih oblik telesne dejavnosti v nosečnosti. Metode: Pregledali smo zbirko Medline. Uporabili smo deskriptorja iz tezavra Medical subject headings (Mesh) joga (»yoga«) in nosečnost (»pregnancy«). Vključili smo randomizirane raziskave, objavljene med letoma 1996 in 2019, ki so vadbo joge primerjale z drugo obliko telesne dejavnosti v nosečnosti. Rezultati: Od leta 1996 je bilo objavljenih 20 randomiziranih raziskav, ki so preučevale učinke joge na perinatalne izide. Le pet raziskav je primerjalo učinke joge z učinki drugih, za nosečnice priporočenih oblik telesne dejavnosti. V primerjavi z vodeno telovadbo ali redno hojo je bila vadba joge v nosečnosti povezana z manjšim tveganjem za duševne motnje, bolezni zvišanega krvnega tlaka, nosečnostno sladkorno bolezen, zastoj plodove rasti in prezgodnji porod. Zaključek: Joga je varna oblika telesne dejavnosti v nosečnosti, ki ugodno vpliva na zdravje nosečnice in ploda. Do danes objavljeni podatki kažejo, da so koristi vadbe joge v nosečnosti lahko večje od koristi drugih oblik telesne dejavnosti.

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Purpose: To evaluate the effect of a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis on postoperative bleeding following large loop excision of the transformation zone (LLETZ) of the uterine cervix.Methods: We performed a retrospective analysis of patients with cervical intraepithelial neoplasia (CIN) who underwent LLETZ at the Clinic for Gynaecology and Obstetrics, UMC Maribor, between 1993 and 2005. Cervical swabs were collected before the procedure to evaluate the presence of Chlamydia trachomatis and other genital pathogens. After the procedure, the occurrence and severity of postoperative bleeding was evaluated.Results: A total of 192 patients were recruited. A modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis was present in 5.2% of patients. The most frequently isolated groups of vaginal pathogens were group B streptococcus and Candida species. The occurrence of postoperative bleeding after LLETZ did not differ significantly when compared between groups with or without a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis (50.0% vs. 37.9%, p = 0.512).Conclusion: Patients with cervical intraepithelial neoplasia (CIN) commonly exhibit a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis. However, this is not an important risk factor for postoperative bleeding after LLETZ.

Purpose: Large loop excision of the transformation zone (LLETZ) under local anaesthesia has almost replaced cold knife conisation in the treatment of cervical squamous intraepithelial dysplasia (SIL). Thermal artefacts in specimens after LLETZ may be so severe, that they prevent histopathological interpretation and evaluation of the radicality of the procedure. There are limited data regarding the prevalence of severe thermal artefacts after LLETZ and their clinical relevance regarding the need for reoperation. Methods: In this retrospective study, we included 314 consecutive patients who were treated with LLETZ or cold knife conisation for cervical SIL in 2016 at our clinic. The primary outcome of the study was to determine the prevalence of severely damaged surgical margins after LLETZ and if these thermal artefacts can predict residual disease or the need for reoperation. The secondary outcome was the prevalence of postoperative and short–term complications. Results: Three hundred and fourteen women underwent surgery for cervical SIL. In 95.2% of cases, we performed LLETZ, and 89.3% of women had this procedure under local anaesthesia. The reoperation rate was 3.8%. Positive or inconclusive margins were present in 20.4% of specimens. In 10.7% of allLLETZ cases, thermal artefacts were so severe that they interfered with histopathological interpretation. However, only one of these patients needed reoperation. Postoperative vaginal discharge and mild bleeding requiring therapeutic intervention occurred in 4.7% and 6.7% of cases, respectively. Conclusion: Although approximately 10% of patients had severe thermally damaged margins after LLETZ, only 3% required reoperation. In our experience, severely damaged margins were not associated with higher reoperation rate. On the other hand, a carefully planned follow–up visit with cytology, human papillomavirus (HPV) testing and colposcopy with biopsy after the procedure is of utmost importance in the evaluation of residual disease.