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Trudnoća obuhvaća razdoblje života svake žene u trajanju od 40 tjedana, 280 dana ili 9 kalendarskih mjeseci uz rast i razvoj fetusa u trbuhu majke i rođenje djeteta novorođenčeta. U pripremi trudnica za porod postoje razni stručni tečajevi koji će pomoći trudnici za primjenu određenog oblika fizičke pripreme prema njenom trenutnom stanju. Od velikog značaja tome pridonose fizioterapeuti ili edukatori koji će pridavati pažnju trudnicama tijekom vježbanja, tehnikama pravilnog disanja, samopomoći prije, tijekom i nakon poroda uz smanjenje stresa da porod prođe što lakše i bezbolnije. U ovom radu objašnjeni su mehanizmi porođaja po porođajnim dobima kao i fiziološke i anatomske promjene u trudnoći. Fizioterapijska procjena temelji se prema SOAP modelu iz kojeg se procjenjuje subjektivni pregled koji se dobiva anamnezom trudnice i objektivni pregled uz opservaciju pojedinih segmenata tijela, palpaciju kože i mekih tkiva te procjenu funkcije prsnog koša, trbuha i zdjelice. Također se veliki naglasak stavlja na apsolutne i relativne kontraindikacije prilikom vježbanja u trudnoći i na znakove za prekid vježbanja. Fizioterapijska intervencija bazira se na tjelesnoj aktivnosti trudnice, tehnikama pravilnog disanja i terapijskom vježbanju kao fizičkoj pripremi trudnice za porođaj. U ovom radu prikazane su i opisane vježbe po svakom tromjesečju. U prvom tromjesečju program vježbi uključuje aktivaciju muskulature trupa, vježbe za aktivaciju muskulature stabilizatora lopatica i gornjeg dijela trupa, vježbe za aktivaciju muskulature gornjih ekstremiteta, vježbe za aktivaciju muskulature donjih ekstremiteta i vježbe za aktivaciju respiratorne muskulature. Tijekom drugog tromjesečja provode se vježbe za aktivaciju muskulature trupa, vježbe za aktivaciju muskulature stabilizatora lopatica i gornjeg dijela trupa, vježbe za aktivaciju muskulature gornjih ekstremiteta, vježbe za aktivaciju muskulature donjih ekstremiteta, vježbe za aktivaciju muskulature zdjeličnog dna i vježbe za aktivaciju respiratorne muskulature. U trećem tromjesečju primjenjuju se vježbe za aktivaciju muskulature trupa, vježbe za aktivaciju muskulature stabilizatora lopatica i gornjeg dijela trupa, vježbe za aktivaciju muskulature gornjih ekstremiteta, vježbe za aktivaciju muskulature donjih ekstremiteta, vježbe za aktivaciju muskulature zdjeličnog dna, vježbe za aktivaciju respiratorne muskulature i vježbe tehnike izgona. Pregnancy includes the period of every woman's life lasting 40 weeks, 280 days or 9 calendar months with the growth and development of the fetus in the mother's womb and the birth of the newborn child. In the preparation of pregnant women for childbirth, there are various professional courses that will help the pregnant woman to apply a certain form of physical preparation according to her current condition. Of great importance are physiotherapists or educators who will pay attention to pregnant women during exercise, proper breathing techniques, self-help before, during and after childbirth while reducing stress so that childbirth goes as smoothly and painlessly as possible. This paper explains the mechanisms of childbirth by birth age, as well as the physiological and anatomical changes during pregnancy. Physiotherapy evaluation is based on the SOAP model, which evaluates a subjective examination obtained from the pregnant woman's history and an objective examination with observation of individual body segments, palpation of the skin and soft tissues, and evaluation of the function of the chest, abdomen and pelvis. Also, great emphasis is placed on absolute and relative contraindications when exercising during pregnancy and on signs to stop exercising. Physiotherapy intervention is based on physical activity of the pregnant woman, proper breathing techniques and therapeutic exercise as physical preparation of the pregnant woman for childbirth. In this paper, the exercises for each quarter are shown and described. In the first trimester, the exercise program includes trunk musculature activation, shoulder stabilizer and upper body musculature activation exercises, upper limb musculature activation exercises, lower limb musculature activation exercises and respiratory musculature activation exercises. During the second trimester, exercises are carried out for activating the musculature of the trunk, exercises for activating the musculature of the shoulder blades and the upper part of the trunk, exercises for activating the musculature of the upper extremities, exercises for activating the musculature of the lower extremities, exercises for activating the musculature of the pelvic floor and exercises for activating the respiratory musculature. In the third trimester, exercises are applicated for activating the musculature of the trunk, exercises for activating the musculature of the shoulder blades and the upper part of the trunk, exercises for activating the musculature of the upper extremities, exercises for activating the musculature of the lower extremities, exercises for activating the musculature of the pelvic floor, exercises for activating the respiratory musculature and exercises expulsion techniques.

Distocija fetalnih ramena je zastoj fetalnih ramena u porodnom kanalu što onemogućuje normalan mehanizam poroda i dovodi do zastoja u porodu. U porodništvu se opisuju dva oblika distocije fetalnih ramena, visoka i niska distocija fetalnih ramena. Ciljevi ovog preglednog rada su kategorizirati i objasniti tehnike rješavanja distocije fetalnih ramena i utvrditi najučinkovitiju tehniku rješavanja distocije fetalnih ramena. Za pretraživanje i prikupljanje podataka koristit će se znanstvena i stručna literatura iz bibliografskih baza podataka te će se odabrati literatura iz odabranih istraživanja za koju će se pretpostaviti da je od važnosti za ovaj pregledni rad. Za odabir izvora podataka koristit će se kriteriji uključivanja i kriteriji isključivanja te ključne riječi. Postoje brojni čimbenici rizika koji su povezani s nastankom distocije fetalnih ramena no ipak su većina istraživanja potvrdila da se distocija fetalnih ramena javlja kad izostanu svi poznati čimbenici rizika. Čimbenici rizika za distociju fetalnih ramena jesu čimbenici od strane majke, od strane djeteta i od strane poroda. Čimbenici rizika za nastanak distocije fetalnih ramena dijelimo u tri velike skupine (prekoncepcijski, antenatalni, intrapartalni) za prevenciju nastanka distocije fetalnih ramena. Dijabetes i fetalna makrosomija dokazano su najčešći čimbenici rizika za nastanak distocije fetalnih ramena. Porod kompliciran distocijom fetalnih ramena završava se nježnim povlačenjem glavice prema dolje uz različite postupke koji se primjenjuju kod distocije fetalnih ramena. Postupci koji se primjenjuju kod distocije fetalnih ramena su ručne pomoći, a dijelimo ih na vanjske (ekstravaginalni primarni postupci), unutarnje (sekundarni vaginalni postupci) i kombinirane (abdominalno vaginalni postupci) postupke. Tehnike rješavanja distocije fetalnih ramena dijele se na vanjske primarne i unutarnje sekundarne te je najučinkovitija tehnika rješavanja distocije fetalnih ramena McRobertsov postupak. Carski rez radi se kada niti jedan postupak nije pomogao da se porod završi vaginalno. Carski rez kao prevencija nastanka distocije fetalnih ramena nije medicinski opravdan. Izvođenje epiziotomije kod poroda kompliciranog distocijom fetalnih ramena procjenjuje se individualno., Fetal shoulder dystocia is a stagnation of the fetal shoulders in the birth canal, which disables the normal mechanism of childbirth and leads to stagnation in childbirth. In obstetrics, two forms of fetal shoulder dystocia are described, high and low fetal shoulder dystocia. The objectives of this review paper are to categorize and explain techniques for resolving fetal shoulder dystocia and to determine the most effective technique for resolving fetal shoulder dystocia. Scientific and professional literature from bibliographic databases will be used to search and collect data, and literature from selected research will be selected that will be assumed to be important for this review paper. Inclusion and exclusion criteria and keywords will be used to select the data source. There are a number of risk factors associated with the development of fetal shoulder dystocia, but most research has confirmed that fetal shoulder dystocia occurs when all known risk factors are absent. Risk factors for fetal shoulder dystocia are factors from the mother, from the child, and from childbirth. Risk factors for fetal shoulder dystocia are divided into three major groups (preconception, antenatal, intrapartum) for the prevention of fetal shoulder dystocia. Diabetes and fetal macrosomia have been shown to be the most common risk factors for fetal shoulder dystocia. Childbirth complicated by fetal shoulder dystocia ends with a gentle pulling of the head down with various procedures applied to fetal shoulder dystocia. The procedures used in fetal shoulder dystocia are manual aids, and we divide them into external (extravaginal primary procedures), internal (secondary vaginal procedures) and combined (abdominal vaginal procedures) procedures. Fetal shoulder dystocia resolution techniques are divided into external primary and internal secondary dystocia, and the most effective fetal shoulder dystocia resolution technique is the McRoberts procedure. Cesarean section is performed when no procedure has helped to complete the birth vaginally. Cesarean section as a prevention of fetal shoulder dystocia is not medically justified. Performing an episiotomy in labor complicated by fetal shoulder dystocia is assessed individually.

Program psihofizičke pripreme trudnica “Fit i zdrava mama” Podgorica, podrazumijeva set fizičkih vježbi i teorijskih predavanja koji imaju za cilj pripremiti trudnicu za porođaj, kako bi dolazak u rodilište bio sa što manje straha, a sa što više pozitivne energije koja će joj pomoći da na svijet donese svoje dijete. Trudnice koje dobro usvoje znanja u rodilište dolaze opuštene i spremne na suradnju sa primaljama i opstetričarima. Trudnice tijekom ovih priprema nauče tehnike disanja, načine na koje se mogu bolje nositi sa kontrakcijama i na taj način olakšati sebi, na koji način roditi svoje dijete, a kako bi cjelokupan doživljaj porođaja bio ugodno i lijepo iskustvo, a ne trauma. Cilj ovoga rada je saznati na koji način pohađanje prenatalne škole utječe na iskustvo rodilja i ishod porođaja i koji faktori utječu na ishod. Za izradu ovoga rada ispitano je 100 trudnica, a koje su se porodile u Kliničkom Centru Crne Gore u Podgorici. Rezultati ovoga istraživanja govore kako su trudnice koje su pohađale program psihofizičke pripreme za porođaj imale šansu upoznati porođaj u nekom ljepšem svijetlu, biti pripremljene, kako bi u rodilište odlazile sa manjom dozom straha, na koji način koristiti tehnike disanja kao i kretanje u porođaju, a kako bi imale što lakši i lijepši porođaj bez upotrebe ljekova i intervencija. Zaključno možemo utvrditi da su one trudnice koje su pohađale program za trudnice „Fit i zdrava mama“ u Podgorici imale manju dozu straha i veći osjećaj zadovoljstva nakon porođaja, zahvaljujući adekvatnoj pripremi i pravim informacijama. Ova škola na najefikasniji način smanjuje šansu za primjenu opstetričke operacije na porođaju u odnosu na druge prenatalne škole u Podgorici., The program of psychophysical preparation of pregnant women "Fit and healthy mother" Podgorica, includes a set of physical exercises and theoretical lectures aimed at preparing pregnant women for childbirth, to come to the maternity hospital with as little fear and as much positive energy that will help her to the world brings its child. Pregnant women who adopt the knowledge well come to the maternity hospital relaxed and ready to cooperate with obstetricians and midwives. During these preparations, pregnant women learn breathing techniques, ways in which they can overcome contractions and thus make it easier for themselves, how to press their baby so that the whole experience of childbirth would be a pleasant and beautiful experience and not trauma. The aim of this paper is to find out how attending prenatal school affects the experience of childbirth and the outcome of childbirth and which factors affect the outcome. For the preparation of this paper, 100 pregnant women who gave birth at the Clinical Center of Montenegro in Podgorica were examined. The result of this study show that pregnant women who attended the program of psychophysical preparation for childbirth had a chance to experience childbirth in a better light, to be prepared, to go to the maternity hospital with a lower dose of fear, to use breathing techniques and movement in childbirth to have as easy and beautiful birth as possible without the use of drugs and interventions. In conclusion, we can say that pregnant women who attended the program for pregnant women “Fit and Healthy Mom” in Podgorica had a lower dose of fear and a greater sense of satisfaction after childbirth thanks to adequate preparation and the right information. This school is the most efficient way to reduce the chance for the application of obstetric surgery at birth in relation to other prenatal schools in Podgorica.

Ovaj rad bavi se pitanjem opstetričkog nasilja nad trudnicama. Osim osobne razine, nasilje nad trudnicama dio je većeg društvenog problema i važan sociološki problem, stoga je objašnjeno i utemeljeno na nekoliko socioloških koncepata i teorija: teoriju rodno uvjetovanog nasilja, institucionalnog nasilja, strukturalnog nasilja te kroz koncept reproduktivne samodeterminacije. Glavni ciljevi rada su utvrđivanje i analiziranje vrsta i oblika opstetričkog i ginekološkog nasilja s kojima se suočavaju trudnice i rodilje u hrvatskim rodilištima, posljedica s kojima kasnije nastavljaju živjeti te oblike njihovih reakcija u slučaju doživljavanja ginekološkog nasilja. Svrha je produbiti znanje o navedenom problemu koji je još uvijek u određenoj mjeri nepoznat javnosti i o njemu se ne govori koliko bi trebalo. Za potrebe rada provedeno je istraživanje kvantitativnom metodologijom: metodom ankete. Uzorak čini 1401 ispitanica prosječne dobi 40,5 godina s područja cijele Republike Hrvatske koje su rodile u hrvatskim bolnicama od 2015. godine do danas. Interpretacijom dobivenih rezultata istraživanja došlo se do zaključka da žene doživljavaju sve vrste opstetričkog nasilja: verbalno nasilje, fizičko nasilje te ostale prisilne prakse poput neinformiranja o postupcima, oduzimanja suodlučivanja i mogućnosti donošenja odluka. Navedena ponašanja utječu na njihov doživljaj poroda. Zbog toga se trudnice suočavaju s nekim negativnim posljedicama poput straha od iduće trudnoće ili odluke o nerađanju, ali i negativnim zdravstvenim posljedicama. Na kraju rada predložene su potencijalne mjere i mogućnosti koje bi dovele do poboljšanja kvalitete i dostojanstva unutar trudničke njege. This paper deals with the issue of obstetric violence against pregnant women. Apart from the personal level, violence against pregnant women is part of a larger social problem and an important sociological problem, so it is explained and based on several sociological concepts and theories: the theory of gender-based violence, institutional violence, structural violence and the concept of reproductive self-determination. The main objectives of this paper are to identify and analyze the types and forms of obstetric and gynecological violence faced by pregnant women and mothers in Croatian maternity hospitals, the consequences with which they later continue to live and the forms of their reactions in case of gynecological violence. For the purposes of the paper, the research was conducted using a quantitative methodology: the survey method. The sample consists of 1401 respondents with an average age of 40.5 years from the entire Republic of Croatia who gave birth in Croatian hospitals from 2015 until today. The purpose is to deepen the knowledge of this problem, which is still to some extent unknown to the public and is not talked about as much as it should be. Interpretation of the obtained research results, it was concluded that women experience all types of obstetric violence: verbal violence, physical violence and other coercive practices such as failure to inform about procedures, deprivation of co-decision and the ability to make decisions. These behaviors affect their experience of childbirth. Because od that, pregnant women face some negative consequences such as fear of the next pregnancy or the decision not to give birth, but also negative health consequences. At the end of the paper were proposed potential measures and possibilities that would lead to the improvement of quality and dignity within maternity care.

Trudnoća je razdoblje u ženinom životu u kojem dolazi do velikih i mnogobrojnih promjena. Da bi se trudnica lakše nosila sa fizičkim, psihičkim i hormonskim promjenama koje se zbivaju preporučeno je pripremati se prije trudnoće ili u ranoj trudnoći čitajući adekvatnu literaturu. Najnormalnija pojava koja se zbiva u trudnoći pa i od početka same trudnoće je razvoj straha prema nepoznatom. Strah od svih nepoznanica koje će se događati u trudnoći i budućem majčinstvu, pogotovo kod prvorotka. Opet, tu dolazi do izražaja educiranost i informiranost koja pomaže trudnicama da upoznaju i prihvate svoje stanje i ako je potrebno potraže pomoć. Od početka razvoja sestrinstva medicinska sestra je bila ta koja je pružala skrb trudnicama, rodiljama, majkama i djeci. Glavna područja djelovanja medicinskih sestara tijekom prenatalne skrbi su: unapređenje i održavanje zdravlja trudnica, otkrivanje visoko rizičnih trudnica, osobito onih koje su van sustava zdravstvene skrbi te ih povezati sa sustavom i pomaganje trudnicama u ostvarenju prenatalne zaštite. Cilj ovog rada je ispitati potrebe žena rodilja vezane za kontinuiranu podršku tijekom trudnoće i poroda te analizirati postoje li razlike između rodilja koje su imale podršku na porodu i rodilja koje istu nisu imale. Za potrebe rada izrađen je i primijenjen anketni upitnik na uzorku od 226 rodilja (N=226). Prikupljene podaci statistički su obrađeni, analizirani i interpretirani. Iz rezultata provedenog istraživanja jasno je uočljivo da većina rodilja smatra da je podrška na porodu potrebna. U radu su prikazane i smjernice kojima se može poboljšati rad medicinske sestre u radu sa ženama tijekom trudnoće i poroda. Pregnancy is a period of a woman's life when so many changes occur. In order for the pregnant women to overcome this physical, psychological and hormonal changes that occur, it is recommended to prepare before pregnancy or at early pregnancy by reading adequate literature. The most normal occurrence that appears in pregnancy and since the beginning of pregnancy is the development of fear towards the unknown. Fear of all the unknowns that will occur in pregnancy and in future motherhood, especially can occur at childbirth. Again, there is a sense of education and information that helps pregnant women to get to know and accept their condition and if it is needed to seek help. Since the beginning of the development modern nursing, nurse was the one who was providing care to pregnant women, mothers and children. The main areas of activity of nurses during prenatal care are: improving and maintaining the health of pregnant women, detection of high-risk pregnant women, especially those outside the health care system and connect them with the system and helping pregnant women in the realization of prenatal care. The goal of this paper is to examine the needs of women and pregnant women related to continuous support during pregnancy and childbirth and to analyze whether there are differences between mothers who have had support during childbirth and mothers who did not have the same support. For the purpose of making this paper it has been made and administered questionnaire on a sample of 226 (N=226) women (mothers). The collected data were statistically processed, analyzed and interpreted. From the results of the study, clearly is showing that the most off mothers consider that the support on childbirth is necessary. This paper also presents the guidelines that can improve the performances of nurses which are working with women during their pegnancy and childbirth.

Značaj podrške na porođaju se kroz povijest mijenjala. Danas je rodiljama omogućeno da odaberu način kojim će roditi, ako rodilja i njezino dijete nemaju zdravstvenih problema. Pratnja na porođaju rodiljama pruža emocionalnu, psihičku i fizičku podršku. Primarni cilj ovog istraživačkog rada je utvrditi kako prisutnost pratnje na porođaju utječe na ishode porođaja. Daljnji ciljevi su utvrditi utječe li prisustvo pratnje na porođaju na vrijeme provedeno u rađaonici te je li vaginalni porođaj učestaliji kod rodilja koje imaju pratnju tijekom porođaja ili kod rodilja koje nemaju pratnju tijekom porođaja. Također cilj je bio ispitati učestalost instrumentalnog dovršenja porođaja kod dvije skupine ispitanica – onih koje su imale pratnju na porođaju u usporedbi s onima koje nisu imale pratnju na porođaju. Podaci korišteni za ovo istraživanje prikupljeni su pomoću online upitnika koji je za potrebe ovog završnog rada s istraživanjem bio kreiran u sustavu Google obrazaca. Rezultati ovog istraživanja pokazuju da prisustvo pratnje na porođaju nije povezano s kraćim vremenom provedenim u rađaonici, kao i da je učestalost vaginalnog porođaja nije veća kod rodilja koje su imale pratnju tijekom porođaja u odnosu na rodilje koje nisu imale pratnju tijekom porođaja. Također, rezultati ovog istraživanja pokazuju da je učestalost instrumentalnog dovršenja porođaja veća kod rodilja su imale pratnju tijekom porođaja u odnosu na one rodilje koje nisu imale pratnju tijekom porođaja., Meaning of social support during labor has changed through time. Today, pregnant women can choose which way to give birth, if their health and health of the newborn allows that. Social support during labor is emotional, physiological and physical. The primary objective of this bachelor thesis is to determine how social support affects on labor outcomes. Further objectives are to determine whether the presence of social support is associated with shorter time spend in the delivery room, whether vaginal delivery is more common with pregnant women who are accompanied during childbirth or with pregnant women who are not accompanied during childbirth. Also, the objective was to determine the frequency of instrumental delivery in two groups of women – those that were accompanied during childbirth in comparison to those women that were not accompanied during childbirth. Data that has been used for this survey was collected using an online survey created for the purposes of this final research paper in the Google Forms system. Outcome of this research show that the presence of social support is not associated with shorter time spend in the labor room, as well as the vaginal delivery is not more common with pregnant women who are accompanied during childbirth or with pregnant women who are not accompanied during childbirth. Also, the results of this research show that the instrumental delivery is more common with pregnant women that were accompanied during childbirth compared to those pregnant women that were not accompanied during childbirth.

Preeklampsija je česta komplikacija trudnoće koja se odražava povišenim krvnim tlakom, proteinurijom i edemima. Važno je započeti s ranim prepoznavanjem bolesti, dijagnozom i liječenjem kako bi spriječile komplikacije HELLP sindroma. Kroz rad se ističu hipertenzivne bolesti u trudnoći s osvrtom na preeklampsiju. U dijagnostici je izrazito važno bolest otkriti na vrijeme kako bi mogli pristupit obradi trudnice laboratorijskim pokazateljima, ultrazvučnom kontrolom fetusa, color doppler pupčane vrpce. U radu je opisan razvoj bolesti, klinička slika, etiologije, patofiziologije, sestrinska skrb kod preeklampsije, porod.U liječenju preeklampsije primjenjuju se antihipertenzivni lijekovi za snižavanje krvnog tlaka. Prirodan porod daje najbolji izbor, noako stanje majke i fetusa to ne dozvoljava porod moramo dovršiti carskim rezom. Preeclampsia is a common complication of pregnancy, which is reflected by increased blood pressure, proteinuria and edema. It is important to start with early disease recognition, diagnosis and treatment to prevent complications of HELLP syndrome. Hypertensive diseases in pregnancy with a focus on preeclampsia are highlighted in the work. In diagnostics, it is extremely important to detect the disease in time so that the pregnant woman can be treated with laboratory indicators, ultrasound control of the fetus, color doppler of the umbilical cord. The paper describes the development of the disease, clinical picture, etiology, pathophysiology, nursing care in preeclampsia, childbirth. In the treatment of preeclampsia, antihypertensive drugs are used to lower blood pressure. A natural birth is the best choice, if the condition of the mother and the fetus do not allow a natural birth, we must complete it with a caesarean section.

Cilj ovog rada bio je opisati ulogu primalje u predviđanju i prevenciji preeklampsije. Preeklampsija je najčešći oblik hipertenzivne bolesti u trudnoći. Definira se kao pojava hipertenzije nakon 20.tjedna trudnoće i to vrijednostima krvnog tlaka >140/90 mmHg (18,7/12,0 kPa) u dva mjerenja u razmaku većem od 6 sati te proteinurijom od 300mg u 24-satnom urinu ili 0,1/L urina u 2 uzorka uzeta u razmaku 4-6 sati. Obzirom na javnozdravstveno značenje preeklampsije provedena su brojna istraživanja o etiopatogenezi i prevenciji ove bolesti. Od metoda predviđanja danas postoje upoznavanje sa osobnom i opstetričkom anamnezom, mjerenje arterijskog tlaka, ultrazvučna doplerska mjerenja te biokemijski testovi i njihove kombinacije. Za prevenciju se koristi heparin, pravastatin, magnezijev sulfat, a najšire se primjenjuje aspirin u dozi 100mg od 12. tjedna trudnoće. Postoje brojne podjele preeklampsije od kojih je danas najznačajnija ona s ranim početkom (prije 24.tjedna) te ona s kasnim početkom (nakon 37.tjedna). Uloga primalje u predviđanju je da već prilikom prvog pregleda izdvoji trudnice sa osobnom i opstetričkom anamnezom koje bi mogle rezultirati nastankom preeklampsije u trudnoći. Na sljedećim pregledima primalja treba trudnicu upozoravati na znakove koji mogu dovesti do preeklampsije. Također, u dogovoru s liječnikom može trudnicu upoznati sa ostalim metodama predviđanja. U pogledu prevencije, uloga primalje je da kroz opće higijensko-dijetetske mjere uputi trudnicu kako je moguće odgovornim ponašanjem smanjiti učestalost preeklampsije. The aim of this paper was to describe the role of the midwife in predicting and preventing preeclampsia. Preeclampsia is the most common form of hypertensive disease in pregnancy. It is defined as the appearance of hypertension after the 20th week of pregnancy, with blood pressure values >140/90 mmHg (18.7/12.0 kPa) in two measurements more than 6 hours apart and proteinuria of 300 mg in 24-hour urine or 0,1/L urine in 2 samples taken 4-6 hours apart. Given the public health significance of preeclampsia, numerous studies have been conducted on the etiopathogenesis and prevention of this disease. Prediction methods today include personal and obstetric anamnesis, arterial pressure measurement, ultrasound Doppler measurements, and biochemical tests and their combinations. Heparin, pravastatin, magnesium sulfate are used for prevention, whilst the most widely used is aspirin in a dose of 100 mg from the 12th week of pregnancy. There are numerous divisions of preeclampsia, the most significant of which nowadays is early onset (before the 24th week) and late onset (after the 37th week). The midwife's role in prediction is to single out pregnant women with a personal and obstetric history that could result in the onset of preeclampsia during the first examination. At the next examinations, the midwife should warn the pregnant woman about the signs that can lead to preeclampsia. Also, in agreement with the doctor, the pregnant woman can be introduced to other prediction methods. In terms of prevention, the midwife's role is to guide the pregnant woman through general hygiene and dietary measures on how to reduce the frequency of preeclampsia through responsible behavior.

Ljudska plodnost i rađanje su od samih početaka važne osobne i društvene vrednote, ali i zadaće koje se tiču svakog bračnog para. Kroz povijest su one nerijetko krivo shvaćene i tumačene i upravo su to teme koje su izazvale oštre nesuglasice u životu Crkve. Crkvene rasprave uvijek su se dijelile na dva dijela, na tzv. stav većine i stav manjine, na stav onih koji su se slagali s tradicionalnim naukom Katoličke crkve i onih koji su željeli promjene smatrajući zastarjelim i besmislenim nauk Crkve. Nesuglasice su se uglavnom odnosile na metode kontrole broja porođaja i njihovu upotrebu. Te podjele na stav većine i manjine i žustre rasprave traju još i danas. Kako bismo bolje i sveobuhvatnije razumjeli značenje i aktualnost načela odgovornog rađanja, rad dijelimo na tri dijela. U prvom dijelu ćemo kratko i u općim crtama iznijeti razumijevanje, značenje i smisao plodnosti i rađanja tijekom povijesti. U drugom dijelu ćemo govoriti o načelu odgovornog rađanja, njegovoj strukturi, stavu Crkve i mogućnosti primjene odgovornog rađanja u nekim životnim situacijama bračnog para. U trećem dijelu rada ćemo iznijeti neke od moralno prihvatljivih i moralno neprihvatljivih metoda kontrole broja porođaja te analizirati najčešća pastoralna pitanja vezana uz odgovorno rađanje svjesni činjenice da će zbog prisutnosti raznih metoda i potrebe ispovijedi zbog korištenja određenih metoda ova tema biti prisutna i u dalekoj budućnosti. From the very beginning, human fertility and birth have been important personal and social values, but also tasks that concern every married couple. Throughout history, they have been misunderstood and misinterpreted. These are precisely the topics that have caused sharp disagreements in the life of the Church. Church debates have always been divided into two parts, the so-called the attitude of the majority and the minority, to the attitude of those who agreed with the traditional teachings of the Catholic Church and those who wanted change by considering the teaching of the Church obsolete and meaningless. Disagreements mainly concerned methods of birth control and their use. These divisions into majority and minority attitudes and heated debates continue to this day. In order to better and more comprehensively understand the meaning and relevance of the principle of responsible birth, we divide the work into three parts. In the first part, we will briefly and in general terms present the understanding, meaning and meaning of fertility and birth throughout history. In the second part we will talk about the principle of responsible birth, its structure, the attitude of the Church and the possibility of applying responsible birth in some life situations of a married couple. In the third part of the paper we will present some of the morally acceptable and morally unacceptable methods of birth control and analyze the most common pastoral issues related to responsible birth aware of the fact that due to the presence of various methods and the need for confession due to certain methods this topic will be present in the distant future.

Fizioterapija u ginekologiji i porodništvu svakim danom postaje traženija i sve više integrirana u ginekološke procese kod trudnica, rodilja, ali i svih preostalih žena koje su suočene sa problemima u toj domeni. Trudnoća je razdoblje brojnih fizičkih, psihičkih i drugih promjena te kao takva zahtjeva stalnu skrb i nadzor više različitih medicinskih stručnjaka. Svaka trudnoća predstavlja individualno stanje koje potencijalno može biti popraćeno određenim komplikacijama i bolnim stanjima koja zahtijevaju specifičan pristup od strane više biomedicinskih grana pa tako i fizioterapije. Bolna stanja u trudnoći predstavljaju široki spektar stanja. Ona se za vrijeme trudnoće javljaju zbog fizioloških, posturalnih i hormonalnih promjena, mehaničkog stresa, porasta tjelesne težine i nekih drugih čimbenika. Trudnoća, kao jedno individualno iskustvo i stanje, predstavlja vremenski period brojnih promjena i prilagodba tjelesnih sustava tijela. No, tako je moguća pojava različitih teškoća i komplikacija. Fizička aktivnost i vježbanje u trudnoći donose brojne dobrobiti. Prednosti vježbanja u trudnoći odnose se i na trudnicu i na fetus, odnosno dijete. Porođaj je istiskivanje fetusa i preostalih produkata začeća u vremenskom razdoblju od 37. do 42. tjedna trudnoće te kao takav predstavlja porodni mehanizam. Rađanje ovisi o više čimbenika. Cilj ovog rada je ispitati kakvo je iskustvo rodilja sa fizioterapijom, korištenjem fizioterapijskih tretmana za vrijeme trudnoće i poslije poroda te dostupnošću istih. Također, ispitati postoje li razlike u korištenju fizioterapijskih tretmana između rodilja koje su rodile vaginalnim porodom ili carskim rezom te jesu li ili nisu imale potrebu za fizioterapijom i zašto. Podaci za ovo istraživanje prikupljeni su pomoću online anketnog upitnika na uzorku od 155 sudionica (N=155). Prikupljeni podaci su statistički obrađeni i interpretirani. Iz rezultata koji proizlaze iz istraživanja uočljivo je kako su sudionice nezadovoljne dostupnošću fizioterapijskih tretmana i usluga te informacijama o istima. Također, sudionice navode potrebu za fizioterapijom te da bi rado pristupile fizioterapijskoj procjeni i tretmanima. Physiotherapy in gynecology and obstetrics is becoming more and more desirable and widely integrated into gynecological processes in pregnant women and mothers, but also all other women who are facing problems in that area. Pregnancy is a period of numerous physical, mental and other changes and as such requires constant care and supervision of several different medical professionals. Each pregnancy is an individual condition that can potentially be accompanied by certain complications and painful conditions that require a specific approach by several biomedical branches, including physiotherapy. Painful conditions in pregnancy represent many conditions. They occur during pregnancy due to physiological, postural and hormonal changes, mechanical stress, weight gain and various factors. Pregnancy, as an individual experience and condition, represents a period of time with numerous changes and adjustments of the body's bodily systems. However, various difficulties and complications are possible. Physical activity and exercise in pregnancy may carry many benefits. The benefits of exercise in pregnancy apply to both the pregnant woman and the fetus/child. Childbirth is the displacement of the fetus and the remaining products of conception in the period from the 37th to the 42nd week of pregnancy and as such represents the birth mechanism. Birth itself is reliant on many factors. The goal of this paper is to examine the experience of mothers with physiotherapy, the use of physiotherapy treatments during pregnancy and after childbirth and their availability. Also, it should be studied whether there are any differences in the use of physiotherapy treatments between mothers who gave birth by vaginal delivery and those which delivered by cesarean section and whether or not they needed physiotherapy and why. Data for this study was collected using an online survey questionnaire of a sample containing 155 participants (N = 155). The collected data was statistically processed and interpreted. As the results of this study it is evident that the participants are dissatisfied with the availability of physiotherapy treatments and services and the information available. Also, the participants state the need for physiotherapy and that they would like to learn more about physiotherapy assessment and treatments.

Trudnoća i porođaj predstavljaju specifično stanje za svaku ženu te tijekom trudnoće žena doživljava različite psihološke i fizičke promjene koje su prisutne u svakoj fazi trudnoće. Trudnoća započinje oplodnjom jajne stanice, u pravilu traje 40 tjedana te završava porodom. Porod može biti prijevremeni, na vrijeme ili kasni, a dijeli se na četiri porođajna razdoblja. Osim u bolnici, žene mogu roditi i izvan bolnice npr. u kolima hitne medicinske službe. Uloga medicinske sestre prilikom poroda u kolima hitne medicinske službe je značajna, a u radu su prikazani statistički podaci hitne medicinske službe Istarske županije za razdoblje od 2017. do 2019. godine. Pregnancy and childbirth is a specific condition for every woman, and during pregnancy a woman experiences various psychological and physical changes that are present in each stage of pregnancy. Pregnancy begins with the fertilization of an egg, usually lasts 40 weeks, and ends with childbirth. Childbirth can be premature, on time or late, and is divided into four childbirth periods. In addition to the hospital, women can give birth outside the hospital, for example in an ambulance. The role of the nurse during childbirth in the ambulance is significant, and the paper presents the statistical data of the emergency medical service of Istria County for the period from 2017 to 2019.

Trudnoća je specifičan period u životu svake žene. To je period u kojem dolazi do značajnih psihickih i fizičkih promjena U većoj ili manjoj mjeri, svaka trudnica doživljava promjene raspoloženja, anksioznost te zabrinutost. Uzimajući u obzir sve promjene koje se događaju, sasvim je normalno da buduće majke osjećaju strah od poroda. lako je stanje trudnoće normalno i poželjno za svaku ženu, nije neobično da trudnice često osjećaju anksioznost. Medutim, postoje situacije kad anksioznost preraste u ekstremni strah od porođaja, što se naziva tokofobija. Tokofobija je psihološki poremećaj, może pogoditi sve žene od djetinjstva do starosti. Neki od razloga za nastanak tokofobije mogu biti strah od boli na porodaju, strah od roditeljstva, strah zbog prijašnjeg traumatičnog iskustva, nedostatak podrske, ekonomska nesigurnost. Bitno je spomenuti pripremu trudnice za porod. Cilj pripreme je smanjiti i ukloniti strah, olakšati kontrolu boli i olaksati porođaj, smanjiti tjeskobu, smanjiti strah od porodaja, ispravljanje zabluda o porodjaju, učenje vježbi disanja i relaksacije Poželjno je da na tečaj s trudnicom dolazi i njezin partner. Kao najčešći ruzlog za strah od porođaja spominje se strah od boli. Strah od boli za neke žene je izjednačen s strahom ed poroda. Način na koji se žene suočavaju s porodom uvelike ovisi o kulturalnim i okolinskim faktorima, Odgoj takoder ima veliki utjecaj na emocije koje rodilja ima tijekom porođaja. Strah i anksioznost povezuju se s vecom procjenom boli na porodu Za smanjenje porodne boli koriste se intervencije poput objašnjenja postupaka koje se provode, objašnjenja tijeka porodaja, razgovora i distrakcije, Cilj ovog rada je ispitati učestalnost straha od porođaja i porodajne boli, analizirati razlike u strahu od poroda izmedu trudnica i zena koje su vec rodile, te zadovoljstvo njihovim životom. Za potrebe izrade ovog rada bio je izraden anketni upitnik kojeg je ispunilo 468 sudionica, Prikupljeni podatci su analizirani prikuzani tablicno. Iz rezultatu je vidljivo da se večina trudnica boji boli na porodu, a žene koje su već rodie opisuju porodnu bol kao napadu bol koju su osjetile Pregnancy is a specific period in a woman's life. It is a period of physical and psychological changes. Every pregnant woman experiences mood swings, anxiety, or concem about childbirth to a smaller or greater extent. Considering all the changes involved, it is perfectly normal for future mothers to experience a fear of giving birth. Even though a pregnancy is natural and desirable for women, it is not unusual for a mother-to-be to feel anxious. However, in some cases the anxiety becomes a significant fear of childbirth, called "tokophobia". Tokophobia is a psychological disorder affecting women from childhood to old age. Some of the reasons for tokophobia arc the fear of labour pain, the fear of parenthood; other causes can be former post-traumatic stress, the lack of support, and economic insecurity. The preparation for childbirth is to be addressed. The goal is to help pregnant women through pregnancy and childbirth by means of reducing and relieving fears of giving birth caused by possible misconceptions, controlling pain and making childbirth easier, as well as training breathing exercises and relaxation. Pregnancy courses should be attended by women with their partners. One of the most common causes of tokophobia is the fear of injury. This fear is for some women equal to the fear of childbirth. The perception women have of giving birth depends on cultural and environmental factors. Their upbringing also has an important influence on the emotions of the mothers during childbirth. Fear and anxiety are associated with a higher pain assessment at birth. Methods used to relieve the pain are explanation of the procedures performed the process of childbirth, conversation and distraction. This paper aims to research the frequency of fear associated with childbirth und labour pain. It also aims to analyse the differences between the fears of giving birth in recently pregnant women and women who have given birth before their life satisfaction. For the purposes of this research, a survey has been conducted among 468 women. The results have been analysed, and are shown in a tabular format. It can be observed that most of the pregnant women questioned are afraid of labour pain, and women who have already given birth describe the pain as the most severe they have experienced

Porod je fiziološki proces, najprirodniji u životu svake žene. Spoznaja da u sebi nosi novi život o kojem mora odgovorno brinuti uzrokuje strah koji je prisutan, u većoj ili manjoj količini, kod svake trudnice. Razlikujemo primarni strah od poroda koji se javlja kod žena koje prvi put rađaju (izvor može biti biološki, psihološki, socijalni i kulturološki) i sekundarni strah koji proizlazi iz prethodnog traumatičnog porodnog iskustva. Suvremeni pristup porodu omogućava kraći, manje bolan i porod s manje komplikacija. Najvažniju ulogu u pobjeđivanju trudnice nad strahom ima njezina spremnost da postane majka, njezin partner i povoljna okolina u kojoj se nalazi. Medicinsko osoblje (liječnici, primalje, anesteziolozi..) ima ulogu da svojom stručnošću trudnicama na razumljiv način objasne fiziologiju trudnoće, tijek poroda, načine ublažavanja boli, ali isto tako i moguće komplikacije. Trudnica koja dođe u bolnicu roditi mora imati osjećaj sigurnosti, mora znati da je njezino pravo biti upoznata sa svime što ju čeka, mora znati da ima pravo dobiti odgovor na sve nejasnoće. Upravo kad stekne taj osjećaj sigurnosti i povjerenja prema medicinskom osoblju i ustanovi u koju je došla, smanjuje se početni strah i povećava se suradnja između rodilje i liječnika / medicinskih sestara koja rezultira normalnim fiziološkim porodom bez trauma za rodilju i dijete. U ovom radu, nakon teoretskog dijela o porodu, edukaciji trudnica i strahu, obradit ćemo postavljene hipoteze u istraživanju provedenom online upitnikom na uzorku 201 ispitanice. Cilj navedenog istraživanja bio je ispitati strahove rodilja prije poroda vezane uz različite aspekte poroda i razdoblja babinja. Podciljevi istraživanja bili su ispitati postoji li povezanost između određenih strahova koje doživljavaju kod višerodilja i prvorodilja. Childbirth is a physiological process, the most natural in every woman's life. The realization that she is carrying a new life that she has to take care of responsibly causes the fear that is present, to a greater or lesser extent, in every pregnant woman. We distinguish between the primary fear of childbirth that occurs in first-time women (the source can be biological, psychological, social and cultural) and the secondary fear that comes from a previous traumatic birth experience. A modern approach to childbirth allows for shorter, less painful and less complicated births. The most important part in defeating a pregnant woman over fear is her willingness to become a mother, her partner and the favorable environment in which she is. Medical staff (doctors, midwives, anesthesiologists ..) have the role of explaining to pregnant women the physiology of pregnancy, the course of childbirth, ways of relieving pain, but also possible complications. A pregnant woman who comes to the hospital to give birth must have a sense of security, must know that her right to be aware of everything that awaits her, must know that she has the right to receive an answer to all ambiguities. Just when she gains this sense of security and confidence in the nursing staff and the institution she comes to, the initial fear decreases and cooperation between the maternity ward and the physician / nurse increases, resulting in normal physiological delivery without trauma to the mother and child. In this paper, after the theoretical part on childbirth, education of pregnant women and fear, we will analyze the hypotheses in the research conducted by online questionnaire on a sample of 201 respondents. The aim of this research was to examine maternity pre-natal fears related to different aspects of midwifery births and periods. The goals of the study were to examine whether there is a correlation between certain fears experienced in multiple births and first births.

Porođaj je niz mehaničkih i fizioloških procesa prilikom kojih se rodilja oslobađa svih pet elemenata trudnoće (ploda, posteljice, pupkovine, plodovih ovoja i plodove vode) vaginalnim putem. Porođaj se dijeli u četiri stadija, odnosno porođajna doba. U ovom radu opisane su nepravilnosti drugog porođajnog doba. Drugo porođajno doba je doba istiskivanja (izgona) djeteta. Komplikacije koje nastaju su posljedica nepravilnosti temeljnih čimbenika u mehanizmu rađanja a to su: nepravilne kontrakcije-trudovi, porođajni kanal, nepravilnosti stava, rotacije i položaja kao i porođajne ozljede majke i djeteta. Nsjčešći položaj čeda u majčinoj zdjelici neposredno prije rođenja je dorzoanteriorni okcipitalni stav, sa zatiljkom u izlazu zdjelice i licem djeteta prema majčinim leđima. Taj stav omogućuje najlakši prolaz djeteta kroz porođajni kanal. Dijete može biti i u jednom od nekoliko drugih (nepravilnih) stavova koji mogu uzrokovati produljeni porođaj i ozljede majke i djeteta. Ozljede novorođenčadi prilikom porođaja u najvećem broju su bezopasne, ne ostavljaju trajne posljedice i obično ne zahtijevaju posebne terapijske postupke. Najčešća su potkožna krvarenja, fraktura (lom) ključne kosti, kefalhematom, prolazna oštećenja facijalnog (ličnog) i brahijalnog (ručnog) živca. Porođajne ozljede majke su: razdor međice (ruptura perinei), razdor stidnice (ruptura vulvae) i razdor maternice (ruptura uteri). Childbirth is a succession of mechanical and physiological processes during which five elements of pregnancy are released vaginally. These elements include fetus, placenta, umbilical cord, fetal membranes and amniotic liquid. The process of labor and birth is divided into four stages. This paper deals with irregularities of second childbirth. The second stage is the process of fetal expulsion. The complications that arise as the consequences of irregularities of fundamental factors in birth are as follows: irregular contractions, birth canal, irregular posture, rotation and position, as well as birth traumas. Occipitoanterior position of an infant in mother’s pelvis just before the birth is ideal for birth. Toward the end of pregnancy, the fetus moves into the most common position for delivery, occipital anterior, which means that fetus is head down, facing mother’s back. This position is ideal for birth as it eases the delivery through the birth canal. Several other (irregular) positions of an infant may occur and they may lead to prolonged delivery or birth traumas. Birth traumas are mostly riskless, cause no permanent consequences and thus, there is no need for therapeutic procedures. However, some birth traumas may occur and the most common ones are subcutaneous haemorrhage, clavicular fracture, cephalhematoma, transitory facial nerve damage (nervus facialis) and brachial nerve damage (nervus brachialis). A mother may have birth traumas such as perineal rupture (ruptura perinei), vulvar rupture (ruptura vulvae) and uterus rupture (ruptura uteri).

Rad prikazuje podatke prikupljene terenskim istraživanjem u mjestima općine Lovinac o tradicijskim oblicima liječenja, higijenskim prilikama i porodu u razdoblju prve polovice 20. stoljeća. Autorica će pokušati predstaviti temu sjećanjima i razmišljanjima kazivača s kojima je razgovarala., The data presented in this paper was collected during field work carried out during March and May of 2010 in the area of the municipality of Lovinac. The research was conducted within the course of Practical Field Research in diploma studies of ethnology and cultural anthropology, of the Faculty of Philosophy, at the University of Zagreb and the project of the Identity and Ethno-cultural Formation of the Bunjevci, under the mentorship of Milan Černelić Ph.D. The data was collected by the method of unstructured interviews, and the questionnaires which were used in interviewing the narrators consisted of four themes in total: the attitude of people towards health and illness, medicinal herbs and their preparations, diseases and their treatment, hygienic conditions and childbirth. The research topics are an important part of human life and all the interviewees were equally familiar with them. Most of the data consisted of memories, stories and personal experiences from the questioned interviewees. The collected data related to the first half of the 20th century, but during the research it was confirmed that some of the medicinal preparations still remain in use today. The article's aim is to consolidate the practice of folk medicine, hygiene conditions and childbirth which comes close to at least a small part of everyday life in the past, as well as their outlines as such in the everyday lives of the inhabitants of the Lovinac region. Being that the Velebit region, to which the municipality of Lovinac belongs, is rich in herbs and water, the knowledge of their properties could be used to promote the development of rural tourism, however this is a separate theme, which in this study, I have not specifically dealt with.