{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T07:01:51Z","timestamp":1780124511193,"version":"3.54.0"},"reference-count":21,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0325_abs_001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stillbirth remains a major public health issue with long-lasting psychological impacts. Despite advancements in prenatal diagnostics, many stillbirths remain unexplained. Slovenia has implemented a structured, centralized algorithm for stillbirth investigation and\u00a0care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0325_abs_002\">\n                    <jats:title>Content<\/jats:title>\n                    <jats:p>This mini-review analyzes a decade of clinical data (2013\u20132023) from the Department of Perinatology at University Medical Centre Ljubljana (UMC Ljubljana), assessing the outcomes of Slovenia\u2019s stillbirth management algorithm. The Slovenian approach is also compared with international guidelines from ACOG, RCOG, CNGOF, PSANZ, SOGC, and FOGSI. Slovenia reports one of the lowest stillbirth rates in Europe\u00a0\u2013\u00a02 per 1,000 births at\u00a0\u226524\u00a0weeks and 1.4 per 1,000 at\u00a0\u226528\u00a0weeks. At UMC Ljubljana, fetal death rates remained stable between 0.4\u202f% and 0.6\u202f%. The structured algorithm includes maternal history, laboratory testing, placental and fetal pathology, and genetic evaluation. Active induction is preferred over expectant management, and routine TORCH screening and centralized committee oversight are emphasized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0325_abs_003\">\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Slovenia\u2019s structured, algorithm-based system has led to notably low stillbirth rates, supported by uniform clinical care and systematic investigations. Although Slovenia\u2019s experience is encouraging, these results derive from a single-center national registry without comparative cohort analysis, limiting attribution of outcomes to specific elements of the algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0325_abs_004\">\n                    <jats:title>Outlook<\/jats:title>\n                    <jats:p>Future progress will involve the expansion of WES access and full ICD-PM implementation by 2027, enhancing data comparability and facilitating broader international research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0325","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T16:50:31Z","timestamp":1758214231000},"page":"108-115","source":"Crossref","is-referenced-by-count":1,"title":["Structured stillbirth management in Slovenia: outcomes and comparison with international guidelines"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7945-6375","authenticated-orcid":false,"given":"Maja","family":"Dolanc Merc","sequence":"first","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Perinatology , University Medical Centre Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Premru-Sr\u0161en","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Perinatology , University Medical Centre Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2026053006093725975_j_jpm-2025-0325_ref_001","doi-asserted-by":"crossref","unstructured":"Lawn, JE, Blencowe, H, Waiswa, P, Amouzou, A, Mathers, C, Hogan, D, et al.. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 2016;387:587\u2013603. https:\/\/doi.org\/10.1016\/s0140-6736(15)00837-5.","DOI":"10.1016\/S0140-6736(15)00837-5"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_002","unstructured":"World Health Organization. Making every baby count: audit and review of stillbirths and neonatal deaths. Geneva: WHO; 2020."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_003","doi-asserted-by":"crossref","unstructured":"Flenady, V, Wojcieszek, AM, Middleton, P, Ellwood, D, Erwich, JJH, Coory, M, et al.. Stillbirths: the way forward in high-income countries. Lancet 2011;377:1703\u201317. https:\/\/doi.org\/10.1016\/S0140-6736(11)60064-0.","DOI":"10.1016\/S0140-6736(11)60064-0"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_004","unstructured":"Heazell, AEP, Siassakos, D, Blencowe, H, Burden, C, Bhutta, ZA, Cacciatore, J, et al.. Stillbirth investigations: an evidence-based approach. BJOG 2017;124:1157\u201367."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_005","unstructured":"World Health Organization. International statistical classification of diseases and related health problems, 10th revision (ICD-10). Geneva: WHO; 2016."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_006","unstructured":"EuroPeristat Project. European perinatal health report: core indicators of the health and care of pregnant women and babies in Europe from 2015 to 2019. Paris: Inserm; 2019."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_007","unstructured":"University Medical Centre Ljubljana, Department of Perinatology. Internal stillbirth data report (2013\u20132023). Ljubljana: UMC; 2024."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_008","unstructured":"Dolanc, MM. Genomic approach in explaining and preventing stillbirths [PhD thesis]. Ljubljana: University of Ljubljana; 2025."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_009","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists. Practice Bulletin No. 200: Early pregnancy loss. Obstet Gynecol 2018;132:e197\u2013207. https:\/\/doi.org\/10.1097\/AOG.0000000000002899.","DOI":"10.1097\/AOG.0000000000002899"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_010","unstructured":"Royal College of Obstetricians and Gynaecologists. Greentop guideline No. 55: late intrauterine fetal death and stillbirth. London: RCOG; 2017."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_011","doi-asserted-by":"crossref","unstructured":"Garabedian, C, Sibiude, J, Anselem, O, Attie-Bittach, T, Bertholdt, C, Blanc, J, et al.. Fetal death: expert consensus of the French College of Obstetricians and Gynecologists. Int J Gynecol Obstet 2025;168:999\u20131008. https:\/\/doi.org\/10.1002\/ijgo.16079.","DOI":"10.1002\/ijgo.16079"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_012","doi-asserted-by":"crossref","unstructured":"Leduc, L, SOGC CLINICAL PRACTICE GUIDELINE. Guideline No. 394-Stillbirth investigation. J\u00a0Obstet Gynaecol Can 2020;42:92\u20139.","DOI":"10.1016\/j.jogc.2019.04.001"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_013","unstructured":"Perinatal Society of Australia and New\u00a0Zealand. Clinical practice guideline: perinatal mortality. Melbourne: PSANZ; 2020."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_014","unstructured":"Federation of Obstetric and Gynaecological Societies of India. FOGSI guidelines for prevention and management of stillbirths. New Delhi: FOGSI; 2021."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_015","unstructured":"National Institute of Public Health, Slovenia. Center for infectious diseases. Toxoplasmosis, 2015. Internet. http:\/\/www.nijz.si\/sl\/toksoplazmoza."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_016","unstructured":"World Health Organization. ICDPM: application of ICD10 to deaths during the perinatal period. Geneva: WHO; 2016."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_017","unstructured":"Heazell, AEP, McLaughlin, MJ, Schmidt, EB, Roberts, D, Flenady, V, Ellwood, D, et al.. Improving perinatal mortality surveillance: data collection and use. BJOG 2021;128:e17\u201325."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_018","doi-asserted-by":"crossref","unstructured":"Flenady, V, Wojcieszek, AM, Middleton, P, Ellwood, D, Erwich, JJH, Coory, M, et al.. Stillbirths: recall to action in highincome countries. Lancet 2016;387:691\u2013702. https:\/\/doi.org\/10.1016\/s0140-6736(15)01020-x.","DOI":"10.1016\/S0140-6736(15)01020-X"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_019","unstructured":"Draper, ES, Gallimore, ID, Kurinczuk, JJ, Smith, PW, Boby, T, Manktelow, BN, et al.. MBRRACEUK perinatal mortality surveillance report 2022. Oxford: NPEU; 2022."},{"key":"2026053006093725975_j_jpm-2025-0325_ref_020","doi-asserted-by":"crossref","unstructured":"Gardosi, J, Madurasinghe, V, Williams, M, Malik, A, Francis, A, Kurinczuk, JJ, et al.. Confidential enquiry into stillbirths: a systems-level approach. BMJ 2013;346:f108.","DOI":"10.1136\/bmj.f108"},{"key":"2026053006093725975_j_jpm-2025-0325_ref_021","unstructured":"European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe from 2015 to 2019. Paris: Inserm;\u00a02019."}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0325\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0325\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:10:16Z","timestamp":1780121416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0325\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,11,19]]},"published-print":{"date-parts":[[2026,1,23]]}},"alternative-id":["10.1515\/jpm-2025-0325"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2025-0325","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"value":"0300-5577","type":"print"},{"value":"1619-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}