Women's attitude towards umbilical cord blood banking in Poland.

Umbilical cord blood (UCB) is considered as a valuable potential source of hematopoietic stem and progenitor cells. A process of collecting and storing UCB in the immediate period after the birth is called UCB banking. The study was conducted in order to determine women's knowledge, awareness, preferences and attitude towards UCB banking in Poland, considering the sociodemographic and obstetric factors. A cross-sectional, self-administered, online questionnaire-based study including mostly multiple choice questions concerning attitude and awareness regarding UCB banking was conducted entirely online among Facebook female users in Poland. A total of 1077 participants correctly completed the survey. Most participants (n = 911, 84.6%) were aware of the possibility of UCB banking. Social media were considered as the main source of information (47.5%). However, the participants mostly indicated the doctor as their preferred source of reliable information (86.8%). The majority of women (61.8%) assessed their level of knowledge of UCB banking as still insufficient. Among the participants who supported UCB banking (70%), the following reasons were considered as the most vital: potential possibility of helping their child (93.9%) and helping other relatives (64.4%). More than half of the respondents (66.9%), who have not stored and are not willing to store their children's UCB, indicated the high cost of UCB banking as the main reason of this decision. The knowledge and awareness of UCB storage and banking possibilities amongst women in Poland could be improved. The professional medical personnel should be a source of reliable information.

Vulvar cancer in a patient with long-lasting premalignant lesions in the genital area: easily overlooked and difficult to diagnose - a case report and literature review.

Vulvar intraepithelial lesions are a heterogenic group of diseases, which can be easily misdiagnosed. The case of a 61-year-old woman with a history of genital intraepithelial lesions and infection with HPV is presented. Her main complaint was vulvar pruritus. Vulvoscopy revealed the presence of two skin lesions: the first one had the morphology of lichen sclerosus, and the second of a Bowenoid lesion. The biopsy of the first lesion revealed vulvar intraepithelial neoplasia, whereas cells of squamous vulvar cancer were identified in the second lesion. After staging, the patient was advised to undergo hemivulvectomy and lymphadenectomy. The coexistence of morphologically diverse vulvar skin lesions may cause difficulties with diagnosis and the selection of an adequate treatment. Long-term follow-up and regular examination are essential for diagnosis of vulvar malignancies in the early stage.

Gestational diabetes mellitus (GDM) - do the number of fulfilled diagnostic criteria predict the perinatal outcome?

OBJECTIVES: The aim of the study was to check whether the number of fulfilled diagnostic criteria of gestational diabetes mellitus (GDM) had any association with patients' characteristics and pregnancy outcomes. MATERIAL AND METHODS: A total of 756 women with single pregnancies and GDM who gave birth at the 2nd Department of Obstetrics and Gynecology of the Medical University of Warsaw between 01.2013-12.2016 were included in a retrospective analysis. Patients were divided into 2 groups: A - 499 patients diagnosed with GDM on the basis of one diagnostic criterion, B - 257 patients diagnosed with GDM on the basis of more than one diagnostic criterion. RESULTS: Patients from group A had lower pre-pregnancy BMI than those from group B (median 24.9 kg/m2 vs. 26.5 kg/m2, p=0.0003). Women from group A were less frequently treated with insulin than women from group B (19.1% vs. 32.7%; p=0.00002). Group A had lower median OGTT levels than group B (85.9 mg/dL vs. 94.1 mg/dL, p=0,0001; 160.2 mg/dL vs. 197.6 mg/dL, p=0.0001; 144.8 mg/dL vs. 167.0 mg/dL,p=0.0001; respectively). Moreover, in group B the average week of labor was earlier than in group A (mean 38,1 and 38,5 weeks of gestation, p=0,0006). CONCLUSIONS: Patients who fulfilled more than one diagnostic criterion for GDM may have worse pregnancy outcome. We think that a number of fulfilled diagnostic criteria for GDM may be an important risk factor for insulin therapy during pregnancy and earlier gestational age at delivery.

New criteria for gestational diabetes mellitus - do they impact the outcome?

OBJECTIVE: The aim of the study was to compare the perinatal outcome of pregnancies in mothers who were diagnosed with gestational diabetes mellitus (GDM) with previous versus current Polish Gynecological Society (PTG) criteria. METHODS: 475 patients were divided into three groups. In group A, the patients only met the previous PTG criteria for a GDM diagnosis, i.e., those with a blood glucose level of 140-152 mg/dl 2 hours after administration, a fasting glucose level <92 mg/dl, and a blood glucose level <180 mg/dl 1 hour after administration. Group B included patients complying with both the previous and current PTG criteria for a GDM diagnosis. Group C included patients who only met the current PTG criteria for a GDM diagnosis, i.e., those with a fasting blood glucose level of 92-99 mg/dl, a blood glucose level <180 mg/dl 1 hour and <140 mg/dl 2 hours after administration, respectively. RESULTS: Women from group C were characterized by the highest fasting glycaemia in the first trimester of pregnancy (93.0 mg/dL vs. 88.0 mg/dL vs. 83.5 mg/dL, p=0.012) and during the OGTT (p=0.001). Gestational diabetes was diagnosed significantly earlier in patients from group C (23 vs. 26 vs. 26 weeks, p=0.005). The patients from group A significantly less frequently required insulin therapy for proper glycemic control (p=0.035). Women from group A were characterized by lower pre-pregnancy BMI (p=0.001). CONCLUSIONS: Current PTG criteria for diagnosing GDM according to the IADPSG allow for identification of women who often require insulin therapy to achieve proper glycemic control.

Evaluation of the amoxicillin concentrations in amniotic fluid, placenta, umbilical cord blood and maternal serum two hours after oral administration.

OBJECTIVES: Amoxicillin is a broad-spectrum beta-lactam antibiotic. Due to its low toxicity, it is commonly used in obstetrics. The objective of this study was to assess amoxicillin concentrations in amniotic fluid, umbilical blood, placenta and maternal serum two hours following oral administration among pregnant women at term and to assess obstetric and non-obstetric factors that might affect amoxicillin's penetration of these tissues. MATERIALS AND METHODS: A total of 30 full-term pregnant women who qualified for elective Caesarean delivery were included in the study. Amoxicillin at a dose of 500 mg was administered prior to surgery. Amoxicillin levels were determined by diffusion microbial assay. RESULTS: The maternal serum, placental, umbilical blood and amniotic fluid levels of amoxicillin two hours after oral administration were 2.18±1.30 µg/g, 1.00±0.71 µg/g, 1.00±0.73 µg/g, and 0.67±0.59 µg/g, respectively (Table 2). Maternal serum levels of amoxicillin were significantly higher compared to other tissues (p<0.05). CONCLUSION: If the target tissues for the use of antibiotic drugs in pregnant patients are the fetus and/or the placenta, the drug should be administered in a higher-than-standard dose than that used to treat infections in non-pregnant patients. Considering that there is a maximum absorbable dose following oral administration, intravenous administration should be considered to prevent failure of antibiotic treatment. A higher dose of amoxicillin should be considered in obese mothers.

Emergency peripartum hysterectomy - a challenge or an obstetrical defeat?

OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications. RESULTS: Nineteen peripartum hysterectomies were performed between January 1, 2007 and October 30, 2013 (0.9/1000), including 16 EPH (0.76/1000). The rate of EPH was between 0.66 and 1.0 per 1000 deliveries. The majority of the patients were multiparous (79.0%), and EPH was performed after at least one cesarean section (75.0%). Fifteen women had a singleton pregnancy and one woman had a triplet pregnancy. The mean gestational age was 34.2 weeks. The delivery mode was cesarean section in 93.8% of the cases. The most common reason for peripartum hemorrhage and the indication for EPH was abnormal placentation (75.0%). All patients underwent a total hysterectomy, including 43.8% during the same operation and 50.0% during a reoperation. There was no maternal death. The serious maternal complication rates were relatively low in our study and included one case of cardiac arrest that required cardiopulmonary resuscitation and one case of sepsis with pulmonary embolism. CONCLUSIONS: EPH is typically performed as a result of massive hemorrhage associated with abnormal placentation, and it should be treated as a challenging, life-saving procedure.

Evaluation of the amoxicillin concentrations in amniotic fluid, placenta, umbilical cord blood and maternal serum two hours after intravenous administration.

OBJECTIVES: The aims of this study were to evaluate amoxicillin concentrations in amniotic fluid, placenta, umbilical cord blood and maternal blood two hours after intravenous administration to assess obstetric and non-obstetric factors that could have influences on the penetration of the antibiotic into the examined tissues and to analyze the sensitivity to amoxicillin of the most common pathogens isolated from the genital tract. METHODS: A total of 35 full-term pregnant women who qualified for elective Caesarean delivery were included in the study. Amoxicillin at a dose of 1000 mg was administered prior to surgery. Amoxicillin levels were determined by diffusion microbial assay. RESULTS: The drug concentration was highest in umbilical cord blood compared with amniotic fluid, maternal blood and placenta (4.20±1.06 µg/g versus 3.96±0.79 µg/g, 3.22±0.64 µg/g and 2.81±0.64 µg/g, respectively). Obstetric and non-obstetric factors had no influence on the amoxicillin concentration. The most common bacteria isolated from the genital tracts of pregnant women (Streptococcus agalactiae, Enterococcus faecalis, Escherichia coli) were sensitive to amoxicillin. The MIC for the sensitive strain of Streptococcus agalactiae was seen in the majority of tissues of all of the patients; however, the MICs for E. faecalis and E. coli were not observed in any compartment. CONCLUSIONS: Amoxicillin proved to have good penetration into the fetal tissues and placenta after intravenous administration. The most common bacteria isolated from the genital tracts of pregnant women were sensitive to amoxicillin. Pregnancy complications were not found to have an influence on the amoxicillin concentrations in the examined tissues.

Shoulder dystocia in diabetic and non-diabetic pregnancies.

OBJECTIVES: Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. DESIGN: We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. SETTING: The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. RESULTS: Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dystocia were more likely to deliver before completion of the 38th week of gestation (30.8% vs. 5.7%, p=0.02) and had a higher incidence of 1st and 2nd stage perineal tears compared with the non-diabetic group (23.1% vs. 0%, p=0.02). There were two cases of symphysis pubis dehiscence in non-diabetic women. Children of diabetic mothers had a significantly higher birth weight (4,425.4±561.6 g vs. 4,006.9±452.8 g, p=0.03). Children of diabetic mothers with dystocia were at significantly higher risk of peripartum injuries (92.3% vs. 45.7%). A significant difference was observed in the percentage of brachial plexus palsy (61.5% vs. 17.1%). Children of diabetic women experiencing shoulder dystocia were more frequently affected by Erb's brachial plexus palsy and respiratory disturbances. These children had an increased likelihood of birth weights above the 90th percentile (not necessarily reaching 4,000 g) compared to children born to non-diabetic mothers. CONCLUSIONS: Shoulder dystocia in women with diabetes mellitus during pregnancy was associated with earlier gestational age of labor, and these women were more frequently overweight. The newborns of diabetic mothers after shoulder dystocia appeared to be at an increased risk for perinatal morbidity compared to the newborns of non-diabetic mothers experiencing this complication.

The Obstetrician's Role in Pregnant Women's Decision-Making Process Regarding Influenza and COVID-19 Vaccination.

Pregnant women are considered to be a population vulnerable to influenza and COVID-19 infections, and the latest guidelines consistently recommend that they receive influenza and COVID-19 vaccinations. A cross-sectional questionnaire-based study was conducted among pregnant women in Poland to determine which factors have the greatest impact on their decision to vaccinate against influenza and COVID-19. A total of 515 pregnant women participated in the study. Among them, 38.4% (n = 198) demonstrated a positive attitude toward influenza vaccination, and 64.3% (n = 331) demonstrated a positive attitude toward COVID-19 vaccination. Logistic regression analysis revealed that the strongest influence on positive attitudes toward COVID-19 vaccination is having it recommended by an obstetrician-gynecologist (OR = 2.439, p = 0.025). The obstetrician-gynecologist's recommendation to vaccinate against influenza also significantly influences the decision to vaccinate (OR = 5.323). The study results also show a strong correlation between the obstetrician-gynecologist as a source of information on influenza and vaccination and participants' positive attitudes toward vaccination (OR = 4.163). Obstetricians have a significant influence on pregnant women's decisions regarding vaccinations. Further recommendations to vaccinate and awareness-raising among obstetricians may be needed to increase the vaccination rate of pregnant women in Poland.

Physical Activity during Preconception Impacts Some Maternal Outcomes-A Cross-Sectional Study on a Population of Polish Women.

BACKGROUND: Physical activity is an element of a healthy lifestyle and is safe in most pregnancies. The aim of this study was to assess the impact of physical activity levels before and during pregnancy on pregnancy outcomes for both the mother and child. METHODS: A cross-sectional survey was conducted on a population of Polish women. An anonymous questionnaire was distributed electronically via maternity and parental Facebook groups. RESULTS: The final research group included 961 women. The analysis showed that physical activity 6 months before pregnancy was associated with a lower risk of gestational diabetes mellitus (GDM), but physical activity during pregnancy showed no such association. In all, 37.8% of women with low activity in the first trimester, in comparison to 29.4% of adequately active women, gained an excessive amount of weight during pregnancy (p = 0.0306). The results showed no association between activity level and pregnancy duration, type of delivery or newborn birth weight. CONCLUSIONS: Our study indicates that physical activity during the preconception period is crucial to GDM occurrence.

Pregnant Women's Knowledge of and Attitudes towards Influenza Vaccination during the COVID-19 Pandemic in Poland.

Pregnant women are more susceptible to influenza virus infections due to the immunological and physiological changes in the course of pregnancy. Vaccination during pregnancy is a safe and effective method for protecting both the mothers and the infants from influenza and its complications. This study was conducted in order to determine the knowledge and attitudes of Polish pregnant women towards influenza vaccination during the COVID-19 pandemic. A questionnaire-based and self-administered study was carried out fully online and a total of 515 women participated. A total of 52% (n = 268) of surveyed women answered that vaccination against influenza during pregnancy was safe. However, only 21% (n = 108) were vaccinated against influenza during their current pregnancy and 17.5% (n = 90) intended to be vaccinated. The participants indicated many concerns about getting vaccinated during pregnancy, but also many benefits that come with the vaccination. General knowledge about influenza, its complications, and vaccination was quite high in the study group.

Difficulties in the management of hypokalemia in a pregnant patient with Gitelman syndrome.

Gitelman syndrome (GS) is a rare renal disorder, and little is known about its impact on pregnancy. We report the successful outcome of pregnancy in a patient with GS that was managed with aggressive oral and intravenous potassium supplementation.

The attitude of Polish women planning pregnancy and/or having children towards vaccinations: a cross-sectional survey study.

OBJECTIVES: Infectious diseases in pregnant women can cause birth defects. Implementing appropriate prevention methods while planning pregnancy can help avoid some of them. MATERIAL AND METHODS: A cross-sectional survey study was performed. The questionnaire investigated attitudes towards vaccinations, as well as opinions on anti-vaccine movements and the so-called "chickenpox parties". The questionnaire was developed for the purpose of this study and the survey was conducted using the google form, which was posted on social media groups for women planning pregnancy, being pregnant or for mothers' groups from Poland. RESULTS: The study group consisted of 2402 women; their median age was 31 years (range 16-54 years). Most women were from cities > 100,000 inhabitants (49.7%, 1194/2402) and had higher education (71.9%, 1726/2402). A positive attitude towards vaccinations was more common among younger, nulliparous women from big cities (p = 0.02, p = 0.04 and p = 0.01, respectively). 2068/2402 (86.1%) of respondents were not vaccinated before pregnancy and 1931/2402 (80.4%) of women were not vaccinated during pregnancy. While most women (1545/2402, 64.3%) considered vaccination safe, and effective (1904/2402, 79.3%) against infectious diseases, many (n = 296/2402 12.3%) have no opinion on the so-called chickenpox party. CONCLUSIONS: Most surveyed women had a positive attitude towards vaccinations and consider vaccines a safe and effective method of protection against infectious diseases. Since a significant proportion of women were not vaccinated before or during pregnancy and about 12% of women are undecided, the physician's role is crucial in educating and persuading the patient to be vaccinated.

The impact of COVID-19 pandemic on reproductive intentions among the Polish population.

OBJECTIVES: The study was conducted in order to determine the impact of the COVID-19 pandemic on the fertility intentions among the Polish population. MATERIAL AND METHODS: A cross-sectional, questionnaire-based online study was carried out among Polish adults in order to determine the impact of the COVID-19 pandemic on the reproductive plans of the Polish society. A total of 984 participants correctly completed the survey. RESULTS: The pandemic has affected the reproductive intentions of 22% (n = 216) of the respondents, most of them want to have a child later than they previously planned (74.1%). The relationship between the change in reproductive intentions and the concerns about the pandemic was found. Most of those who changed their plans were afraid that the access to prenatal care and delivery services could be limited (86.6%) or were afraid about giving birth at the hospital (81%). More than half (51.9%) of those who changed reproductive plans were afraid of losing their income and 40.3% had already experienced a decrease in their income. The change in partner's emotional relationships was also observed. More than half of respondents (56.7%) admitted that during the pandemic they had developed a deeper emotional relationship with their partners or felt more emotionally supported (56.6%). Most participants responded that the frequency of their sexual intercourses was not affected (66.7%) and that they had not experienced limited access to contraceptives (95.1%) during the pandemic. CONCLUSIONS: The COVID-19 pandemic has affected Polish people's reproductive intentions. Concerns related to healthcare access and the economic difficulties have the most significant impact.

Results of expectant management in singleton and twin pregnancies complicated by preterm premature rupture of membranes.

OBJECTIVES: This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies. MATERIAL AND METHODS: It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at premature rupture of membranes (PROM), management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome. RESULTS: The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03). CONCLUSIONS: Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.

Physical activity during pregnancy - the state of Polish women's knowledge.

OBJECTIVES: Regular and moderate physical activity during uncomplicated pregnancy has been considered beneficial for both the expectant mother and her unborn child. It reduces the risk of gestational diabetes mellitus (GDM) and preeclampsia. The aim of the study was to assess women's knowledge concerning specific aspects of physical activity during uncomplicated pregnancy. MATERIAL AND METHODS: A cross-sectional survey study on a sample of Polish women in a tertiary referral centre was performed. A questionnaire that was validated in the Polish language was based on the Committee Opinion of American College of Obstetricians and Gynaecologists, which was published in December 2015. Sociodemographic parameters in relation to specific aspects of physical activity during pregnancy were analysed. RESULTS: A total of 259 (92.5%) women were aware of the beneficial impact of physical activity on the course of pregnancy. Higher education was associated with greater awareness (p = 0.001). Regarding the optimal frequency and recommended duration of exercise, the overall rates of correct answers were only 106 (38.1%) and 167 (59.6%), respectively. The most common sources of information on physical activity during pregnancy were the Internet (81, 50.0%) and books (62, 38.3%). Doctors and midwives instructed the respondents only in 36 (22.4%) and 31 (18.9%) cases, respectively. CONCLUSIONS: Women's knowledge about physical activity during pregnancy seems satisfactory. However, awareness concerning the optimal duration and frequency of exercise, as well as recommended voluntary activities during pregnancy, should be improved. Medical professionals may also reinforce their role as a provider of reliable information, resulting in the prevention of many pregnancy complications.

Knowledge, opinions and attitudes of Polish women towards banking and donation of human breast milk.

OBJECTIVES: The aim of the study was to obtain information on the knowledge, opinions and attitudes of Polish women in terms of functioning of human milk banks, as well as the possibility to be a donor. Specific objectives included consideration of responses in the sociodemographic aspect and identification of factors influencing donation decisions. MATERIAL AND METHODS: A cross-sectional survey was conducted, obtaining 871 responses. Women were asked to provide basic sociodemographic data, information related to pregnancy and lactation. Knowledge and opinion about breast milk banks as well as the impact of various factors on a potential donation decision were investigated. RESULTS: Of all women participating in the study, 604 (69%) were aware of the breast milk banks existence. 69% of respondents indicated the Internet, 10% - a nurse or midwife, while only 4% - a doctor as source of knowledge about human breast milk donation. Among women who had children (n = 453), only 9 (2%) donated breast milk in the past. The indicated reasons for not donating were no milk excess (38%), insufficient knowledge about the procedure or unawareness of its existence (33% and 25%, respectively), long distance to affiliated facility (17%). CONCLUSIONS: The awareness of breast milk banks existence, possibilities and terms of donation in the studied group is not satisfactory. Widely sharing reliable information on banking and promoting the idea of donating human breast milk in society can lead to impressive results. There is a need for further development of human breast milk banks and continuous improvement of their availability in Poland.

Risk factors for unsuccessful vaginal birth after caesarean at full dilatation.

OBJECTIVES: The purpose of this study was to determine the risk factors for caesarean sections in the second stage of labour after a previous caesarean section among women who underwent trial of labour (TOL). MATERIAL AND METHODS: From a total of 639 women who experienced one caesarean section, 456 women were qualified for TOL. From this group, 105 women were subjected to a caesarean section in the first stage of labour and another 351 women reached the second stage of labour. From the latter group, 309 women delivered naturally and 42 were subjected to a caesarean section. RESULTS: Risk factors for the necessity of performing a caesarean section in the second stage of labour after a previous caesarean section was the weight gain during pregnancy (OR = 1.07), the height of fundus uteri (OR = 1.25) before delivery, and the estimated foetal weight (OR = 1.01), a past delivery of a child with a birth weight exceeding 4.000 g (OR = 2.14), the presence of pre-gestational diabetes (OR = 15.4) and gestational diabetes (OR = 2.22), necessity of applying a delivery induction (OR = 2.52), stimulation of uterine activity during delivery (OR = 2.43) and application of epidural analgesia (OR = 4.04). A factor reducing the risk of a caesarean section in the second stage was a vaginal delivery in a woman's history (OR = 0.21). CONCLUSIONS: Women should be encouraged to deliver naturally after a previous caesarean section, especially when their history includes a vaginal delivery and if there is no need for labour induction.

Gestational weight gain and glycemic control in GDM patients with positive genital culture.

OBJECTIVE: Gestational diabetes mellitus (GDM) is related to many complications of pregnancy. The aim of the study was the assessment of cervical colonization in GDM patients and its correlation with inappropriate glycaemic control and gestational weight gain (GWG). MATERIALS AND METHODS: The study included 483 women with GDM in a singleton pregnancy who delivered at term. Cervical smears samples were collected >35th week of gestation and cultured for aerobic and aerobic bacteria, and fungi. The patients were divided into two groups on the basis of cervical culture test results: women with negative and positive cervical culture results. Gestational weight gain was estimated in both groups as inadequate, adequate or excessive based on pre-gestational body mass index (BMI) according to the Institute of Medicine (IOM) guidelines. GWG and need of insulin therapy were used as an indicator of complying with dietary recommendations. RESULTS: Patients with positive cervical culture results more frequently had pre-pregnancy BMI >35kg/m2 (4.9% vs 9.5%, p = 0.0508) than patients who had negative cervical culture results. One third (32.1%) of patients had one, and 9.3% had at least two microorganisms in their genital tracts. The most frequent bacteria species isolated was Streptococcus agalactiae (20.1%). Fungi were present in 14.1% of the cervical cultures. Patients with GDM with inadequate GWG more often had genital tract's colonization with Enterococcus spp. (6.83% vs. 1.19% vs. 1.83%, in group with inadequate GWG vs. adequate GWG vs. excessive GWG respectively p = 0.007). CONCLUSION: Insulin therapy in GDM patients was not correlated with the presence of microorganisms in genital tracts. Inadequate GWG in GDM may be linked to genital tract colonization with Enteroccocus spp. Genital colonization during pregnancy among patients with GDM is more often among patients' with pre-pregnancy BMI >35 kg/m2.