Perinatal Outcomes and Level of Labour Difficulty in Deliveries with Right and Left Foetal Position-A Preliminary Study.

BACKGROUND: Many studies have shown the negative influence of the foetus's occiput posterior position during birth on the final perinatal outcome. This study aims to add to the discussion on the impact of foetus positioning on the course of labour and subjective assessment of the level of labour difficulty. METHODS: The cross-sectional study took place from February 2020 to September 2021, and consisted of filling out observation forms and the assessment by the midwives and women of the level of labour difficulty. This study is based on the observation of 152 labours in low-risk women. FINDINGS: When compared to left foetal positioning, labours in which the foetus was in the right position were longer and more frequently failed to progress (in 11.3% vs. 37.5%), and epidural was more frequently administrated (in 30.4% vs. 52.7%). Both women and midwives subjectively evaluated deliveries with a foetus in the right position as more difficult. CONCLUSIONS: The right positioning of the foetus was related to greater labour difficulty and worse perinatal outcomes. The position of the foetus' head in relation to the pelvis should be considered as an indicator of the difficulty of labour and a support plan for the woman should be offered accordingly.

Knowledge of women in Poland on the profession and competencies of a midwife.

INTRODUCTION: The profession of a midwife, despite its long tradition in Poland, is still not widely known in the society. Both in terms of the competencies and roles, it is often confused with other medical professions such as nurses or gynecologists. In this study, we assessed the knowledge of women in Poland on the profession of a midwife. The aim of the research project was to obtain detailed data on the knowledge of women regarding the specific professional competencies of midwives. METHODS: The study used the method of a cross-sectional survey. A survey of 1134 adult Polish women was conducted. A 20-item questionnaire was developed with fourteen of the questions being based on the midwife's professional competencies. The study was conducted in 2019 and the questionnaire was distributed through various social groups for Polish women. RESULTS: Knowledge about the professional competencies of midwives increases proportionally to the level of the education of the respondents, their age and the scope of cooperation with midwives. The most well-known forms of midwifery were those related to lactation education (78.7%) and puerperal care (78.9%). The lowest rates, among other results, were prescribing drugs (23.1%) and collecting samples for cervical cytology (24.4%). CONCLUSIONS: The profession of a midwife in Poland is insufficiently popularized. Competencies shared with doctors require more dissemination. It is worth paying particular attention to the promotion of the profession in younger age groups, so that women can use their knowledge at subsequent stages of their lives.

The impact of endometriosis on the quality of women's life.

OBJECTIVES: Endometriosis is a disease that involves the ectopic growth of the endometrial tissue outside the uterine cavity. Its average occurrence is about 10% of women of reproductive age. Making a diagnosis of the disease is commonly long-lasting and ambiguous due to the wide variety and intensity of symptoms. The aim of the study is to determine factors affecting the quality of life of women struggling with endometriosis. MATERIAL AND METHODS: A cross-sectional study was conducted using a diagnostic survey method with the use of the author's questionnaire and the WHOQOL-BREF questionnaire. The study population included 650 people (group with endometriosis - 361 women and group without endometriosis - 289 women). RESULTS: In the group of women with endometriosis, the mean age was significantly higher (31.87 vs 24.99). Difficulties with conception were significantly more common (51.67%) in the endometriosis group compared to 5.52% in the non-endometriosis group. In each area, the quality of life of women with endometriosis was significantly lower (p = 0.000). Women with the history of the disease of over 3 years significantly more often complained of dyspareunia (p = 0.048), bladder pain (p = 0.01) and lower back pain (p = 0.029). CONCLUSIONS: Endometriosis significantly reduces women's quality of life. Factors that deteriorate the quality of life of women with endometriosis include severe pain, infertility, dyspareunia and reduced satisfaction in various spheres of life (somatic, mental, social). More research is necessary to improve the quality of life of women with endometriosis.

Using Robson classification to analyze cesarean section and induction rates in relation to changes in the standards of perinatal care in one hospital in Poland.

BACKGROUND: Poland has one of the highest cesarean birth (CB) rates in Europe. For this study, we used the Robson Ten-Group Classification System (TGCS) to analyze trends in the induction and CB rates in one hospital in Poland over a period of 11 years. We compare these trends with changes in National Legislative and Medical Guidelines introduced during this time that were aimed at lowering rates of unnecessary medical interventions. METHODS: We conducted a retrospective study including all births after 24 weeks' gestation between 2010 and 2020 from one tertiary hospital (n = 66,716 births). After the deletion of records with missing data, 66,678 births were included in the analysis. All births were classified according to the Robson TGCS. The size, CB rate, and contribution of each group for every year were calculated. Linear regression analyses were used to analyze trends over time. RESULTS: The total CB rate varied from 29.6% to 33.0% during the study period, with a linear increase of 0.045 percentage points annually (R2 = 0.021; F(1) = 0.189; p = 0.674). This study was considerably lower than the total CB rate for Poland, which rose from 33.9% in 2010 to 45.1% in 2020, increasing at a rate of 1.13 percentage points per year (R2 = 0.93; F(1) = 61.88; p < 0.001). Induction rates among both nulliparous (R1 + R2) and multiparous (R3 + R4) women at term also increased. Study groups R5 (previous cesarean birth), R2 (nulliparous in induced or prelabor cesarean delivery), and R1 (nulliparous women at term with single cephalic pregnancy in spontaneous labor) were the highest contributors to the overall CB rate. The greatest decrease in the CB rate was detected in group R5b (more than one previous CB). None of the groups showed statistically significant increases in CB rates over the study period. CONCLUSIONS: The CB rate in the hospital where the study was conducted was considerably lower than the total CB rate in Poland. When compared with countries with similar CB rates, group R2b (women with nulliparous, prelabor cesarean birth) in our study was considerably larger. More comparisons across different hospital settings in Poland are needed. However, as hospitals are not encouraged to routinely collect the data needed to construct TGCS, such comparisons are very difficult to conduct.

Epidural analgesia: effect on labor duration and delivery mode - a single-center cohort study.

OBJECTIVES: Parturients in labor experiencing severe pain may develop several complications, which could be avoided using various forms of labor analgesia. Researchers hold divergent opinions about the effect of epidural analgesia (EA) on labor duration and delivery mode. This paper aims to establish if EA affects the duration of the 1st and the 2nd phase of labor and the percentage of emergency Cesarean sections (CS) and instrumental delivery. MATERIAL AND METHODS: The patients in this cohort study were recruited at St. Sophia's Specialist Hospital in Warsaw, between 1/1/2020 and 6/1/2020. We used following inclusion criteria: patients aged 18-40 with singleton pregnancies and cephalic presentation of the fetus who gave live birth at a gestational age of 37-42 weeks to neonates with birthweight 2500-4250 g and received EA at the cervical dilation between three and six centimeters. The control group didn't receive anesthesia. We excluded planned CS and vaginal births after CS. Data analysis was performed for all parturients and separately for multiparas and nulliparas. Results Out of 2550 deliveries, we included 1052 patients - 443 participants with EA and 609 in the control group. Patients with epidural analgesia experienced longer labor 415 vs 255 min (p < 0.01), longer 1st and 2nd stage (p < 0.01). They had a lower risk of emergency CS (OR = 0.56) (p < 0.01) but were more likely to have instrumental delivery. CONCLUSIONS: EA prolongs the first and the second stage of labor yet doesn't affect neonatal outcomes. Moreover, the risk of emergency CS in nulliparas with EA is three times lower.

Association between Parity and Preterm Birth-Retrospective Analysis from a Single Center in Poland.

Preterm births and parity are two medical areas that seem to be entirely different from each other. The aim of this study was to analyze the relationships between parity and maternal and neonatal outcomes associated with preterm birth. This study involved a retrospective analysis of electronic medical records from St. Sophia Hospital in Warsaw (Poland). This study was conducted among women who gave birth to preterm infants between 1 January 2017 and 31 December 2021. A total of 2043 cases of preterm births were included in the final analysis. A higher odds ratio of preterm birth in primiparas was found in women living in a city/town (OR = 1.56) and having secondary (OR = 1.46) and higher education (OR = 1.82). Multiparas who gave birth to preterm infants were more frequently diagnosed with gestational diabetes (19.69%) than primiparas. Multiparas were more likely to give birth to preterm infants who received an Apgar score of ≤7 both at 1 and 5 min after birth (25.80% and 15.34%). The results of our study emphasize the differences between primiparas and multiparas who give birth to preterm infants. Knowledge of these differences is essential to improve the perinatal care provided to mothers and their infants.

"This pregnancy makes sense": Experiences of women who have decided to continue pregnancy after lethal fetal diagnosis.

Lethal fetal diagnosis defines severe developmental disorders that lead to the death of a fetus or newborn. Using semi-structured interviews, we explored the experiences of women in Poland who actively decided to continue with the pregnancy after diagnosis. We thematically analyzed data collected from 10 women. We identified four themes: pregnancy as an experience of prenatal motherhood; the child as person; birth as encounter and farewell; and the mother experience in retrospect. This study was conducted while the termination of pregnancy due to the irreversible fetal abnormality was legal in Poland. Since October 2021, it is no longer legal.

What Differentiates Rural and Urban Patients with Type 1 Diabetes-A Pilot Study.

The effective management of diabetes is a complex issue and may be determined according to numerous patient-dependent and patient-independent factors. This study aimed to analyze the relationship between the place of residence and selected sociodemographic, psychological and diabetes-related parameters in people with type 1 diabetes (T1D). This study was conducted on 419 adults with T1D using nonprobability sampling. The following questionnaires were used: the Diabetes Dietary Guidelines Adherence Index, the Acceptance of Illness Scale, the Sense of Responsibility for Health Scale, the Diabetes Eating Problem Survey-Revised scale, the Eating Attitudes Test and questions on sociodemographic and diabetes-related parameters. People living in rural areas were characterized by a significantly lower age and level of education, a higher incidence of being overweight, a higher glycated hemoglobin concentration, a lower number of glucose measurements during the day and a higher level of acceptance of the disease compared to urban residents. The degree of adherence to dietary recommendations and the sense of responsibility for one's own health were significantly higher among urban residents. It is necessary to assess barriers to a proper diet and to increase the effectiveness in managing the disease in rural communities. Targeted actions promoting the health of type 1 diabetics need to be developed with particular emphasis on patients from rural areas.

Place of residence and time of day as factors affecting the course of vaginal delivery.

INTRODUCTION AND OBJECTIVE: Childbirth is one of the most important events in a woman's life and is influenced by many factors. The aim of the research was to analyze the impact of the place of residence of women giving birth and the time of day on the course of natural birth. MATERIAL AND METHODS: The study was conducted using the method of analysis of retrospective electronic documentation of patients who gave natural vaginal birth in the St. Zofia hospital in Warsaw, Poland. The analysis covered the period from 1 January 2015-31 December 2020; from 40,007 cases, 20,980 were qualified for final analysis. Analysis of the documentation allowed to obtain the following data: socio-demographic, lifestyle, obstetrics, course of delivery and the condition of the newborn. Analysis of the relationship between qualitative variables was performed using the Chi-square test, while the Mann-Whitney U test was used to compare two quantitative variables. RESULTS: Women giving vaginal delivery from rural areas were younger (30.9 vs. 31.3), had primary education (2.4% vs. 1.7%) and secondary education (16.2% vs. 10.1%), were in a relationship (86.1% vs. 81.6%) and more often had a higher BMI at birth (27.8 vs. 27.0), compared to the patients living in cities (p<0.05). In addition, between 07:00-18:59., induction of labour (20.7% vs. 19.1%), epidural anesthesia (35.4% vs. 34.0%) and episiotomy were performed more often (29.1% vs. 27.8%) (p<0.05). CONCLUSIONS: Differences were shown in the course of vaginal delivery in relation to the place of residence of the women, and the time of day of the delivery. These factors should be considered in the planning of perinatal care. At the same time, it is necessary to conduct further research on the analyzed aspect in order to ensure the highest quality care.

Epidural anesthesia during childbirth - retrospective analysis of maternal and neonatal results.

OBJECTIVES: In Poland, in accordance with applicable regulations, every woman should have access to epidural anesthesia. The advantage of this type of analgesia is primarily analgesic effectiveness. The aim of the study is to identify variables related to epidural anesthesia and to verify the relationship between them and the occurrence of perinatal complications in the mother and the child. MATERIAL AND METHODS: This was a single-center retrospective cohort study. Electronic documentation of patients of the Hospital of St. Sofia in Warsaw was used to create an anonymous retrospective database of all births in the years 2015-2020. 27,340 cases were qualified for the analysis. RESULTS: The logistic regression model showed that the risk of episiotomy (OR = 5.539; CI = 5.169-5.935) increases more than fivefold and perineal laceration (OR = 2.190; CI= 2.036-2.356) increases twice in the case of epidural anesthesia application. There is also an increased risk of operative delivery (OR = 2.668; CI = 2.255-3.156), at the same time the risk of performing a cesarean section decreases more than fivefold (OR = 0.043; CI = 0.036-0.052). CONCLUSIONS: Epidural anesthesia affects the delivery mechanism leading to an increase in the number and intensity of additional medical procedures - episiotomy, perineal laceration, operative delivery. The rationale for the routine use of this method of anesthesia should be considered in the context of the implications for the woman's reproductive health and research on the effectiveness of other methods of birth anesthesia should be conducted.

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study of 4350 Women in Warsaw, Poland, 2015-2020.

BACKGROUND Although there have been some recent clinical trials on the effects of augmentation of labor with oxytocin, or augmentation of labor, there are no clinical guidelines to explain the variations in obstetric practice between countries and within countries. This retrospective case-control study from a single center in Warsaw, Poland aimed to evaluate the use and effects of augmentation of labor with oxytocin in 4350 women between 2015 and 2020. MATERIAL AND METHODS This was a single-center, retrospective, case-control study in which 29 455 cases were qualified for analysis. The study included the analysis of 2 groups: the study group consisted of 4382 patients who underwent stimulation of childbirth, and the control group consisted of 25 073 patients who did not undergo this obstetric procedure. RESULTS Multivariate logistic regression analysis showed that the factors increasing the frequency of augmentation of labor were higher BMI (P<0.05), preinduction (P<0.05), epidural anesthesia (P<0.05), and family present at birth (P<0.05). Factors influencing reduction in the frequency of augmentation of labor were higher number of deliveries (P<0.05), vaginal birth after cesarean (P<0.05), and pre-pregnancy hypertension (P<0.05). CONCLUSIONS This study from a single center in Poland showed that BMI, preinduction, epidural anesthesia, and family present at birth significantly increased the frequency of labor stimulation with oxytocin. However, a history of previous pregnancies, previous cesarean sections, and pre-pregnancy hypertension significantly reduced the frequency of augmentation of labor with oxytocin.

Retrospective Analysis of the Factors Affecting the Induction of Childbirth in 4350 Women from a Single Center in Warsaw, Poland.

Labor induction is one of the most common procedures performed during childbirth, on average in 20−30% of all pregnant women. The aim of this paper was to perform a retrospective analysis of the factors influencing the induction of childbirth. The data provide population-based evidence for Poland (Masovian Voivodeship). The electronic patient records of a hospital in Warsaw were used to create an anonymous retrospective database of all deliveries from 2015 to 2020. The study included an analysis of two groups of patients. The study group consisted of patients with labor induction­4350 cases, and the control group of patients with spontaneous contractions­20,345. The factors influencing the lower frequency of labor induction in the study group were previous cesarean section (OR = 0.73, 95% CI: 0.64−0.84, p < 0.05) and a higher number of deliveries (OR = 0.74, 95% CI: 0.68−0.80, p < 0.05). It is necessary to conduct further research about obstetric procedures used during childbirth, such as induction of childbirth, to reduce the risk of complications and improve the perinatal care of the mother and the neonate.

Episiotomy for Medical Indications during Vaginal Birth-Retrospective Analysis of Risk Factors Determining the Performance of This Procedure.

The WHO (World Health Organization) recommends that the percentage of perineal incisions should not exceed 10%, indicating that this is a good goal to achieve, despite the fact that it is still a frequently used medical intervention in Poland. The risk factors for perineal incision that have been analyzed so far in the literature allow, among others, to limit the frequency of performing this procedure. Are they still valid? Have there been new risk factors that we should take into account? We have conducted this study to find the risk factors for performing perineal incision that would reduce the frequency of this procedure. The aim of the study was to check whether the risk factors that were analyzed in the literature are still valid, to find new risk factors for perineal incisions and to compare them among Polish women. This was a single-center retrospective case-control study. The electronic patient records of Saint Sophia's Hospital in Warsaw, Poland, a tertiary hospital was used to create an anonymous retrospective database of all deliveries from 2015 to 2020. The study included the analysis of two groups, the study group of patients who had had an episiotomy, and the control group-patients without an episiotomy in cases where an episiotomy was indicated. A logistic regression model was developed to assess the risk factors for perineal laceration. Independent risk factors for episiotomy in labor include oxytocin use in the second stage of labor (OR (Odds Ratio) = 6.00; 95% CI (Confidence Interval): 4.76-7.58), the supply of oxytocin in the first and the second stage of labor (OR = 3.18; 95% CI: 2.90-3.49), oxytocin use in the first stage of labor (OR = 2.72; 95% CI: 2.52-3.51), state after cesarean section (OR = 2.97; 95% CI: 2.52-3.51), epidural anesthesia use (OR = 1.77; 95% CI: 1.62-1.93), male gender (OR = 1.10; 95% CI: 1.02-1.19), and prolonged second stage of labor (OR = 1.01; 95% CI: 1.01-1.01). A protective factor against the use of an episiotomy was delivery in the Birth Centre (OR = 0.43; 95% CI: 0.37-0.51) and mulitpara (OR = 0.31; 95% CI: 0.27-0.35). To reduce the frequency of an episiotomy, it is necessary consider the risk factors of performing this procedure in everyday practice, e.g., limiting the use of oxytocin or promoting alternative places of delivery.

Spontaneous Perineal Trauma during Non-Operative Childbirth-Retrospective Analysis of Perineal Laceration Risk Factors.

Childbirth-related perineal trauma (CRPT) is defined as damage to the skin, muscles of the perineum, as well as to the anal sphincter complex and anal epithelium. The aim of the study was to analyze the risk factors for spontaneous injuries to the soft tissues of the birth canal during non-operative delivery. This was a single-center retrospective case-control study. The study included the analysis of two groups, the study group featured 7238 patients with spontaneous perineal laceration (any degree of perineal laceration) and the control group featured patients without perineal laceration with 7879 cases. The analysis of single-factor logistic regression showed that the factors related to perineal laceration during childbirth are the age of the patients giving birth (p = 0.000), the BMI before delivery (p = 0.000), the number of pregnancies (p = 0.000) and deliveries (p = 0.000), diagnosed gestational diabetes (p = 0.046), home birth (p = 0.000), vaginal birth after cesarean (VBAC) (p = 0.001), the use of oxytocin in the second stage of childbirth (p = 0.041), the duration of the second stage of childbirth (p = 0.000), body weight (p = 0.000), and the circumference of the newborn head (p = 0.000). Independent factors that increase the risk of perineal laceration during childbirth are an older age of the woman giving birth, a history of cesarean section, a higher birth weight of the newborn, and factors that reduce the risk of spontaneous perineal trauma are a higher number of deliveries and home birth.

Women's views and preferences regarding the mode of birth after cesarean section: Polish cross-sectional web-based survey.

OBJECTIVE: Currently, the most common indication for cesarean section is a previous cesarean section. Some of them are performed for no medical reasons. Therefore, it is crucial to recognize the preferences and expectations of women concerning birth after cesarean section. This study's main aim was to understand the women's points of view on the mode of birth after cesarean. STUDY DESIGN: A cross-sectional study was conducted, and data was collected using an original structured online questionnaire. The study group consisted of 733 pregnant Polish women who had previously undergone a cesarean birth. RESULTS: Women more often preferred vaginal birth after cesarean section (73.26%) and less frequently (23.33%) chose elective cesarean section. Women preferring VBAC when making decisions were guided by the benefits, opportunities, and risks associated with each mode of birth. For women preferring elective cesarean section the only highly significant factor was the experience of previous deliveries. Women mainly use Internet sources and the support of other women giving birth after cesarean section. More than half of the women did not talk about the mode of birth with their midwife, and every fifth did not talk about it with the obstetrician. CONCLUSION: Obstetric history and personal beliefs about birth after cesarean section, motivations, and concerns about childbirth affect women's preferences regarding the mode of birth. It is necessary to educate women, in particular, talks about the opportunities and risks associated with cesarean birth carried out by the medical staff at an early stage of pregnancy.

A Questionnaire-Based Study to Evaluate Health-Related Behaviors in 602 Women of Reproductive Age in Poland.

BACKGROUND Women's health and undertaking health behaviors during the reproductive period by women, especially during pregnancy, are an important indicator that is reflected both in their own health and in health of their children. This study aimed to use a questionnaire to evaluate the health-related behaviors in women of reproductive age in Poland. MATERIAL AND METHODS The studies were conducted among 602 women of reproductive age by diagnostic poll method with the use of questionnaire technique. The applied tool was an original on-line questionnaire. A link to the questionnaire was sent to women aged 18-49 years using the snowball sampling technique and was posted on thematic pro-health website forums. RESULTS The majority of women participating in the study exhibited health behaviors on the average level (65.3%; M=7.6). Pro-health behaviors were exhibited mainly by women with higher education (M=7.7; SD=2.6), married women (M=8.0; SD=2.6), and women who were pregnant at the time (M=8.8; SD=2.6). However, single women participating in the study consumed alcohol more often (80.6%). The observed relationships were statistically significant (P<0.05). CONCLUSIONS This survey showed that younger women with no children were significantly less likely to be aware of positive health-associated behaviors and lifestyle when compared with older women with children. This small study supports the importance of health education in young women before they have children.

Suspected Miscarriage in the Experience of Emergency Medical Services Teams-Preliminary Study.

Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland's National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.

Oxytocin administration for induction and augmentation of labour in polish maternity units - an observational study.

BACKGROUND: There is not enough data regarding practices and protocols on the dose of oxytocin administrated to women during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in two maternity units in Poland. METHODS: The article presents a prospective observational study. Data from 545 (n = 545) labours was collected in two maternity units. First, the total dose (the total amount of oxytocin provided from the beginning in the labour ward until delivery including the III and IV stage of labour) and cumulative dose of oxytocin (the amount of oxytocin given until the birth of the neonate) administered to women during labour was calculated. Then, the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss) was analysed. Finally, the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour was examined. RESULTS: The average cumulative dose of oxytocin administrated to women before birth was 4402 mU following labour induction and 2366 mU following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. The two units participating in the study had similar protocols and did not differ significantly in terms of total oxytocin dose, rates of induction and augmentation - the only observed difference was the mode of delivery. CONCLUSIONS: The study showed no effect of the mean cumulative oxytocin dose on short-term perinatal outcomes and high rate of non-compliance of the practice of oxytocin administration for labour induction and augmentation with the national recommendations. Cooperation between different professional groups of maternity care providers should be considered in building national guidelines for maternity care.. Further studies investigating possible long-term effects of the meant cumulative dose of oxytocin and the reasons for non-compliance of practice with guidelines should be carried out.

Women's views of birth after cesarean section.

BACKGROUND: Vaginal birth is a safe mode of childbirth for the majority of women after cesarean section (CS). However, data show that women who have undergone a CS are more likely to have an elective CS (ECS) than a vaginal birth after CS (VBAC) in many areas of the world. AIM: This study aimed to review the literature about women's mode of birth preferences and attitudes and the underlying reasons for, and factors associated with, their preferences. METHODS: This is narrative literature review. PubMed/MEDLINE and Scopus databases were searched, limiting the results to non-interventional studies published between 1990 and 2020. Twenty-one articles were included in the analysis. RESULTS: The review found 34 different factors that influence women's preferences. Five factors influenced both VBAC and ECS preference, depending on the study. The most common factors having a dualistic effect on preference were: medical staff recommendation, doctor's opinion, and fear of pain. The most common factors were: desire to experience natural childbirth, faster/easier recovery, support from doctor's, and midwife's opinion. Among the factors influencing the preference for ECS, two were particularly prominent: predictability, controllability and comfortability of CS and the belief that CS is safer for the baby and/or mother. CONCLUSIONS: Our review showed that there are a variety of factors that influence women's preference for the mode of delivery after CS. Some of these have a dualistic effect according to the study. The key to making an informed decision regarding the mode of delivery is communication with medical professionals.

Polish Medical Air Rescue Crew Interventions Concerning Neonatal Patients.

The purpose of the study was to present the characteristics of Helicopter Emergency Medical Service (HEMS) and Emergency Medical Service (EMS) interventions concerning newborns in Poland. The study involved a retrospective analysis of missions by Polish Medical Air Rescue crews concerning newborns, carried out in Poland between January 2011 and December 2020. Polish Medical Air Rescue crews were most commonly dispatched to urban areas (86.83%), for patient transfer (59.67%), using an airplane (65.43%), between 7 AM and 6:59 PM (93.14%), and in the summer (28.67%). Further management involved handing over the neonatal patient to a ground neonatal ambulance team. Most of the patients studied were male (58.02%), and the most common diagnosis requiring the HEMS or EMS intervention was a congenital heart defect (31.41%). The most common medical emergency procedure performed by Polish Medical Air Rescue crew members for the neonatal patients was intravenous cannulation (43.07%). The odds ratio for congenital malformations was higher in male newborns. The type of Polish Medical Air Rescue mission was associated with the location of the call, time of the call, ICD-10 diagnosis associated with the dispatch, selected clinical findings, most commonly performed medical emergency procedures, and mission duration and distance covered.