The Influence of Gestational Diabetes Mellitus on Maternal and Neonatal Outcomes: A Retrospective Study in Rzeszów, Poland.

BACKGROUND Gestational diabetes mellitus (GDM) affects 5.8-12.9% of pregnant women, while pre-gestational diabetes mellitus (PGDM) affects 0.4-1.1%. GDM increases the risk of perinatal complications and long-term health issues. This retrospective study from a single centre in Rzeszów, Poland aimed to evaluate maternal and neonatal outcomes of pregnancy of 65 women with gestational diabetes mellitus. MATERIAL AND METHODS The study group consisted 65 women with GDM. The control group consisted 60 women without. GDM were diagnosed with carbohydrate metabolism disorders during pregnancy based on the results of the oral glucose tolerance test (OGTT). Methods of evaluation of the mothers: age, body mass before pregnancy, body height, body mass index (BMI), gravidity, parity, the number of miscarriages, length of stay (LOS) of mother, gestational weight gain (GWG), duration of pregnancy, type of delivery, treatment of diabetes. Methods of evaluation of the child: LOS, birth weight, Apgar points. RESULTS Women with diabetes stayed in hospital longer than women without, similarly applies the length of stay (LOS) of the child (p<0.001). It turned out that the women with GDM were significantly more likely to deliver by caesarean section (CS) (p=0.024) and these women most often had gestational weight gain (GWG) within the recommended range (p<0.001). Body mass index (BMI) before pregnancy was significantly higher in the women with GDM (p=0.023). CONCLUSIONS The above study confirms that the occurrence of GDM has an undoubted impact on prolonged LOS of the mother and child, more frequent CS delivery and normal GWG.

Opinions and attitudes of parturients, midwives, and obstetricians about Caesarean section in the provinces of Podkarpackie, Poland, and Ivano-Frankivsk, Ukraine.

INTRODUCTION AND OBJECTIVE: Present the opinions of parturients, midwives, and obstetricians concerning CS in the provinces of Podkarpackie (Poland) and Ivano-Frankivsk (Ukraine). MATERIAL AND METHODS: An anonymous questionnaire for parturients (n=1,295), midwives (n=47) and obstetricians (n=78), assessing demographics, knowledge and attitudes concerning CS, was distributed in 13 hospitals. In addition to measured anxiety among parturients, we also used the State-Trait Anxiety Inventory (STAI). RESULTS: Differences between the subgroups concerned respondents' ages and place of residence (p=0.0000). Parturients from Poland more often accepted the possibility of vaginal delivery after previous CS (p=0.0000), they more often believed that free access to epidural analgesia and the presence of a chosen partner in the delivery room would decrease the CS rate (p=0.0000). Polish midwives more rarely accept the idea of CS on maternal request (p=0.0012) and were convinced that free access to epidural analgesia could decrease the rate of CS (p=0.0479). In Poland parturients more often accepted CS on maternal request than obstetricians and midwives (p=0.0000). In Ukrainian population midwives and obstetricians more often accepted possibility of natural delivery after previous CS (p=0.0010). According connected with delivery in Poland parturients returned lower scores on the A-State scale (p=0.0000), but higher scores on the A-Trait scale (p=0.0067). CONCLUSIONS: There are some differences in Polish and Ukrainian obstetricians, midwives and parturients in respect of: - vaginal delivery after CS, - epidural analgesia, - CS on request, - anxiety connected with labour. The above may to some extend explain the difference in Cs rate in two countries.

[Level of satisfaction in patients giving birth in Poland/Rzeszów and in the Federal Republic of Germany/Gross-Gerau]. / Satysfakcja z opieki okoloporodowej pacjentek rodzacych w Polsce/Rzeszow i w Republice Federalnej Niemiec/Gross-Gerau.

AIM OF THE STUDY: The main purpose of the study was to examine opinions on perinatal care expressed by women hospitalized after childbirth in Poland and Germany Different socio-demographic variables were also analyzed in order to evaluate the quality of perinatal care in two different countries. MATERIALS AND METHODS: The study group comprised of postpartum patients from two facilities: the Clinical Ward of Gynecology and Obstetrics of Frideric Chopin Province Specialist Hospital in Rzeszów, Poland, and the Obstetrics-Gynecology Hospital in Gross-Gerau, Germany The group of randomly selected women, who were initially invited to participate in the study included 259 Polish and 230 German females. In order to measure the level of satisfaction with perinatal care, the authors used "The Newcastle Satisfaction with Nursing Scale" (originally constructed at the Center for Health Services Research, "University of Newcastle upon Tyne, UK, and adopted in Poland by Poznan University of Medical Sciences) and their own questionnaire. Finally 200 patients, one hundred from Poland and one hundred from Germany were enclosed. Statistical analysis was performed using the Statistics 8.0 software and a p valued below 0.05 was regarded significant. RESULTS: Generally perinatal care was assessed as being satisfactory by both Polish (91%) and German (97%) respondents. The study population varied in terms of age, education, place of residence or marital status. Only one socio-demographic variable (education) had a significant impact on the perception of the obtained perinatal care. However a limited number of patients (25% in Poland and 47% in Germany) participated in the prental and parenting classes. CONCLUSIONS: 1. Perinatal care was positively assessed by Polish and German patients of both hospitals. 2. The greatest importance in selecting the location for childbirth was attributed by both Polish and German subjects to such factors as: opinion of their friends, highly qualified personnel, modern medical equipment and instruments on premises. Additionally Polish respondents found it important that the doctor who had provided care for a given woman during pregnancy was employed at that particular hospital. In turn, German respondents also paid particular attention to the distance between their place of residence and hospital. 3. All study participants, regardless of their nationality admitted that the hospitals offered to their close relatives the possibility to visit and accompany the patients during childbirth.

The incidence of Streptococcus Group B in 100 parturient women and the transmission of pathogens to the newborn.

OBJECTIVES: Perinatal infections are one of the fundamental causes of early puerperal complications in mothers and neonates. The aim of the study was to determine the incidence of Streptococcus group B (GBS) colonization in parturient women and the rate of pathogen transmission to the newborn. MATERIAL AND METHODS: The study group consisted of 100 consecutive parturient women and their newborns. Smear samples for GBS identification were taken from the parturient vagina and from the newborns' nasal cavity. In patients with positive smears, both the mother and the child, a more in-depth analysis was performed, including investigation of the mode of delivery and premature rupture of membranes incidence. RESULTS: GBS colonization was found in 19 parturient women and in 4 newborns in the first 24 hours of their lives. In case of 4 women who gave birth to 4 colonized newborns, two cases of premature rupture of membranes, two vaginal and two caesarean deliveries and one case of symptomatic infection in the mother were found. No symptoms of infection appeared among the four colonized newborns. CONCLUSIONS: 1. prevalence of GBS colonization appeared in one in five parturient women, 2. in GBS positive women, the risk of transmission to newborns is about 21%, 3. caesarean section and intact membranes do not prevent the transmission of GBS to a newborn.

[Introduction of the Birthcenter System (according to Belegsystem) in Germany--comments]. / Doswiadczenia niemieckie z wprowadzaniem Centrum Opieki Polozniczej wedlug Belegsystem.

Recent years have undoubtedly been a time of dynamic changes for German midwives, which had had their source in numerous social, economic and political changes. The medical care cost growth, lack of profitability of medical centers and an increasing number of redundancies have been given lots of attention in various discussions. The above mentioned problems have started to concern the professional group of German midwives, thus giving birth to the introduction of innovatory system of obstetric care in German hospitals, known as Belegsystem. In Europe the Belegsystem has been introduced in certain Scandinavian countries, Great Britain, Austria and Switzerland. In Germany the first labour room within the Belegsystem rules has been opened on 1 June 2003 in Brema (Klinikum Bremerhaven Reinkenheide). The following two Centers have been opened in Hamburg at the beginning of 2004 (Allgemeines Krankenhaus Hamburg-Harburg i Allgemeines Krankenhaus Hamburg-Barmbek). The folllowing article presents the functioning rules and procedures of the Belegsystem labour rooms in Germany, as one of the labour care alternatives.

[The constribution of Justyne Siegemundin, the midwife of the Brandenburg court, to the development of the obstetrics at XVII century]. / Wklad justyny siegemundin, poloznej dworu brandenburskiego, w rozwój XVII-wiecznego poloznictwa.

From the beginning of the world assisting during childbirth was and is the women's domain. On the evolution this profession composed of many famous midwifes. Into this group unquestionably we can count Justine Siegemundin (1636-1705), midwife-self-taught person. Her activity contributed to rise the obstetrics knowledge in XVII century. Justine Siegemundin, the midwife of the Brandenburg court, published in 1690 a book describing a surgical trick still bears her name today. It is called the "double hold"--"Gedoppelter Handgriff", or "Siegemundin-Handgriff". This book counts as on the most important milestones of obstetrics history.