[Patient's preferences concerning the course of labor]. / Preferencje kobiet dotyczace przebiegu porodu.

OBJECTIVE: Much concern is being focused on the improvement of perinatal care standards in recent time. Not only the safety of woman and newborn, but also the comfort and individual preferences should to be considered. The aim of this study was to assess of expectations and requirements of the delivering women in relation to the course of labor and usage of the most common procedures in clinical practice. MATERIAL AND METHODS: 47 women who delivered in Obstetrical Word in Puck were questionnaire. Mean gestational age was 39 +/- 1.5 hbd. 47% of women were nulliparous, 53% were multiparous. The following variables were analyzed: the presence of medical staff and family at delivery, possibility of the delivery position choice, use of auxiliary devices, a friendly atmosphere during delivery, use of analgesia and labor induction, episiotomy and ante-partum preparation, cesarean section on request, attendance to labor school. Mann-Whitney, Pearson and Yule tests were used for statistical analysis. RESULTS: 25% of women, mainly younger gravidae, attended the labor school. The midwife was considered the most important person at delivery. The presence of family member(s) was important for highly-educated women. The possibility to choose the delivery position and to walk during the 1st stage of labor was important for 73% of respondents. The majority of women who had attended the labor school avoided the horizontal position. Over 60% of patients accepted the usage of labor induction. A vast majority of women were against antepartum perineal shaving and episiotomy. Better-educated women preferred water delivery. 69% of the studied women would like to listen to the music at the delivery room. Cesarean section on request was supported by 11% of women. CONCLUSIONS: The tendency to promote modern delivery methods and active participation in labor leading is noticed. The significant influence of labor school on women's knowledge and their preferences was found.

[The influence of water immersion on the course of labor]. / Wplyw immersji wodnej na przebieg porodu.

OBJECTIVE: The aim of this study was to examine the influence of water immersion on the course of labor. MATERIAL AND METHODS: The study group consisted of 109 women, who have delivered in water in Obstetrical Ward in Puck from 1998 to 2000. 110 women composed control group. Mean patients' age in study and control group was respectively 26.40 +/- 4.33 and 26.72 +/- 5.82 years (ns). Gestational age was 40.69 +/- 5.91 and 39.71 +/- 2.03 weeks (ns). The duration of labor stages, time from membranes rupture to delivery, birthweight and newborns condition, frequency of episiotomy and perineum injuries as well as necessity of labor stimulants use were analyzed. Particular parameters were also assessed regarding to parity. The differences were determined using T-test. RESULTS: Mean duration of 1st labor stage was 319 min in study group and 375 min in control group (p < 0.02). The 2nd and 3rd labor stages did not differ significantly. II labor stage in nulliparous and I stage in multiparous were shorter in study group (respectively 34.41 vs. 45.5 min; p < 0.02 and 258.23 vs. 329.83 min; p < 0.02). The episiotomy was less frequent in study group (p < 0.01), whereas perineum injuries in control one (p < 0.05). Use of oxytocin was comparable between both groups. 97% of newborns from study group and 93% from control group, they were in good condition (ns). CONCLUSIONS: The profitable influence of water immersion to short 1st labor stage was noted. There were no differences in newborns' condition. The water birth is a safe method of labor in patients with physiological pregnancy.

[The condition of premature newborns of patients hospitalized due to premature rupture of fetal membranes (PROM)]. / Stan urodzeniowy noworodków urodzonych przedwczesnie przez pacjentki hospitalizowane z powodu przedwczesnego pekniecie pecherza plodowego (PROM).

OBJECTIVES OF THE STUDY: The aim of the study was to compare the premature newborns' condition of patients hospitalized due to PROM with the group of premature newborns of patients with amniorrhexis at the time of labor. MATERIAL AND METHODS: The studied group consisted of 74 newborns of 70 gravidas hospitalized in the Department of Pathological Pregnancy and the control group of 77 newborns of 70 patients. On analysing the investigated materials special attention was paid to: the time of PROM, the time and the way of pregnancy, the age of the, obstetrical history, the symptoms of intrauterine infection. In assessment of the newborns' condition the following factors were taken into consideration: characteristics of infection, Apgar scores, birth weight, respiratory disorders and other newborns' diseases. RESULTS: Theoretic risk of sepsis was higher in study than in control group (p = 0.00). The sepsis occurrence was comparable in both groups (7 vs 8). The infection occurred more frequently in study group. CONCLUSIONS: 1. The newborn condition depends on the week of pregnancy termination, with better prognosis for longer pregnancies and with no differences between both groups 2. In spite of statistically important risk of sepsis occurrence in study group, the real occurrence was comparable in both groups 3. There is a statistically important difference between CRP and 5' Apgar score in study group. 4. Percentiles of birthweight and birthlength appropriate for gestational age were comparable between both groups.