Objective: To assess changes in caesarean section (CS) rates in Europe from 2015 to 2019 and utilise the Robson Ten Group Classification System (TGCS) to evaluate the contribution of different obstetric populations to overall CS rates and trends.Design: Observational study utilising routine birth registry data.Setting: A total of 28 European countries.Population: Births at ≥22 weeks of gestation in 2015 and 2019.Methods: Using a federated model, individual‐level data from routine sources in each country were formatted to a common data model and transformed into anonymised, aggregated data.Main Outcome Measures: By country: overall CS rate. For TGCS groups (by country): CS rate, relative size, relative and absolute contribution to overall CS rate.Results: Among the 28 European countries, both the CS rates (2015, 16.0%–55.9%; 2019, 16.0%–52.2%) and the trends varied (from −3.7% to +4.7%, with decreased rates in nine countries, maintained rates in seven countries (≤ ± 0.2) and with increasing rates in 12 countries). Using the TGCS (for 17 countries), in most countries labour induction increased (groups 2a and 4a), whereas multiple pregnancies (group 8) decreased. In countries with decreasing overall CS rates, CS tended to decrease across all TGCS groups, whereas in countries with increasing rates, CS tended to increase in most groups. In countries with the greatest increase in CS rates (>1%), the absolute contributions of groups 1 (nulliparous term cephalic singletons, spontaneous labour), 2a and 4a (induction of labour), 2b and 4b (prelabour CS) and 10 (preterm cephalic singletons) to the overall CS rate tended to increase.Conclusions: The TGCS shows varying CS trends and rates among countries of Europe. Comparisons between European countries, particularly those with differing trends, could provide insight into strategies to reduce CS without clinical indication.

Background: Although risk factors associated with maternal postpartum depression (PPD) have been recognized, it is still unknown how some newborn characteristics could influence the appearance of PPD. Aim: Our research aimed to unravel the impact of a newborn’s features on women with PPD. Methods: The study was conducted in the Obstetrics and Gynecology Department at our University Emergency County Hospital, between August 2019 and April 2021. We included 904 women from the second day of the postpartum period, divided into two groups: women with PPD (n = 236) and control (i.e., women without PPD, n = 668), by using the Edinburg Postpartum Depression Scale. Characteristic information on the newborns (i.e., the months in which they were born, premature delivery, birth weight, or sex) was evaluated. Results: Our results suggest that the winter season (i.e., December and January months, p = 0.01) births and male newborns (p = 0.02) were strongly related with the appearance of depressive symptoms during the postpartum period. Conclusions: Therefore, our study sustains that women who give birth to male newborns in the winter season are more prone to developing PPD. This should be analyzed by all public health care systems in order to prevent such a condition earlier in certain groups of women.

Standards of care offer doctors and patients the confidence that an established quality, evidence-based, care is provided, and represent a tool for optimal responding to the population’s needs. It is expected that they will increasingly express a multimodal relationship with gynecologic laparoscopy. Laparoscopy is, now, a standard procedure in operative gynecology, standards are embedded in many laparoscopic procedures, standardization of the skills/competency assessment has been progressively developed, and the proof of competency in laparoscopy may become a standard of care. A continuous development of surgical education includes standard equipment (that may bring value for future advance), standardized training, testing (and performance) assessment, educational process and outcome monitoring/evaluation, patients’ care, and protection, etc. Standards of care and training have a reciprocally sustaining relationship, as training is an essential component of standards of care while care is provided at higher standards after a structured training and as credentialing/certification reunites the two. It is envisaged that through development and implementation, the European wide standards of care in laparoscopic surgery (in close harmonization with personalized medicine) would lead to effective delivery of better clinical services and provide excellent training and education.

Background: Due to social behavior modulation contribution, synthetic oxytocin (synOT) has been routinely used to augment or induce labor. Aim: The present study examined the association between intrapartum synOT administration and maternal postpartum depression (PPD) using an observational prospective study on women who delivered in our department on the 2nd day postpartum. Methods: This study was conducted in our University Emergency County Hospital between August 2019 and April 2021. We included 904 women, of whom 609 (67.36%) received synOT and 295 (32.63%) did not receive synOT during the intrapartum period. Using the Edinburgh Postpartum Depression Scale, we showed that 26.10% of women had PPD and 73.89% of women did not have PPD. Demographic participant characteristics (i.e., age, parity, ethnicity, delivery type, and postpartum hospitalization days) were assessed. Results: Our results show that the rate of PPD was lower in women with synOT administration in comparison with women without synOT administration (p < 0.001). Younger age and shorter hospitalization days of the women with synOT were statistically significant in comparison with women without synOT administration (p < 0.001). Further, primiparous women with spontaneous delivery were positively associated with synOT administration (p < 0.001). Conclusions: Our study sustained that synOT could represent a potential mediator on the PPD prevalence. These results suggest that intrapartum synOT administration may offer a potential benefit to mothers at risk of PPD.

Background: Osseous tissue in the endometrium is a rare find, and it is most often discovered when the patient presents with infertility. It is frequently associated with dysmenorrhea and abnormal menstrual bleedings. Although its etiology remains unclear, in almost all described cases until now, the patient has an obstetrical history. Case report: In this report, we present a unique case of endometrial osseous metaplasia in a 27-year-old primary infertile patient. The transvaginal ultrasound revealed a 18/13/7 mm hyperechoic endometrial mass with posterior acoustic shadowing and no flow on color Doppler. A hysteroscopic examination found a polygonal calcification on the endometrial posterior face of the uterine cavity, in the corporeal isthmic region, which was extracted. The histopathological evaluation revealed microscopic elements compatible with endometrial calcification. The patient had a good postoperative course and the complex endocrinologic, immunologic and electrolytical investigation failed to prove any abnormality. Follow-up transvaginal ultrasound examinations revealed no modifications. Three years later, the patient conceived spontaneously, had an uneventful pregnancy and delivered a full-term fetus. Conclusion: We assumed that this entity can be a serious cause of infertility since the patient had a long history of (primary) infertility and its resection made the pregnancy’s occurrence possible. Finally, since neither history of abortion or chronic inflammation nor any abnormal laboratory test were noticed, we concluded that the etiology of this entity remained unclear.

Background and Objective: Although possible risk factors associated with maternal postpartum depression (PPD) have been elucidated, it is still unknown how some newborns characteristics could influence the appearance of PPD. Our research aimed to unravel the impact of newborn’s characteristics on PPD. Methods: The study was conducted in the Obstetrics & Gynecology Department, from our University Emergency County Hospital, between August 2019 and April 2021. We included women in the 2 nd day of the postpartum period (n=904), divided into 2 groups: women with PPD (n=236) and control (women without PPD, n=668), by using the Edinburg Postpartum Depression Scale. Characteristic information on newborns (i.e., the months in which they were born, premature delivery, birth weight, or gender) were assessed. Results: Our findings suggest that the winter season (i.e. December and January, p=0.01) births and male newborns (p=0.02) were associated with the appearance of depressive symptoms during postpartum. Conclusions: Therefore, our study showed that women who give birth to male newborns in winter are likely to develop PPD. This should be considered by all public health systems in order to prevent such manifestations in certain groups of women.