The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian agenesis or aplasia, is a congenital disease manifested by the aplasia of the uterus and the upper 2/3 of the vagina; its incidence is 1 in 4,000-5,000 female live births. We can distinguish 2 types of the MRKH syndrome: type I, which is characterized by an isolated absence of 2/3 of the vagina and uterus; and type II or MURCS (Müllerian duct aplasia, unilateral renal agenesis and cervicothoracic somite anomalies), which is also associated with other symptoms. The treatment of the MRKH syndrome patients aims at creating a neovagina and enabling sexual intercourse. Non-surgical techniques are the first-choice methods, and more than 90% of patients notice an anatomical and functional improvement if they are well-prepared emotionally. If non-surgical treatment does not bring about the expected results, a surgical procedure remains an option. The surgical method is mainly determined by the surgeon's experience. There are a few types of operations, though none of them seems superior to others. The next challenge is to provide these patients with a chance to become parents. Nowadays, a uterine transplant, a surrogate or adoption are the available solutions. An interdisciplinary approach is required, and the treatment should consist of medical and psychological support. This review presents the current knowledge about the MRKH syndrome with regard to the current methods of non-surgical and surgical treatment as well as a summary of the associated psychological problems.

Remote pregnancy monitoring is one of the most promising applications of telemedicine; however, the diagnostic value of self-examination using mobile cardiotocography (CTG) devices and remote analysis of the subsequent results has never been properly studied. The study aimed to compare the diagnostic usefulness of CTG self-examination using a mobile device to examination performed by a medical professional using a stationary device; and to evaluate the quality of CTG analysis performed remotely. Eighty-two pairs of CTG recordings were collected; each pair consisted of a single recording from an examination performed by a midwife using a stationary device, and another recording from an unassisted patient self-examination using a mobile device. Recordings were performed with a maximum time interval of 30 min. Each recording was analyzed twice. Primary analysis included a comparison of the assisted examination evaluated on-site vs the self-examination evaluated remotely in pairs. Secondary analysis was conducted by an independent expert who evaluated the unpaired recordings. Baseline fetal heart rate (BFHR) values were compared independently. We found that patients were more likely to perform inconclusive recordings than experienced midwives; however, the self-examination feasibility was satisfactory. The primary analysis showed 88.4% agreement of the recorded pairs; 11.6% of inconsistent pairs were due to inter-observer variability or medical reasons. The independent expert's analysis showed 97.1% agreement between the assisted and unassisted examinations. Paired t-test for BFHR values showed a statistically significant but clinically negligible mean difference between the 2 devices at 1.75 bpm. The CTG examinations performed using mobile devices present satisfactory feasibility and equivalent diagnostic value compared to conventional devices, while the remote evaluation of recordings is as reliable as on-site analysis. Remote pregnancy surveillance is safe, effective and may be implemented into everyday obstetric care.

Over the past centuries maternal and neonatal morbidity and mortality has fallen dramatically. This is mainly due to the fact that we achieved a lot in the field of medicine in a very short amount of time. Evidence, mostly from Europe but also from US, suggested that home birth can be relatively safe provided the appropriate conditions are met. The question is “What if something goes wrong?” How to increase patient safety in the case of birth before arrival (BBA) or it may not be associated with any increased risk? Our study review nowadays available articles and describes rates, obstetrical characteristics and perinatal and maternal outcome of unplanned out-of-hospital deliveries. Over the past centuries maternal and neonatal morbidity and mortality has fallen dramatically. This is mainly due to the fact that we achieved a lot in the field of medicine in a very short amount of time. Evidence, mostly from Europe but also from US, suggested that home birth can be relatively safe provided the appropriate conditions are met. The question is “What if something goes wrong?” How to increase patient safety in the case of birth before arrival (BBA) or it may not be associated with any increased risk? Our study review nowadays available articles and describes rates, obstetrical characteristics and perinatal and maternal outcome of unplanned out-of-hospital deliveries.

Planned out-of-hospital births, facilitated by highly skilled and experienced midwives, offer expectant parents a distinct opportunity to partake in a personalized, intimate, and empowering birth experience. Many parents opt for the care provided by midwives who specialize in supporting home births. This retrospective study is based on 41,335 EMS emergency calls to women in advanced pregnancy, of which 209 concerned home birth situations documenting obstetrical emergencies over four years (January 2018 to December 2022), of which 60 involved the assistance of a midwife. Data were obtained from the Polish Central System for Emergency Medical Services Missions Monitoring, encompassing all EMS interventions in pregnant women. The most frequent reason for emergency calls for obstetrical emergencies with the assistance of a midwife was a failure to separate the placenta or incomplete afterbirth (18 cases; 30%), followed by perinatal haemorrhage (12 cases; 20%) and deterioration of the newborn’s condition (8 cases; 13%). Paramedic-staffed EMS teams conducted most interventions (43 cases; 72%), with only 17 (28%) involving the presence of a physician. Paramedics with extensive medical training and the ability to provide emergency care are in a unique position that allows them to play a pivotal role in supporting planned out-of-hospital births. The analysed data from 2018–2022 show that EMS deliveries in Poland are infrequent and typically uncomplicated. Continuing education, training, and adequate funding are required to ensure the EMS is ready to provide the best care. EMS medical records forms should be adapted to the specific aspects of care for pregnant patients and newborns.

Background/Objectives: Respiratory syncytial virus (RSV) is a major cause of severe lower res-piratory tract infections in infants, particularly in vulnerable populations such as preterm new-borns and those with underlying health conditions. The approval of the RSVpreF vaccine for pregnant individuals offers a new strategy to reduce the burden of RSV-associated illness in newborns. The aim of this study was to assess RSV vaccination coverage among pregnant wom-en, identify factors contributing to vaccination hesitancy, and evaluate the knowledge of the bene-fits of vaccination among patients in Poland. Methods: The study was conducted on 668 re-spondents from Poland. The study utilized an original, anonymous questionnaire consisting of 23 questions, which was distributed via social media platforms from July 25 to August 1, 2024. Par-ticipants, including women who had recently given birth or were about to, were recruited through Facebook groups and Instagram. Results: We confirmed that responders with medical back-grounds had statistically greater knowledge about RSV than non-medical individuals. Addi-tionally, indivudals with medical medical backgrounds were more likely to receive the RSV vac-cination during pregnancy, as were patients who obtained vaccination information directly from their physician. Furthermore, a key finding was that patients who had previously received vac-cinations for other diseases, such as influenza and pertussis, were more likely to opt for RSV vac-cination. Conclusions: Vaccination against RSV during pregnancy is a crucial method for safe-guarding newborns from infection and its severe complications. Awareness of RSV and vaccina-tion rates among pregnant women remains low, necessitating educational initiatives and public health campaigns to improve coverage.

Background: Obstetric haemorrhage, particularly postpartum haemorrhage (PPH), remains a significant global health challenge and a leading cause of maternal mortality. Despite advancements in understanding and preventing PPH, haemorrhage remains a leading cause of maternal mortality worldwide. The aim of this study was to review the current literature on the use of uterotonic drugs, particularly oxytocin, in reducing perinatal mortality during prehospital deliveries. Methods: In December 2024, a comprehensive search was conducted across PubMed, Web of Science, Embase, and Scopus, yielding 108 records, of which four studies met the inclusion criteria. Results: The limited evidence underscores the need for targeted research and adherence to international obstetric guidelines to improve PPH management and maternal outcomes. In some countries, the only uterotonic drug available in all EMS teams is oxytocin; in others, there is none. Emergency Medical Services (EMS) play a critical role in providing lifesaving interventions during obstetric emergencies, often serving as the first and sometimes only point of medical contact for women experiencing complications during childbirth. Conclusion: There is a lack of high-quality clinical studies evaluating the effectiveness of uterotonic agents in EMS operations and their role in treating postpartum haemorrhage in prehospital settings. Addressing this gap requires targeted research to generate robust evidence and inform the development of standardized protocols. Such efforts could enhance the timely management of PPH, ultimately reducing maternal mortality and improving outcomes in resource-limited and prehospital environments. By bridging the evidence gap, EMS systems worldwide can be better equipped to handle obstetric emergencies effectively.