Background: Adolescent pregnancy is associated with increased risk of both maternal and neonatal complications. Common maternal complications include anemia, hypertensive disorders, and a higher incidence of infections, including Group B Streptococcus (GBS). Additionally, adolescents are at increased risk for gestational diabetes and postpartum hemorrhage. Neonatal complications often involve low birth weight, prematurity, and an increased likelihood of neonatal intensive care unit (NICU) admission. Objectives: This study aims to assess and compare the prevalence of obstetric complications between adolescent and older pregnant women. Methods: This retrospective study investigates obstetric outcomes in adolescent pregnancies, analyzing data collected from 1 January 2016 to 30 June 2024. This study included 902 participants, of whom 224 were adolescents. The variables were categorized into maternal, birth, and neonatal characteristics. Results: Adolescent patients demonstrated a significantly higher prevalence of Group B Streptococcus (GBS) infection, affecting 25.89% of this group. Adolescent patients reported 17.86% nicotine use during pregnancy, a rate significantly higher than that of older age groups (p < 0.001). Additionally, adolescent pregnancies were associated with the highest mean blood loss during delivery, averaging 500 mL during vaginal birth and 1050 mL during cesarean section, leading to a higher incidence of blood transfusions (3.13%, p = 0.021). Newborns from adolescent pregnancies had the lowest mean birth weight (3199 g) and length (53.6 cm). Neonatal complications were more frequent in this group, affecting 20.09% of newborns, with a significantly higher rate of admission to intensive care units (2.68%, p = 0.008). These findings underscore the need for targeted interventions and more proactive management strategies to address the specific challenges faced by this population.

Objectives: The cross-sectional survey was conducted aiming to evaluate the knowledge and experiences of the Polish obstetricians and gynecologists regarding the External Cephalic Version (ECV) and investigate their practices concerning this procedure. Material and methods: An online survey constituting author-created questionnaire with 22 questions, was distributed among gynecologists and obstetricians. The questionnaire evaluated participants' knowledge about ECV, work experiences, and workplace practices. Results: Out of 461 respondents, 56.20% were specialists in gynecology and obstetrics. Elective cesarean section (CS) was preferred by 78.70% for primiparas and 73.50% for multiparas with non-cephalic presentation, while ECV would be chosen by 21.3% and 23.6%, respectively. While 73.80% knew centers performing ECV, only 16.70% had actively participated in the procedure. Major differences in the experiences and knowledge regarding ECV were observed based on work experience, and workplace reference level. Experienced physicians showed higher concerns about ECV complications and emergency CS risks. The most common concerns regarding the procedure referred to periprocedural pain, perceived low efficacy, and complications, and were more prevalent among respondents with longer experience and from lower-reference centers. Conclusions: The study demonstrated that among Polish obstetricians for term pregnancies with non-cephalic presentation, elective cesarean section is preferred over ECV, especially among experienced practitioners. Knowledge about ECV was relatively low, indicating a need for improved educational efforts. Addressing concerns about ECV's safety and efficacy, particularly through enhanced training and anesthesia options, could promote its adoption and reduce CS rates.   Keywords: external cephalic version breech presentation delivery

Objectives: The purpose of this study was to assess and compare the knowledge, attitudes, and practices of Polish midwives and obstetricians concerning external cephalic version (ECV), with particular attention to how professional qualifications, experience, and the reference level of the healthcare facility influenced these factors across both groups. Material and methods: An author-created, 22-question online survey was distributed separately to midwives and obstetricians, with each group receiving a questionnaire customized to assess their specific knowledge of ECV, professional experience, and attitudes toward the procedure. Results: The study included 839 participants: 378 midwives and 461 physicians. Knowledge and experience with ECV varied significantly based on work experience and the reference level of the workplace. When comparing the results between midwives and obstetricians, the median (Q1–Q3) score for correct answers on ECV was highest among obstetrics and gynecology residents (5, 3–6), while the lowest scores were seen among midwives with bachelor’s degrees (2, 1–4). Conclusions: The study identified significant considerable knowledge gaps regarding ECV, particularly among midwives. Educational initiatives targeting both midwives and obstetricians are recommended to encourage the greater use of ECV and potentially reduce the rates of elective cesarean sections in cases of non-cephalic fetal presentations. Keywords: external cephalic version breech presentation delivery midwifery

One of the most perilous complications in obstetrics, often leading to severe bleeding and sometimes a need for urgent hysterectomy, is placenta accreta spectrum, which significantly increases the risk of peri-partum complications, even including the risk of death for the mother and the child. Dealing with excessive bleeding in this situation is paramount. We have found a Foley catheter tourniquet to be useful as a temporary tourniquet to control placental and uterine hemorrhage. We have used this method and find it very useful. In this publication, we describe the last two cases of the use of the Foley catheter as a tourniquet for peri-partum hemorrhage prevention, and we will present a review of the literature in this field.

Objectives: This study aimed to assess the safety and feasibility of implementing an external cephalic version (ECV) with routinely offered regional anesthesia and its impact on the cesarean section (CS) rate at a single large center in Poland. Material and methods: A retrospective analysis was conducted on 110 pregnant women with non-cephalic fetal presentations who were offered an ECV procedure at term between October 2023 and November 2024. Patients were offered regional anesthesia regularly. The endpoints studied were the success rates of ECV, pain levels in the VAS (Visual Analogue Scale) score and subsequent delivery methods. A univariable regression model was employed to identify factors influencing ECV success. Results: Of the 110 pregnant patients fulfilling the criteria for ECV, 56 underwent a total of 61 ECV attempts. Of those, 39 attempts (63.9%) were successful, resulting in 30 vaginal deliveries. Once administered, regional anesthesia significantly reduced procedural pain (VAS 3 [2–4] vs 0 [0–1] points, p < 0.001). A logistic regression model identified maternal BMI as a significant factor influencing ECV success (OR = 1.257, p = 0.018). Of the 61 attempts of ECV, two resulted in urgent cesarean section. ECV implementation resulted in a 2.12% reduction in the overall CS rate at the institution. Further reductions—up to nearly 4% — could be achieved if all eligible patients consented to the procedure. Conclusions: This study demonstrates that ECV, especially with regional anesthesia, is a feasible and effective strategy for reducing cesarean section rates and can be easily implemented into routine clinical practice. Widespread adoption of ECV could significantly decrease CS rates, improving perinatal care in Poland. Keywords: Cesarean Section External Cephalic Version obstetric outcomes regional anesthesia vaginal delivery

Background: The study aimed to evaluate the clinical effects of utilizing acellular dermal matrix (ADM) for treating pelvic organ prolapse. The motivation behind exploring a new treatment method stems from the limited efficacy of current surgical options, which are often associated with side effects. Methods: Ten patients with reproductive organ prolapse underwent surgery at the Chair and Department of Gynecology, Obstetrics, and Gynecological Oncology in Katowice. ADM was used as a support material, with eight patients receiving double TOT and two undergoing a six-point fixation mesh procedure. Pelvic organ prolapse was evaluated pre-operatively and one month post-surgery using the Pelvic Organ Prolapse Quantification (POP-Q) System. General medical history and complaints were assessed using the short form (PFDIQ-SF20). The study included ten patients aged 39 to 71 (mean: 63.6 years), all with a history of at least one vaginal delivery (mean of two). None had undergone a cesarean section. Four patients exhibited POP-Q 3, and five had POP-Q 2. Results: The mean PFDIQ-SF20 score before surgery was 70.6 points. No major complications occurred during or after surgery. One patient experienced a vaginal fungal infection and an allergic reaction to sutures. Post-operation, ailments reduced by an average of 60.76 points, with five patients reporting no complaints. Conclusions: ADM emerges as a material of interest for gynecological surgery, with initial reports highlighting its effectiveness and optimistic safety profile. Further research is warranted to explore its potential as a promising option in pelvic organ prolapse treatment.