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Physical activity during pregnancy is established to derive clinically meaningful improvements in pregnancy, childbirth, and postpartum health outcomes. Evidence-based pre-screening tools have been developed to support the implementation of physical activity programmes, and enhance communication between health care providers, exercise professionals and pregnant women. The Get Active Questionnaire for Pregnancy (GAQ-P) and the Health Care Provider Consultation Form for Prenatal Physical Activity (HCPCF) empower pregnant women to identify whether they require additional counselling from their obstetric health care provider in terms of physical activity. However, these tools are not available in Polish. This work details the process taken to translate the GAQ-P and HCPCF into Polish. Material and Methods: We followed the translation process outlined by the Translation and Cultural Adaptation International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines between August 2022 and August 2023. We formed an expert group that included representatives of the Polish Society of Sports Medicine, The Polish Society of Gynaecologists and Obstetricians, practitioners, and scientists in physical activity during pregnancy. We implemented 9 of the 10 steps recommended by ISOPR in the translation process. At the Cognitive Debriefing stage, we collected opinions on the Polish version of GAQ-P and HCPCF from 70 stakeholders on the clarity and cultural appropriateness of the translation. Results and Conclusions: Target users have positively evaluated the Polish version of GAQ-P and HCPCF. Thanks to the ISPOR methodology, we obtained a trustworthy, evidence-based screening tools, which can reduce the barriers for most women to be physically active during pregnancy. [ABSTRACT FROM AUTHOR]

This article discusses the preventability of cervical cancer in Poland through HPV vaccination and screening. While Poland has implemented a screening program, coverage rates are low. The article suggests measures to improve prevention, including education, logistics, and wider access to screening. The quality of healthcare services and management of cervical neoplasia vary regionally. HPV vaccination is the most effective method, but coverage is currently insufficient. The article emphasizes the need for comprehensive actions, including coordination of care, training, national guidelines, and collaboration among stakeholders. [Extracted from the article]

Objectives: The aim of the present study is the assessment of thickness and percentage change in thickness of the musculus obliquus externus abdominis (OE), musculus obliquus internus abdominis (OI) and musculus transversus abdominis (TrA) among women suffering from stress urinary incontinence (SUI) in comparison with healthy controls. Material and methods: The thickness and its percentage changes of the OE, OI and TrA among women with and without SUI were assessed. We observed the reactions of the abdominal muscles among 84 women by means of ultrasound imaging. Results: The thickness of the OE was significantly greater in the SUI group during rest and tension of the lower part of the abdomen. Significant changes were found in the OI for the controls during isometric tension of the abdominal muscles, tension of the lower part of the abdomen, and ASLR (active straight leg raise) test of right leg. The thickness changes in the TrA were significant for the controls during isometric tension of the abdominal muscles. Conclusions: Our results suggest interactions of the pelvic floor and the abdominal muscles during pelvic floor activity, differing in the women with SUI and controls. [ABSTRACT FROM AUTHOR]

Objectives: Hyperglycemia in pregnancy (HIP) is one of the most common complications of pregnancy. Recently adopted new criteria for the diagnosis of HIP as well as the greater prevalence of risk factors could have a significant impact on HIP prevalence. The objective of the study was to assess the rates of HIP and the associated complications. Material and methods: This was a retrospective analysis of clinical records from pregnant women who delivered in eight tertiary hospitals in Poland in 2016. Results: The number of pregnant women with hyperglycemia totaled 1280 (7.25%), including gestational diabetes mellitus (GDM) in 1169 (6.62%) women and pregestational diabetes mellitus (PGDM) in 111 (0.63%). In addition to dietary modifications, 477 (41% of the GDM group) women received medical treatment (GDMG2). In women with PGDM multiple daily insulin injections (MDI) were used in 53 (47.7%) cases, continuous subcutaneous insulin infusions (CSII) in 57 (51.3%) cases and one woman was treated with metformin. The rate of cesarean sections was 69.4% and 62.9% for PGDM and GDM, respectively. Large-for-gestational-age (LGA) infants accounted for 38% and 21% of births in the PGDM and GDM groups, respectively. Of note are high rates of hyperbilirubinemia in infants born to mothers treated with insulin (13.5% for PGDM and 14.4% for GDMG2) vs infants born to mothers with diet (GDMG1) (3.4%). Conclusions: In Poland, the prevalence of HIP has nearly doubled in the past twenty years. Even with appropriate management, HIP is a significant risk factor for a cesarean section delivery, bearing an LGA infant and adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to assess general knowledge regarding human papillomavirus (HPV) and the attitude to primary prevention in form of HPV vaccination (HPVv) among Polish obstetricians and gynecologists (OBGYNs). In addition, we wanted to study the willingness of physicians to promote the HPVv among patients, based on their general attitude to vaccinations as well as HPV-related knowledge. The gynecologists were also asked to assess their patients' awareness of HPV infection. Material and methods: A questionnaire consisting of 25 questions was used to collect the data and with support of the Polish Society of Gynecologists and Obstetricians (PTGiP) and the Polish Society of Colposcopy and Cervical Pathology (PTKiPSM) sent via their mailing lists to all members and beyond. The total amount of 213 fully filled questionnaires were gathered and analyzed using descriptive statistics. Results: Most of the surveyed OBGYNs showed a good knowledge of HPV and HPVv. They were able to correctly identify the high-risk oncogenic HPV types (hrHPV) and admitted to using HPV genotyping in their daily practice and actively promoting HPVv, being in majority supporters of mandatory vaccinations in general. Almost 90% confirmed the importance of informing patients about sexually transmitted diseases (STDs). On the other hand, there was a group of OBGYNs with clearly insufficient knowledge about the HPV and its prevention. Conclusions: General knowledge of Polish physicians about HPV is good, independent of gender and age. The acceptance of all vaccines is high, but the low availability of the HPV vaccines seems to be the biggest problem stopping patients from getting them. [ABSTRACT FROM AUTHOR]

Objectives: In Poland, in accordance with applicable regulations, every woman should have access to epidural anesthesia. The advantage of this type of analgesia is primarily analgesic effectiveness. The aim of the study is to identify variables related to epidural anesthesia and to verify the relationship between them and the occurrence of perinatal complications in the mother and the child. Material and methods: This was a single-center retrospective cohort study. Electronic documentation of patients of the Hospital of St. Sofia in Warsaw was used to create an anonymous retrospective database of all births in the years 2015-2020. 27,340 cases were qualified for the analysis. Results: The logistic regression model showed that the risk of episiotomy (OR = 5.539; CI = 5.169-5.935) increases more than fivefold and perineal laceration (OR = 2.190; CI= 2.036-2.356) increases twice in the case of epidural anesthesia application. There is also an increased risk of operative delivery (OR = 2.668; CI = 2.255-3.156), at the same time the risk of performing a cesarean section decreases more than fivefold (OR = 0.043; CI = 0.036-0.052). Conclusions: Epidural anesthesia affects the delivery mechanism leading to an increase in the number and intensity of additional medical procedures -- episiotomy, perineal laceration, operative delivery. The rationale for the routine use of this method of anesthesia should be considered in the context of the implications for the woman's reproductive health and research on the effectiveness of other methods of birth anesthesia should be conducted. [ABSTRACT FROM AUTHOR]

Objectives: The impact of infection with novel coronavirus -- SARS-CoV-2 -- on women's and fetus' was unclear; therefore, it was the reason for many worries. We wanted to understand and describe the worries of pregnant women, assess mental well-being, and analyse the problems affecting prenatal care and hospital stay in this unprecedented time. Material and methods: We designed an original 23-question survey aimed at women who were pregnant during the pandemic or who gave birth at that time. The survey included demographic data, questions about prenatal care, mental status and worries, and hospitalisation. Results: Our study included 1321 women: 1010 (76.5%) during pregnancy and 311 (23.5%) after the delivery in the studied time. For 1168 (88,4%) respondents, the pandemic had a negative impact on their mood. The three main concerns were: the need for isolation from the child (n = 498, 37.7%), the childbirth without a partner/trusted companion (n = 417, 31.6%) and the risk of infection of the child in hospital (n = 381, 28.8%). Conclusions: The novel coronavirus pandemic affects the mental health of pregnant women. Pregnant patients should be considered a group of particular concerns. Patients consider remote obstetrical consultations as an insufficient approach. The reason for the highest worries of pregnant patients is a lack of companionship during labour. There was no difference between the rate of childbirth via caesarean sections over vaginal delivery during the "first wave" of the pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Cancer of the female genital organs is one of the most common causes of death of women in Poland. The aim of the study was to translate and analyze the psychometric properties of the Polish version of the Gynecological Cancers Awareness Scale (GCAS). Material and methods: Cross-sectional study and questionnaire technic were used to collect data. The study was conducted from June 10th to July10th 2021 among 443 adult women in Poland. Results: The Cronbach Alpha measure was used to assess the internal consistency of the scale. Cronbach's Alpha values greater than 0.7 indicates that the scale has high reliability. Conclusions: The analysis confirms that the Polish version of Gynecological Cancers Awareness Scale has a very high reliability to assess the women's cancers awareness and knowledge of cancers. [ABSTRACT FROM AUTHOR]

Objectives: Human papillomavirus (HPV) is a prevalent sexually transmitted infection with significant implications for public health. In Poland, a nationwide vaccination program offers a choice between the 9-valent (9v) and 2-valent (2v) HPV vaccines. We aimed to assess the cost-effectiveness of the 9v vs 2v vaccine from the public payer perspective in Poland., Material and Methods: A cost-effectiveness analysis was conducted to compare the public health and economic benefits of using 9v vs 2v vaccine in Poland over 100-year horizon using a previously published deterministic dynamic transmission model. A target population of girls and boys aged 12-13 years was considered. The model was populated with local epidemiological inputs, utilities, and costs, including vaccine and administration costs, as well as costs related to medical procedures for HPV-related diseases., Results: The 9v vaccine reduced the prevalence of HPV infections and HPV-related diseases substantially more than 2v vaccine when both are compared to no vaccination strategy. The total discounted cost savings of using the 9v vaccine instead of 2v, excluding the vaccine costs, amounted to EUR 66 million. The incremental cost-effectiveness ratio amounted to 8094 EUR per quality-adjusted life year, much below the official cost-effectiveness threshold in Poland set up at the three times the annual gross domestic product per capita. 9v cost-effectiveness ratio remained unchanged when shorter time-horizons of 20, 40, 60, or 80 years were considered., Conclusions: Using 9v HPV vaccine in Poland is highly cost-effective compared to the 2v vaccine.

Objectives: To analyze cervical cancer prevalence as well as treatment methods, and its effects and assessment of overall survival of patients after chemotherapy for cervical cancer in Poland. Material and methods: Data were collected from the registry of the National Health Fund (the only public payer in Poland). The data of patients treated in 2008-2015, who were shown to the payer with the diagnosis of malignant neoplasm of cervix (C53 according to the ICD-10 classification), were included in the analysis. The annual and eight-year prevalence rates were calculated. The overall survival was calculated for patients treated with chemotherapy. Results: In the analyzed period (2008-2015), 83,100 women were diagnosed with C53, of which 33,300 (40%) were reported in the group of hospital treatment. The median age of patients was 59 years (58.8 ± 12.87). The highest prevalence rate was observed in 2008 (16.94 patients/100,000 inhabitants). The highest annual and period (2008-2015) prevalence rates patients per 100,000 inhabitants were observed in the Podlaskie (17.03 and 115.53 respectively) and Pomorskie (14.19 and 101.43 respectively) voivodeships and the lowest in Dolnośląskie voivodeship (10.47 and 78.87 respectively) and Podkarpackie voivodeship (10.79 and 71.29 respectively). Mean survival time was 55.12 months and its median 45.46 months. Annual survival time was observed in 76.79% of patients, 2-year in 60.61%; 3-year in 53.08% and 5-year in 46.65%. Conclusions: In the years 2008-2015 in Poland, the incidence of cervical cancer was even 4 times higher than the EU average, and the mortality was as much as 70% higher than the average for EU countries. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the incidence and overall survival rate of patients with vulvar cancer in Poland, based on the report- ing data from the National Health Fund. Material and methods: The incidence of vulvar cancer in Poland in 2008--2016 (9-year follow-up period) by voivodship and the number of patients undergoing combined hospital treatment were analyzed. For the group of patients treated systemically, overall survival (OS) probability was calculated using the Kaplan-Meier estimation method. Results: In the period 2008-2016 in Poland, the diagnosis of malignant neoplasm of the vulva (C51% group) was made in 29,702 patients. The mean annual prevalence rate per 100,000 inhabitants was 8.3 ± 1.2 for Poland. The largest numbers of patients were reported in Mazowieckie and Slaskie voivodeships and the lowest in Opolskie and Podlaskie voivodeships. The median overall survival of patients treated with the combined method in 2008--2016 in Poland was 64.7 months (95% Cl: 58.0--70.0). One-year survival rate was observed in 77.6% of patients, 2-year in 64.4%, 3-year in 58%, over 5 years -- 54.22%. Conclusions: In the years 2008--2016 in Poland, based on the data reported to the National Health Fund, the incidence of vulvar cancer was 4 times higher than the statistics of the National Cancer Registry, the WHO or the USA, which indicates either substantive or reporting errors. In Poland, 54% of patients treated with the combined therapy survive over 5 years which is a much lower result compared to highly developed countries. [ABSTRACT FROM AUTHOR]

Objectives: A novel coronavirus -- SARS-CoV-2 -- outbreak has, for sure, been the greatest medical challenge in recent years. The maternal and neonatal consequences of the infection are still largely unknown. Material and methods: This prospective study aims to describe the perinatal care and outcomes of SARS-CoV-2 positive pregnant women and their newborn infants during the third wave of the pandemic, in a large tertiary university center in Wroclaw/Poland from 15 February to 1 May 2021. Results: The paper describes a group of 83 women with confirmed SARS-CoV-2 infection during delivery, as well as their newborn infants (n = 84). The course of COVID-19 disease in pregnant patients was mostly asymptomatic (54.2%) but 31% women manifested mild to moderate symptoms and 14% had severe infection. The median gestational age at the delivery was 39 weeks. On average, 16.7% of mothers were separated from their newborns at birth, 83.3% practiced skin-to-skin, and roomed in with their babies, and 84.5% of the infants received any mother's milk. Preterm infants were more often born by mothers with symptomatic course of COVID-19 infection. Need for neonatal treatment was only due to prematurity. Neonates with acquired infection (after 14th day of life) had to be treated symptomatically with fever and loose stools, only 28.5% had symptoms of respiratory failure. Conclusions: Despite the confirmed SARS-CoV-2 infection, the majority of mother-infant dyads were in a good health condition. The data on perinatal care reported in the paper could be helpful contribution supporting childbirth physiology protection during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Human papillomavirus infection is one of the most common sexually transmitted infections. Long-term exposure to the HPV leads to high-grade squamous intraepithelial lesions affecting cervical cancer. Knowledge about the distribution of HPV genotypes is crucial to guide the introduction of prophylactic vaccines. We aimed the genotype distribution in patients reporting due to abnormal Pap -- smear tests. Material and methods: We provide a prospective observational cohort study. We obtained material from 428 women registered to Provincial Hospital in Poznan and Specialist Medical Practice in 2018-2021. In the current study, we analyze results from the first 110 inclusions with the diagnosis of HSIL from a cervical biopsy. The probe for the molecular test was collected with a combi brush and passed to an independent, standardized laboratory. HPV detection was done using PCR followed by DNA enzyme immunoassay and genotyping with a reverse hybridization line probe assay. Sequence analysis was performed to characterize HPV-positive samples with unknown HPV genotypes. The molecular test detected DNA of 41 HPV genotypes. We performed statistical analyzes using the STATISTICA package 13.3. Results: We found that 98.2% of patients received HPV-positive test results. The most frequent HPV genotype was 16, which assumed for 54.1%. In patients negative for HPV 16, the percentage decreased with increasing age. We detected that the following HPV types are next most common: HPV 31 (16.2 %), HPV 52 (11.7%), HPV 51 (9.9%), HPV 18 (9.0%), HPV 33 (9%). Moreover, thyroid diseases were the most common comorbidities and occurred in 15 patients. Conclusions: To our knowledge, this study is the most extensive assessment of HPV genotypes in HSIL diagnoses in Poland. [ABSTRACT FROM AUTHOR]

Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcomes (APO): preconception obesity and gestational weight gain. This study aimed to assess compliance with the 2009 IOM guidelines, compare GWG with and without correcting for gestation duration, and observe the relationship between pre-pregnancy BMI and GWG and neonatal birth weight. Material and methods: This is a cross-sectional study conducted from 2015-2018 at the St. Sophia's Specialist Hospital in Warsaw, Poland. Self-reported pre-pregnancy and predelivery weight were collected. Results: The presented data set amounts to 7820 records. Analysis of weight gain compliance with IOM recommendations showed that only 41-44% (depending on the calculation method) of women had weight gain in accordance with IOM guidelines (22-23% -- below; 33-37% -- above). Overweight and obese women with diabetes are more likely to comply with IOM than women without diabetes. In contrast, women with normal-weight and underweight with diabetes are less likely to achieve IOM weight gain in pregnancy than women without diabetes. Women who have GWG below recommendations significantly more often gave birth to SGA neonates, and women who exceeded GWG standards significantly more often gave birth to LGA neonates. Conclusions: Less than half of women had GWG within the recommended norms. Statistically significant differences were found in methods of calculation of GWG, but it was not found clinically significant. Correction for pregnancy duration when calculating GWG reclassifies two percent of patients. We underestimate the risk of crossing the line between overweight and obesity during pregnancy. [ABSTRACT FROM AUTHOR]

The Polish Society of Colposcopy and Cervical Pathophysiology (PTKiPSM) together with the Polish Society of Gynecologists and Obstetricians (PTGiP) issued a final summary of interim guidelines for secondary cervical cancer prevention during the SARS-CoV-2 pandemic based on the analysis of the latest directional publications and the authors' own experiences. The aim of the summary is to facilitate the implementation of the most effective possible screening of cervical precancerous lesions and cervical cancer due to temporary significant limitation of screening as a consequence of the ongoing epidemiological threat. These final guidelines are taking into account the 2020 call of the World Health Organization (WHO) for global epidemiological elimination of cervical cancer. The guidelines supplement the interim guidelines of PTKiPSM and PTGiP announced in March 2020 on the possible deferral of diagnostic and therapeutic procedures in patients with abnormal screening tests results in secondary prevention of cervical cancer in current pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Vaccination is the most effective method of controlling influenza in the human population, where pregnant women belong to a risk group that is especially vulnerable to influenza-related morbidity and mortality. The objectives of the survey were to report estimates of maternal vaccination coverage and assess reasons for the lack of influenza vaccination among Polish women of childbearing age. Material and methods: The survey analysis included 564 pregnant women who had been surveyed in a self-reported questionnaire during the 2017-2018 influenza season in Warsaw, Poland. Results: Over 95% of Polish women of childbearing age did not vaccinate against influenza due to the low perception of risk and a lack of providing evidence-based information on vaccine by physicians and midwives. General practitioners were most often indicated as healthcare workers who educated women about influenza risk factors and recommended influenza vaccine to them. Conclusions: The results of the survey suggest that women of childbearing age did not vaccinate against influenza due to the low perception of risk and a lack of providing evidence-based information by healthcare workers (including obstetrician-gynaecologists and midwives), while their recommendations appear to be a powerful method of overcoming barriers to influenza vaccination among patients. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this publication is to present data on the results and complications associated with infertility treatment using assisted reproductive technology (ART) and intrauterine insemination (IUI) in Poland between 2013 and 2016. Material and methods: The report was prepared by the Polish Society of Reproductive Medicine and Embryology (PTMRiE) and the Fertility and Sterility Special Interest Group of the Polish Society of Gynaecologists and Obstetrics (SPiN PTGiP) as a part of the European IVF Monitoring program (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). Reporting was voluntary and the data was not subject to external control. The report presents the availability and structure of infertility treatment services, the number of procedures, their effectiveness and complications. Results: Between 2013 and 2016, a total of 106,718 treatment cycles using ART [64,413 classical in vitro fertilization and in vitro fertilization with intracytoplasmic sperm injection (IVF + ICSI), 36,041 frozen embryo replacements (FER)] and 51,405 IUI were recorded. The clinical pregnancy rates per embryo transfer in IVF, ICSI and FER were 38.3%, 38.1% and 32.4%, respectively. The effectiveness of IUI with husband/partner's semen (IUI-H) was 11.1% and with donor semen (IUI-D) 16.7%. Multiple delivery rates were 11.3% and 6.2% in IVF + ICSI and IUI, respectively. The most common complication was the ovarian hyperstimulation syndrome (OHSS) (0.34%). Conclusions: PTMRiE and SPiN PTGiP report is the only national study documenting Polish reproductive medicine. The results of infertility treatment effectiveness in Poland are comparable with the European data, complications are less frequent than in other countries. The low percentage of multiple pregnancies, and so perinatal complications, is especially valuable. However, due to the lack of a central database and register, the possibility of external control and monitoring of pregnancies and births is limited. Thus, a fully reliable assessment of the treatment quality in our country is not possible. [ABSTRACT FROM AUTHOR]

Objectives: To create outcome dependent fetal growth curves and birth weight standards that can be analyzed for use in clinic specifically for Western European populations. Material and methods: We conducted a retrospective study on fetal growth and birth weight trends from live birth singleton pregnancies between 2005 and 2018 at one of the largest tertiary gynecologic-obstetric hospitals in Poland. The inclusion criteria were at least 22 weeks of gestation at birth regardless of delivery mode (vaginal or C-section), no congenital anomalies diagnosed before and after delivery and an Apgar score of at least 7 in the first minute. The final sample had a total of 39,413 cases (18,562 girls and 20,851 boys). We presented 7 (for all fetuses in the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles) and 6 (for boys and girls each at 10th, 50th and 90th percentiles) fetal growth curves between 25 and 40 weeks of gestation. Birth weight trends were obtained and analyzed from all babies in the 5th, 10th, 25th, 50th, 75th and 95th percentiles born between 22 to 42 weeks of gestation with also separate trends for boys and girls. Results: The largest differences in fetal growth curves were observed in the 10th and 50th percentiles between 22 and 34 weeks of gestation. A decreasing fetal weight gain pattern was observed between 27 and 30 weeks and after 38 weeks of gestation, the decrease was more drastic in female. A significant increase from 2009 to 2017 was observed in the weight of 50th percentile babies born at or after 35 weeks. We found significant discrepancies between our results and the most used European fetal growth curves particularly in the 10th and 90th percentile weights at 30 weeks. Conclusions: Separate scales for boys and girls were implied and given the overall difference form commonly used references. We believe there is significant value in using these unique patterns found in fetal growth curves and birth weights of ethnically homogenous population (such as Poland) at everyday clinical practice for more opportunities of safe obstetric care and higher chances of delivering a healthy child. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to understand knowledge, attitudes and practices of non-nutritional breast milk use among lactating women in respect of skin diseases and other frequent ailments. Material and methods: The study, in the form of a questionnaire, spread on social media, was targeted at breastfeeding women. The questionnaire consisted of questions regarding the knowledge of non-nutritional usage of human milk, its use in practice, subjective opinion on the observed results and inclination towards future use. Chi-square tests and c-Pearson coefficients were used for statistical calculations. Results: A total of 1187 responses were acted upon. In the study group, 879 women claimed to have knowledge of non-nutritional use of human milk in respect of skin and most common ailments, whilst 688 of them claimed to use at least one usage. The most frequently, breast milk was used for: care of cracked nipples, care of healthy skin, treatment of diaper dermatitis and treatment of neonatal acne. A correlation between duration of breastfeeding (p < 0.05) and gestational age (p < 0.05) and practical use of non-nutritional human milk was found. Conclusions: The study showed a great enthusiasm of mothers in respect of using breast milk for non-nutritional purposes, including the treatment of skin diseases and other common ailments. However, given the scant studies determining possible concerns surrounding these methods, there is a requirement for parental education with emphasis on the need for prompt medical examination and pertinent treatment. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess the impact of the change of 1-hour postprandial glycemic target from < 6.7 mmol/L (120 mg/dL) to < 7.8 mmol/L (140 mg/dL) on gestational diabetes mellitus (GDM) treatment and pregnancy outcomes., Material and Methods: In a retrospective analysis of 1021 GDM patients from the Department of Metabolic Diseases, University Hospital in Cracow, Poland, we compared insulin therapy regimens and pregnancy outcomes between women admitted in 2014-2016 (before the change) and in 2018-2019 (after it)., Results: A total of 377 patients were admitted between 2014 and 2016 (TIGHT group) and 644 between 2018 and 2019 (LESS TIGHT group). Women from the LESS TIGHT group were older (32 vs 30 years, p < 0.001) and gained less weight during pregnancy (7.0 vs 9.0 kg, p < 0.001). There was no change in the frequency of any insulin therapy (51.6% vs 56.1%, p = 0.168). In the LESS TIGHT group, the basal insulin-only model was used more frequently (32.5% vs 10.2%, p < 0.001), while the prandial insulin and basal-bolus model less frequently (23.6% vs 42.6% and 21.4% vs 36.7%, p < 0.001, respectively) than in the TIGHT group. There were no differences in the frequency of cesarean sections, preterm births, Hbd of delivery, mean birth weight or prevalence of perinatal complications., Conclusions: Less tight glycemic targets in women with GDM, compared to tighter targets, were associated with less frequent use of prandial insulin, with insulin therapy often limited to basal administration. The change in glycemic targets did not affect the prevalence of adverse pregnancy outcomes, providing evidence supporting new recommendations.

Objectives: The aim of the study was to find out what proportion of women with MRKHS have decided to become mothers and have children or would like to have children and consider various options for motherhood. Additionally, the survey aimed at identifying factors that might influence the women's decisions and opinions regarding adoption, gestational surrogacy (GS) and uterus transplantation (UTx)., Material and Methods: The study group consisted of 100 adult women with MRKHS who filled out questionnaires consisting of 56 questions. The survey was self-administered and anonymous., Results: Most of the study participants were under 30, lived in large cities ( > 150 000 inhabitants) and declared to be heterosexuals in a steady relationship (p < 0.05). While 11 participants had children, 66 out of 89 childless women (74%) expressed a desire for motherhood, but as many as 80 surveyed women have felt pressured to have children. The number of participants for whom a biological relationship with offspring was significant and insignificant respectively equaled (p = 1.000). The majority of the study participants supported the process of legalizing GS in Poland (95 vs 4) yet would opt for commercial rather than altruistic GS (64 vs 31) (p < 0.05). Most respondents stated that UTx is consistent with their faith and conscience (91 vs 4) and found UTx ethical (88 vs 4) (p < 0.0001)., Conclusions: The majority of Polish women with MRKHS express the need to become a mother, but only one in ten has a child. The women's interest in biological motherhood is significant.

Objectives: We aimed to assess self-reported participation in cervical cancer screening among Polish women between 2004 and 2019 and to identify the groups with the lowest participation rate., Material and Methods: Data on declared participation in cervical cancer screening were obtained from the European Health Interview Survey from 2004 to 2019., Results: In 2019, 86.7% of Polish women aged ≥ 15 years declared that they had ever undergone a Pap test. Compared to 2004, the coverage of ever-screened women improved by 16.6 percentage points. The proxy population coverage was 72.9%. The highest proportion of women who underwent a Pap smear in the last three years was observed among those aged 35-44 years and 25-34 years (84.0% and 83.2%, respectively), and the lowest among women aged ≥ 75 years (20.5%). The proportion screened within the last three years also varied by education (up to lower secondary education 26.4%, up to post-secondary non-tertiary education 62.8%, and the highest level of education 83.7%), urbanization (large cities 66.7%, suburbs, and smaller cities 62.8%, and rural areas 59.0%), income (poorest households 42.5%, wealthiest households 70.6%), and declared health status (best 68.9%, worst 41.4%). The lowest participation in screening was observed in the southeastern regions and the highest in the northwestern regions of Poland., Conclusions: In Poland, in 2019, the approximate coverage of cervical cancer screening was high compared to other European countries and has improved over the last 15 years. A complete screening registry is required to confirm questionnaire-based self-reported data. Targeted interventions should be implemented to address low participation in the identified regions and socioeconomic groups.

Objectives: External cephalic version (ECV) is an alternative to caesarean section for abnormal fetal position. ECV is recommended by the most important scientific committees in the world. ECV complications are rare and occur in 6.1% of cases, however severe complications requiring urgent caesarean section are found in less than 0.4%. Our aim was to demonstrate the effectiveness and safety of ECV and to present our own experience with the procedure of ECV., Material and Methods: ECV was performed on 62 patients (32 nulliparas and 30 multiparas). Qualification criteria included: singleton gestation, gestational age > 36 + 6, longitudinal pelvic lie, no uterine contractions, intact membranes. Indications for immediate cesarean section within 24 hours of ECV were considered a procedural complication. In patients with complications, the condition of the newborn was checked according to the APGAR score and the day of discharge of the mother and child from the maternity ward was analyzed., Results: ECV finished successfully in 66.1% (nulliparas 56.2% and multiparas 76.7%). Patients with a successful ECV were significantly older and had higher median gestational age. ECV was more often successful when placenta was located on the posteriori wall. In our patients, there were 4 cases of complications requiring delivery at the time of ECV. No serious consequences associated with increased maternal or neonatal morbidity or mortality were reported., Conclusions: ECV seems to be a safe alternative for women wishing to deliver vaginally, as this procedure does not increase the risk of adverse obstetric outcomes.

Objectives: Pregnancy is a period which is especially sensitive to physical violence and its aftermath. Subjecting a pregnant woman to violence can have negative effects on both the mother as well as the child. In Poland, there are programs, such as the Blue Card, aimed at protection against violence, however the phenomenon is underestimated., Material and Methods: Documentation covering forensic examinations carried out at the request of the police or privately at the Department of Forensic Medicine in Poznan in the years 2015-2020 was analyzed. Out of 7,689 cases, 22 were concluded to meet the criteria of violence against pregnant women. The cases were then further analyzed, consideration of the victim's age, professional status, relations with the perpetrator, form of physical violence, and medical assistance., Results: The average age of the women at the time of the incident was 31.1 years. In 90.1% of the cases, the perpetrator was a known man, usually a current or former partner. The most common injuries were abrasions and bruises, while the most common locations of injuries were the head, neck, and arms. The most common forms of violence were grappling, kicking, and hitting with an open hand. Over 72% of the women sought medical attention after the incident., Conclusions: There is a need for educational programs concerning the effects of violence during pregnancy and ways to help. Gynecologists and midwives play an especially important role, by having direct contact with the patient, thus being able to quickly identify victims of violence and take actions to secure safe environment for the woman and the child.

Objectives: Group B streptococcus (GBS) colonization among pregnant women is the leading cause of neonatal infection. Intrapartum antibiotic prophylaxis (IAP) is the most effective method to reduce the incidents of neonatal sepsis. We describe compliance with GBS management and the implementation of IAP in the context of the long-term effect of antibiotics., Material and Methods: The study was conducted among 249 childbearing women hospitalized between January 2022 and February 2022 at University Clinical Center in Gdansk, Poland. The data were obtained from the questionnaire and medical records. We analyzed maternal colonization with GBS, compliance with GBS screening and treatment guidelines, risk factors contributing to GBS colonization, IAP administration, and neonatal congenital infection occurrence., Results: Of all patients, 240 (96.4%) were screened for GBS, 215 (89.6%) between 35-37 weeks of gestation. Fifty (20%) were GBS-positive, 184 (74%) negative, 15 (6%) had unknown GBS status. There were no significant differences between the GBS-positive and GBS-negative groups in maternal age, mode of delivery, gestational age at birth, maternal comorbidities, parity, GBS status in previous pregnancies, and the development of infection among infants of both groups, regardless of IAP administration. Of all the studied women, 158 (63.5%) received antibiotics, 91 (36.5%) did not. The study showed the low positive and the high negative predictive value of the antenatal GBS screening test., Conclusions: We found that compliance with the universal GBS screening is widespread. The management of women with absent or only partial screening test requires assessing the risk factors before administering IAP.

Objectives: Prehabilitation is a concept of holistic approach to the patient and includes preoperative efforts focused on optimalization of patient's general condition. The idea of prehabilitation started at the beginning of the 21st century. However, prehabilitation programs in gynecological cancer patients are not standardized and are heterogeneous. The aim of the study it to present the concept of prehabilitation and propose prehabilitation protocol to be introduced in Polish oncological centers., Material and Methods: A search in PubMed, Medline, EMBASE (Ovid) and PsycINFO databases was conducted using the following keywords: prehabilitation, gynecological, abdominal surgery, and cancer. The primary outcomes were complications, hospitalization stay, intensive care unit transfer rate, blood loss, wound healing, and reoperation rate. The search was performed in July 2022 and covered the period from 1st January 2000 till 30th June 2022., Results: A total number of 1,118 articles have been identified. Out of all eligible papers only 42 fulfilled the research criteria and were included in the study. The analysis showed that there is no standardized prehabilitation protocol for gynecological cancer surgery, although most include three-modal approach - physical activity, nutrition, and psychological intervention. There is no standard model for physical capacity evaluation, however, 1,118 6 Minute Walk Test (6MWT) is the most common. Frailty evaluation is based on different measurements that prevent from direct comparison of obtained results between studies., Conclusions: We are not ready to implement the prehabilitation program in polish oncological centers. The main reason elvicz is: lack of accredited ovarian cancer centers, lack of well-established standardized prehabilitation programs for gynecological malignancies (ovarian cancer especially), and lack of proper information for patients about advantages of adequate preparation elvic expected surgery. Furter studies on different prehabilitation programs and information campaigns both for patients and gynecologist are required to make implementing prehabilitation possible in Poland.

Objectives: Numerous physical and chemical processes lead to rupture of membranes. Within the fetal membranes there are numerous types of metalloproteinases, which cause collagen type I degradation. The C-terminal telopeptide of colagen type I (ICTP) is the breakdown product of type I collagen. The aim of the study was to determine whether ICTP is secreted into the vaginal-cervical fluid (VCF) in the case of physiological rupture of the membranes of the fetus before delivery., Material and Methods: The study was conducted in March 2021 at the Department of Obstetrics and Perinatology of the Jagiellonian University in Cracow, Poland. Twenty-three cases were included in the study. During routine gynecological examination with the use of specula, VCF was collected twice in a volume of 50 µL. The obtained material was then subjected to enzyme immunoassay using the Human C-telopeptide of type I collagen (ICTP) ELISA Kit (Catalog Number. CSB-E10363h). The concentration of ICTP in the sample was calibrated. The concentration range that the device can detect was 25 ng /mL-800 ng/mL., Results: The presence of ICTP in the VCF was confirmed. The minimum concentration was 43.72 ng/mL, the maximum was 762.59, in five cases the concentration was outside the maximum scale of the device., Conclusions: ICTP was confirmed in the VCF of pregnant women before physiological delivery. Further studies are required to accurately evaluate ICTP as a marker of the processes of collagen degradation in fetal membranes in the mechanism of physiological labor and premature rupture of the membranes.

Objectives: Endometriosis is a disease that involves the ectopic growth of the endometrial tissue outside the uterine cavity. Its average occurrence is about 10% of women of reproductive age. Making a diagnosis of the disease is commonly long-lasting and ambiguous due to the wide variety and intensity of symptoms. The aim of the study is to determine factors affecting the quality of life of women struggling with endometriosis., Material and Methods: A cross-sectional study was conducted using a diagnostic survey method with the use of the author's questionnaire and the WHOQOL-BREF questionnaire. The study population included 650 people (group with endometriosis - 361 women and group without endometriosis - 289 women)., Results: In the group of women with endometriosis, the mean age was significantly higher (31.87 vs 24.99). Difficulties with conception were significantly more common (51.67%) in the endometriosis group compared to 5.52% in the non-endometriosis group. In each area, the quality of life of women with endometriosis was significantly lower (p = 0.000). Women with the history of the disease of over 3 years significantly more often complained of dyspareunia (p = 0.048), bladder pain (p = 0.01) and lower back pain (p = 0.029)., Conclusions: Endometriosis significantly reduces women's quality of life. Factors that deteriorate the quality of life of women with endometriosis include severe pain, infertility, dyspareunia and reduced satisfaction in various spheres of life (somatic, mental, social). More research is necessary to improve the quality of life of women with endometriosis.