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Physical activity is associated with beneficial health effects for both mother and her future child, as well as the course of pregnancy. The aim of this review was the comparison of international guidelines with Polish recommendations. Data were collected from PubMed platform and international guidelines and narrowed to open access studies published between 1990-2023 in English, German and Polish. The existing literature shows an increase of interest in the impact of body activity during pregnancy and pelvic floor muscle training (PFMT). The recommendations move away from the more conservative approach, that previously suggested limitation of all exercise-related activities. Recently, The Polish Society of Gynecologists and Obstetricians and Polish Society of Sports Medicine announced a planned release of joint recommendations on physical activity during pregnancy and after childbirth, as well as the translation of the "Get Active Questionnaire for Pregnancy", a screening tool for pregnant women, doctors and midwives, developed in accordance with the recommendations of international gynecological societies.

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.

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.

Objectives: To evaluate the balloon occlusion of the internal iliac arteries during a caesarean section in the group of patients with placenta accreta spectrum., Material and Methods: We analysed 29 pregnant women with placenta accreta spectrum. The study group consisted of 15 patients, who underwent a caesarean delivery with temporary bilateral internal iliac artery occlusion. In the control group, we examined 14 women who had a standard caesarean delivery without any radiologic procedure. We compared pre- and post-operative haemoglobin level, necessity of blood transfusion, intraoperative blood loss, intensive care requirement, complications, duration of surgery, anaesthesia and hospital stay., Results: The history and obstetric outcomes were similar in both groups. The study group required fewer blood transfusions than the control group (p = 0.0176). We administered less packed red blood cells and fresh frozen plasma. Complications were more frequent in the control group (p = 0.0014). Complications related to occlusion of the internal iliac arteries did not occur. The intensive care unit transfer was more frequent in the control group (p = 0.0329). The duration of surgery and hospital stay did not differ between groups. The anaesthesia time was longer in a study group, which related to the radiologic procedure., Conclusions: Caesarean delivery for placenta accreta spectrum with bilateral balloon occlusion of the internal iliac arteries requires fewer transfusions. It contributes to a decrease in the complication rate and maternal morbidity.

Objectives: Incomplete healing of the uterine scar after cesarean section may result in formation of a niche. The aim of this study is to identify the potential risk factors for the improper uterine healing after cesarean section in women with single layer, full thickness uterine closure with the use of two- and three-dimensional transvaginal ultrasonography., Material and Methods: 204 women with a history of at least one low transverse cesarean section (CS) with a single layer uterine closure participated in the study. Residual myometrial thickness (RMT), adjacent myometrial thickness (AMT), width (W), depth (D) and volume of the niche, RMT/AMT, RMT/D, RMT/W ratio and clinical characteristics were analyzed., Results: A niche after cesarean section was found in 153 cases. However only five patients had a RMT < 2.2 mm, and 35 had an RMT/AMT ratio ≤ 0.5. The RMT and RMT/AMT ratio among women who had undergone more than one cesarean section was lower than among women who underwent the first cesarean section. No statistically significant relationship was found between the incidence of niche, its parameters and cervical dilation, uterine contractions, cesarean section in the second stage of labor, type of uterus incision expansion and flexion, operator's experience., Conclusion: Healing of the uterine cesarean section scar in women with single-layer continuous suture covering the entire thickness of the myometrium, excluding the decidua is not affected by the mode of caesarean section, type of uterine incision expansion and flexion, operator's experience, stage of labor at the time of caesarean section.

The consequence of each cesarean section is the uterine scar formation. In some patients, uterine scar after cesarean section heals incompletely and as a result, the uterine niche is formed. Most of the small niches are asymptomatic, but the large cesarean scar niches in nonpregnant women may cause a cesarean scar syndrome, which manifest itself as abnormal uterine bleeding, dysmenorrhea and secondary infertility. Among pregnant women, the presence of large niches may be associated with potentially life-threatening consequences, such as cesarean scar dehiscence and uterine rupture, placenta accreta spectrum disorders, placenta previa, cesarean scar pregnancy. Due to the possibility of dangerous consequences related to the occurrence of a uterine niche, in recent years many studies have focused on the term of cesarean scar niche, its risk factors, diagnostic methods and treatment options. Uterine niche can be examined using two- or three-dimensional transvaginal ultrasonography, as well as two- and three-dimensional sonohysterography, hysterosalpingography, hysteroscopy or magnetic resonance imaging. However, neither of the above diagnostic method is considered as the "gold standard". There are no unambiguous guidelines on some aspect concerning the diagnosis of cesarean scar niche. The aim of this study is to analyze and describe the diagnostic methods of cesarean section niche.

The publication presents recommendations on the performance of surgical procedures in gynecology during the COVID- 19 pandemic. The recommendations were prepared by the Polish Society of Gynecologists and Obstetricians, based on current knowledge of SARS CoV-2. These recommendations contain the latest guidelines of scientific societies related to the subject of operational procedures.

Placental mesenchymal dysplasia (PMD) is a rare benign vascular anomaly of the placenta. It can be misdiagnosed as a molar pregnancy resulting in unnecessary termination of pregnancy. A 30-year-old woman was referred to our hospital at 18 gestational weeks due to suspicion of molar pregnancy. The ultrasound showed a bulky placenta with multiple cysts. Oligohydramnion and fetal hypoechogenic cystic area without doppler flow were diagnosed at 23 weeks. The baby was operated on after delivery, and an 80 mm multifocal cyst originating from the right lobe of the liver was removed. The placenta demonstrated swelling stem villi with enlarged vessels and increased interstitial cells without trophoblast proliferation. PMD and fetal hepatic cyst can coexist; however, the relationship between those conditions remains to be elucidated. PMD is associated with adverse pregnancy outcomes but also with a good prognosis.

We present recommendations on performance and safety measures of ultrasound examinations in obstetrics and gynecology during the SARS COV-2 pandemic. The statement was prepared based on the current knowledge on the coronavirus by the Ultrasound Section of the Polish Society of Obstetrics and Gynecology. It has to be noted that the presented guidance is based on limited evidence and is primarily based on experiences published by authors from areas most affected by the virus thus far, such as China, Singapore, Hong Kong, and Italy. We realize that the pandemic situation is very dynamic. New data is published every day. Despite the imposed limitations related to the necessity of social distancing, it is crucial to remember that providing optimal care in safe conditions should remain the primary goal of healthcare providers. We plan to update the current guidelines as the situation develops.

Objectives: Cervical cancer is rated fourth in terms of incidence and cancer-related mortality in women. Cytology-based screening programs and colposcopy provided insufficient rates of detecting cervical intraepithelial neoplasia (CIN) prompting researchers to develop new tools. The aim of this study was to evaluate whether folate receptor-mediated staining is useful in detecting CIN2+ during gynecological examination with colposcopy., Material and Methods: In total 96 women with abnormal cytology findings were enrolled. The study was conducted on the Polish population. The diagnostic process consisted of colposcopy, receptor-mediated diagnosis (FRD), and histopathology examination. All women were subjected to the same diagnostic procedure., Results: The patient mean age of 96 women was 38 ± 14.5 years. On colposcopy, high-grade lesions were detected in 83 women. The FRD gave positive results in 63 women. Histopathology revealed 1 case of carcinoma plano epithelial akeratodes, 21 cases of high-grade squamous intraepithelial lesions, 13 cases of low-grade squamous intraepithelial lesions. A total of 61 cases presented no pathology. FRD as an adjunct to colposcopy gave the following test results in detecting CIN2+ lesions: sensitivity - 94.29%, specificity - 46.67%, PPV - 50.77%, NPV - 93.33%, and accuracy - 64.21%. Using both techniques provided better results than using each of the tests alone., Conclusions: FRD is a promising test for the diagnosing CIN2+ cervical pathologies because it can increase the probability of detecting CIN2+ without any additional burden posed on patients. Further studies should be conducted on large and various populations to complement current evidence.

The recommendations represent the current procedure, which may be modified and changed where justified, after a thorough analysis of the given clinical situation, which may be the basis for their modification and updating in the future.

Objectives: Screening with cytology decreases cervical cancer burden, but new methods have emerged. We assessed thediagnostic value of electrical impedance spectroscopy (EIS) in the real-world gynecological setting. The study aimed todetermine the diagnostic usefulness of EIS used as an adjunct to colposcopies in the diagnosis of high-grade squamousintraepithelial lesions in women with abnormal cytology findings., Material and Methods: A cross-sectional, single center, observational study considered 143 women. All were subjected toa colposcopy and EIS with ZedScan. ZedScan-guided or colposcopically-guided biopsies were carried out., Results: Data from 118 women were analyzed. The average age of the included women was 38.29 } 12.52 years (range:22-86 years). Overall, 27 had a diagnosis of CIN2+ and above on histopathological examination, 99 had low-grade colposcopyresults, 18 had high-grade colposcopy results, and 80 had positive ZedScan examination. No adverse events relatedto the examination with ZedScan were observed. EIS used as an adjunct to colposcopies showed sensitivity of 96.30%(95% CI: 81.03-99.91) and specificity of 39.56% (95% CI: 29.46-50.36), and accuracy of 52.54% (95% CI: 43.15-61.81). Theprocedure allowed to detect 11 additional cases with positive histo-pathological result in comparison to colposcopies alone., Conclusions: Colposcopies performed with ZedScan as an adjunct were effective in detecting high-grade cervical lesions.Advantages of ZedScan include real-time result display, no additional diagnostic burden posed on the patient, andgood safety profile. Studies on large patient cohorts are needed for further evaluations of this diagnostic procedure andfactors which may affect its diagnostic accuracy.