To reduce the risk of infection of SARS-CoV-2 during commuting to the clinic or due to contact with medical staff, the American College of Obstetricians and Gynecologists has recommended arranging some appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the SARS-CoV-2 pandemic and the role of telehealth in the implementation of prenatal care standards. This is a cross-sectional study. The study group included 618 women who were pregnant and/or gave birth in Poland during the COVID-19 pandemic. The majority of the participants experienced difficulties accessing medical care because of the pandemic. The correlation between this experience and the use of the hybrid healthcare model was established. The affiliation to public or private healthcare was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommendations for a hybrid pregnancy management model should be created with detailed information regarding which appointments patients must be present for in-person and which can be conducted remotely. To reduce the risks associated with movement and interpersonal contact, all visits during which tests and screenings take place should be conducted in-person; other appointments can be arranged in the form of telehealth.

To reduce the risk of infection of SARS-CoV-2 during the commute to the clinic or due to the contact with medical staff, The American College of Obstetricians and Gynecologists recommended ar-ranging part of the appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the Sars-Cov-2 pandemic and the role of telehealth in implementation of prenatal care standards. This is a cross-sectional study. The study group in-cluded 618 women that were pregnant and or gave birth during the COVID-19 pandemic in Poland. The majority of participants experienced difficulties in access to medical care because of the pandemic. Correlation between this experience and the use of hybrid healthcare model was es-tablished. However, affiliation to public or private healthcare group was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommen-dations for a hybrid pregnancy management model should be created with detailed information for which appointments patients must be present and which can be done remotely. To reduce movement risk and interpersonal contact, all visits during which tests and screenings take place should be done in-person. Other appointments can be arranged in the form of telehealth

Background: Growth charts are the primary tools for evaluating neonatal birth weight and length. They help and qualify the neonates as Appropriate for Gestational Age (AGA), Small for Gestational Age (SGA), or Large for Gestational Age (LGA). The most commonly used neonatal charts include Intergrowth-21st, WHO, and Fenton. The aim of the study was to compare the tools used for assessing neonatal birth weight and the incidence of SGA and LGA using the different charts. Methods: Data on 8608 births in the Clinical Department of Obstetrics and Gynecology were compared. We divided the patient population into five gestational age groups. The 10th and 90th percentiles were calculated. The percentage of cases meeting the SGA and LGA criteria was determined. Results: Statistically significant differences between growth charts were identified for each of the groups. The 10th percentile for the study population corresponded to 2970 g for females and 3060 g for males born in the 40th week of gestation. The 90th percentile values were 4030 g and 4120 g. Our analysis showed a statistically significant difference in detection of LGA or SGA between three growth charts and our data both in male (χ 2 (3) = 157.192, p < 0.001, Kramer's V = 0.444) and female newborns (χ 2 (3) = 162.660, p < 0.001, Kramer's V = 0.464). Discussion: Our results confirm that differences exist between growth charts. There is a need for harmonizing growth assessment standards. It is recommended that a growth chart should be developed for the Polish population, which would improve the diagnosis of SGA and LGA.

Objectives: Significance of the crown-rump length (CRL) measurement criteria in the assessments of gestational age and actual precision in daily clinical practice. Material and methods:We recruited 806 pregnant women with singleton pregnancy and history of regular menstrual periods.We analysed retrospectively CRL measurements obtained during routine first trimester scan performed between 11 + 0 and 13 + 6 weeks gestation. Gestational age was calculated using both the last menstrual period (LMP) and the CRL. The images of the CRL measurements were assessed by the expert. The visual analysis of the images in terms of meeting the five criteria recommended by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) was performed. Statistical analysis were used to assess how the above-mentioned criteria influenced calculation of the gestational age. results:The study showed 323 out of 806 of the CRL measurements (40.1%) were qualified by a specialist as accurate, 279 (34.6%) as inaccurate, and 204 (25.3%) as inaccurate, but not changing the duration of a pregnancy. With the application in the assessment of the five criteria of the ISOUG 217 (26.9%), the following results of qualification were obtained: accurate -fulfilled ≥ 4, inaccurate 341 (42.3%) -fulfilled ≤ 2, whereas inaccurate, but not changing the duration of a pregnancy 248 (30.8%) -3 criteria fulfilled. We found that only the neutralof the fetus demonstrated a significant corellation with the assessment of the duration of a gestation. conclusions: a) the accurate audit of the CRL measurements is recommended; b) neutral position of the fetus is the most important criterion out of 5.

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