Strain elastography of the uterine cervix may be useful in the diagnosis and prediction of obstetric complications. The inability to obtain quantitative results, with only the possibility of visual semiquantitative evaluation of the obtained elastograms, has been the limitation of the method thus far. E-Cervix is a software program that uses intrinsic compression to excite tissue and allows the evaluation of quantitative parameters on the basis of pixel distribution in an elastogram. The aim of this study was to assess the repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix) of the uterine cervix and to assess the correlation of the obtained parameters with selected clinical features of patients in the third trimester of pregnancy. In total, 222 patients participated in the study. We assessed 5 ultrasound parameters: elasticity index (ECI), hardness ratio (HR), internal os strain (IOS), external os strain (EOS) and IOS/EOS ratio. Each study was performed according to a predetermined standardized protocol. For all assessed elastographic parameters, we obtained good intra- and interobserver reproducibility. The interclass correlation coefficient (ICC) ranged from 0.77 to 0.838 for intraobserver variability and from 0.771 to 0.826 for interobserver variability. We demonstrated a significant correlation of some obtained elastographic parameters with the basic clinical features of patients, such as age, the number of previous caesarean sections, pregnancy weight and BMI. In each case, the correlation was very low. Quantitative elastographic assessment with the use of E-Cervix is characterized by good repeatability. Some clinical features may affect the value of the parameters obtained. The clinical relevance of this interference requires further investigation.

Induction of labour (IOL) is increasingly used in obstetric practice. For patients with unfavourable cervix, we are constantly looking for an optimal, in terms of effectiveness and safety, ripening of cervix protocol. It was retrospective cohort study. We analyzed obstetrical results in 481 patients undergoing IOL in one center using two different vaginal inserts that release prostaglandins at a constant rate for 24 h—misoprostol vaginal insert (MVI) with 200 µg of misoprostol (n = 367) and dinoprostone vaginal insert (DVI) with 10 mg of dinoprostone (n = 114). Full-term, single pregnancy patients with intact fetal membranes and the cervix evaluated in Bishop score ≤ 6 were included in the analysis. In the group of MVI patients, the labour ended with caesarean section more often (OR 2.71 95% CI 1.63–4.47) and more frequent unreassuring cardiotocographic trace indicating the surgical delivery occurred (OR 2.38 95% CI 1.10–5.17). We did not notice any differences in the percentage of vacuum extraction and patients in whom the use of oxytocin was necessary during labour induction. The clinical status of newborns after birth and the pH of cord blood did not differ between groups.The use of MVI 200 μg in patients with an unriped cervix is associated with a greater chance of completing delivery by caesarean section and increased chance of abnormal intrapartum CTG trace compared to the use of DVI 10 mg. These differences do not affect the clinical and biochemical status of the newborn.

Objective: The twisting of the umbilical cord around the fetal neck is a common phenomenon in the delivery room, and despite the lack of univocal evidence of its negative impact on perinatal events, it causes anxiety and stress in patients. The aim of the study was to assess the prevalence of nuchal cord and its impact on adverse obstetric and neonatal outcomes. Methods: We conducted a retrospective cohort study. All patients who gave birth in the clinic within one year (n = 1467) were included in the study group. We compared the prevalence of nuchal cord in distinct subgroups of patients. In the next stage, we estimated the chance of specific perinatal outcomes and compared the neonatal outcomes between groups with and without nuchal cord. Results: Nuchal cord was present in 24% of labors. It was twice as common among patients giving birth vaginally (32.14%) than among patients giving birth by a caesarean section (16.78%, p < 0.001). Nuchal cord was also more frequent in births with meconium-stained amniotic fluid (33.88% vs. 23.34%, p = 0.009). In the group of patients with nuchal cord, we observed a slight increase in the risk of a non-reassuring fetal heart rate trace (OR = 1.55, CI 95% 1.02–2.36) as an indication of the completion of labor by caesarean delivery. We did not note an increase in the risk of completing natural childbirth by vacuum extraction. In the group of nuchal cord patients, there was a higher chance of a serious or moderate neonatal condition in the first minute of life (Apgar 0–7 points) (OR = 2.00, 95% CI = 1.14–3.49). Conclusions: Nuchal cord increases the risk of a caesarean delivery due to a non-reassuring fetal heart rate trace. Nuchal cord increases the chance of a reduced Apgar score (0–7 points) in the first minute of life. The observed relationships do not translate to neonatal arterial blood gas testing.

Introduction: Caesarean section (CS) is one of the most common abdominal surgeries performed in the world. The 10-Group Classification System (TGCS, Robson classification) is a World Health Organization recommended classification assessing indications based on 5 variables (parity, previous caesarean section, labour onset, foetal presentation, gestational age, and number of fetuses). The TGCS provides the opportunity to compare indications between different countries, audit, and evaluate of the quality and impact of the recommendations. Aim of the research: Classification of CS data derived from 2 centres according to the TGCS. Material and methods: We used the above-mentioned tool to classify 2000 Caesarean sections from two centres -II and III degree of reference. Results: In both groups, group 5 (RG5 -Robson group 5) constituted the largest part of all Caesarean sections, at 39.9% and 35.17%, respectively. The sum of groups from 1 to 4 (RG 1-4) had a relative contribution to the total number of Caesarean sections in individual centres of 46.94% and 53.48%, respectively. The percentage of occurrence of particular classes was similar in both centres. Conclusions:The results of our study are an attempt to determine the trend in indications for Caesarean sections according to the TGCS in Poland and to popularize the tool used according to WHO recommendations. All activities aimed at effective reduction of the number of Caesarean sections in Poland should be aimed primarily at reducing the percentage of Caesarean sections in the RG5 group. StreszczenieWprowadzenie: Cięcie cesarskie (CC) to jedna z najczęściej wykonywanych operacji brzusznych na świecie. System Robsona oparty na 10 grupach (TGCS -The 10-Group) jest klasyfikacją CC zalecaną przez Światową Organizację Zdrowia. Pacjentki klasyfikowane są na podstawie 5 zmiennych (rodność, obecność blizny po CC na macicy, rozpoczęcie porodu, położenie i liczba płodów oraz wiek ciążowy). TGCS umożliwia porównanie wskazań między różnymi krajami, audyt ośrodków oraz ocenę wpływu zaleceń. Cel pracy: Klasyfikacja CC według TGCS. Materiał i metody: Przy użyciu TGCS sklasyfikowaliśmy 2000 CC z dwóch ośrodków -II i III stopnia referencyjności. Wyniki: W obu grupach grupa 5 (RG5 -Robson group 5) stanowiła największy odsetek wszystkich CC, odpowiednio 39,9% i 35,17%. Suma grup od 1 do 4 (RG 1-4) miała względny udział w ogólnej liczbie CC w poszczególnych ośrodkach, odpowiednio 46,94% i 53,48%. Odsetek występowania poszczególnych klas był podobny w obu ośrodkach. Wnioski: Wyniki naszego badania są próbą określenia trendu wskazań do CC według TGCS w Polsce oraz popularyzacji tego narzędzia. Wszystkie działania mające na celu efektywne zmniejszanie liczby CC w Polsce powinny być ukierunkowane na zmniejszanie liczby pacjentek klasyfikowanych do grupy 5.

During the COVID-19 pandemic, the academic community had to drop out of the full-time on-site education and switch to distance learning. After two years of this state of affairs and the current return to the traditional form, we would like to explore the opinions of academic teachers on this form of teaching.  The study was a questionnaire-based survey, including 86 teaching staff members of the Jan Kochanowski University of Kielce, working at four faculties. The teachers assessed the level of distance learning as average, no different from the traditional approach.  However, they pointed out that the involvement, activity of students, regularity of work, quality of the assignments completed, and the adequacy of the grades received is greater in the traditional approach. In the case of remote learning, in the group's assessment, the timeliness of performing the assignments had not deteriorated. The most frequently indicated advantage of remote learning was time saving, while the most common disadvantage was reduced contact with students. In the teachers' opinion, the traditional mode of learning still has an advantage over distance learning. Studies assessing effectiveness in achieving educational goals are needed in order to objectify the results.