Objective. We performed a prospective observational audit study to compare neonatal and maternal outcomes of the primary cesarean sections performed in first stage versus second stage of labour. Methods. One thousand three hundred and eighty-nine nullipara women who had undergone cesarean section in a tertiary teaching hospital between February 1, 2009 and January 31, 2010 were included in the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury, requirement for hysterectomy, and duration of hospital stay. Results. A total of 1389 women underwent cesarean section at this 12 month time period. Of these 1389 cesarean sections, 1271 were in the first stage of the labour and 171 were in the second stage of the labour. Urinary injuries, transfusion requirement, and uterine atonia hysterectomy were significantly more frequent in women who underwent cesarean section in the second stage of the labour compared to women undergoing cesarean section in the first stage of the labour. Conclusion. Cesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing cesarean section in the second stage of the labour.

Abs tractAim: To retrospectively evaluate patients with postpartum hemorrhage (PPH) and to report the incidence, indication, and complications of PPH-related hysterectomies.Methods:We evaluated medical records of patients who received the diagnosis of in a university-affiliated tertiary care hospital between February 2013 and September 2014.Results:A total of 1724 deliveries were included in the study. 36 deliveries (2.08%) were complicated with PPH. PPH was found to result from the following conditions; uterine atony (n=19), placenta previa (n=8), vaginal lacerations (n=7), and coagulation disorders (n=2). A total of 7 patients (19.4%) with PPH, of whom two had uterine atony and five had placenta previa, underwent hysterectomy (4.06 per 1000 births). Application of B-Lynch uterine compression suturing and hypogastric artery ligation did not stop PPH in two patients with atony after primary caesarean section. Balloon tamponade was successful in 71.4% of patients with placenta previa. The most common complication among hysterectomy patients was admission to intensive care unit. Conclusion:Despite the improvements in conservative management strategies, our hysterectomy rate was higher than the reported literature. We conclude that management options should be individualized according to diagnosis, hemodynamic stability of patients and also facilities of the medical centre.

Objectives: This study aimed to reveal the knowledge level of pregnant women about prenatal diagnostic tests, Down syndrome (DS) and amniocentesis, their attitudes toward uptaking these tests, undergoing amniocentesis, and the termination of pregnancy. It also aimed to evaluate the effects of providing information, as well as a written information brochure about all the issues concerning women's knowledge and attitudes. Materials and Methods: The gynecologists provided verbal and written information on prenatal screening tests (PSTs) and invasive prenatal diagnostic tests. Data were collected using an anonymous questionnaire, which was designed by the researchers on the basis of the literature. Results: Knowledge of both DS and amniocentesis was found to be significantly higher after the education (p = 0.000 and p = 0.000, respectively). Attitudes toward amniocentesis changed significantly after the education. Conclusions: This study has shown that women had an inadequate knowledge about PSTs, DS, and amniocentesis. It has also revealed that education provided by gynecologists along with a written brochure of information tended to increase women's knowledge about PSTs.