Rationale Defensive caesarean section (CS) has become one of the most common medical procedure worldwide. Additionally, performing CS in accordance with the patient's choice is an appropriate professional practice. Aims and Objective This paper reports a prospective, observational, multicenter study to quantify the use of this type of practice that is performed by obstetricians to avoid medico‐legal complaints and decrease the frequency of malpractice litigations. Methods We interviewed 73 obstetricians from three distinct units of obstetrics and gynaecology, to assess their opinion regarding defensive caesarean delivery and caesarean delivery performed upon maternal request. We conducted an opinion‐based survey using questionnaires based on nine, close‐ended questions. Results Out of 73 respondents, 51 (69.9%) stated that they perform defensive CS; 63 (86.3%) declared that their choice of birth delivery is influenced by the risk of being accused of malpractice; 60 (82.2%) indicated that it is normal for the patient to be able to decide on the type of delivery; and 63 (86.3%) declared that they consult their patients regarding their delivery preferences. We found statistically significant differences between the respondents who declare that they perform defensive CS (69.9%) and those who said that they are influenced by the risk of malpractice when they choose the method of delivery for their patients (86.3%) ( P < .001; McNemar Test). Conclusions The results of our study indicate that defensive caesarean section is a widespread practice among obstetrics practitioners in Romania.

Rationale: The extent of pregnancy in adolescents and young adults, especially in low and middle-income countries, is a source of increasing concern given its social and economic impact. Aims and Objective:We hypothesized that there would be correlations between female patients becoming pregnant at a young age and practices such as harmful alcohol misuse, cigarette smoking, and drug use, the use of toxic substances, low educational attainment, and an essential absence of health care seeking about the outcome of adolescent pregnancies. Methods:We performed a prospective cross-sectional study of patients who gave birth between August and November 2017 at St. Pantelimon Emergency Hospital in Bucharest, Romania. Seventy-four patients aged 14 to 20 years, with a mean maternal age of 18.07 years, were enrolled in the study and answered a 15-item questionnaire about their social, educational, and medical background.Results: Fifty-three patients (71.6%) gave birth by caesarean section and 21 (28.3%) by vaginal delivery. Notably, patients aged 14 to 16 years had a lower rate of caesarean delivery compared with those aged 17 to 20 years. Moreover, 83.0% of the caesarean sections and 76.1% of the vaginal deliveries were at term. With reference to age and type of delivery, women are more likely to give birth by caesarean section at any age group (the association is not statistically significant at P < .05), except for the age of 15 years (five out of six patients in our sample had a spontaneous birth).Smoking was the most common risk behavior in the sample (45.9%, n = 34), followed by alcohol consumption (17.5%, n = 13) and drug use (5.40%, n = 4). Conclusions:A high percentage of caesarean delivery was reported, particularly in patients aged >17 years. The percentage of female participants who underwent a caesarean delivery for their second pregnancy was significantly higher than compared with primipara participants. Patients receiving consistent antenatal care visits compared with those who did not monitor their pregnancy did not differ in the likelihood of undergoing a caesarean section.

The ovarian hyperstimulation syndrome (OHSS) is one of the major complications which occurs as a result of controlled ovarian stimulation (COS) in the assisted human reproduction. There are several factors including age, body mass index (BMI), plasma estradiol level, the anti-mullerian hormone (AMH) level and the antral follicle count (AFC), which can be used to identify the cases with high risk for this complication. The purpose of the study is to establish the predictive value of AMH for the development of OHSS before COS as well as its association with the plasma estradiol level during stimulation. The study group included 155 COS cycles using gonadotropin-releasing hormone (GnRH) agonist protocols, and analyzed the predictive value of the mentioned parameters for OHSS. The serum AMH level is superior to age and BMI for identification of patients with high risk for OHSS before starting the ovulation stimulation, and the cut-off level is 3.78ng/mL with 91.1% sensibility and 85.2% specificity.

No abstract

Women�s perception on childbirth experience is frequently related to pain struggle, regardless the type of birth. We aimed to present our Department�s experience on pharmacologically treating postpartum related pain. We developed a 6 months retrospective, descriptive study which included a number of 305 patients. Two sample patients were formed depending on the type of birth. In the sample of vaginal delivery a correlation between episiotomy and Paracetamol consumption was found (Pearson correlation of 0.238). In the sample of cesarean section births, for Acupan, Ketoprofen and Algifen the correlations with epidural anesthesia are negative and statistically significant at the 99.9% confidence level.