Objective:To document the practice of labour in water, to assess the effects of water immersion during labor and/or birth (labour stages 1, 2 and 3) on maternal, fetal and neonatal wellbeing and to compare the outcomes and safety with conventional vaginal deliveries and deliveries with epidural analgesia. Material and Methods:Two-hundred and seven women electing for waterbirth (n=207) were compared with women having conventional vaginal deliveries (n=204) and vaginal deliveries with epidural analgesia (n=191). Demographic data, length of 1 st , 2 nd and 3 rd stage of labor, induction and episiotomy requirements, perineal trauma, apgar scores, NICU requirements and VAS scores were noted. Results:The 1 st stage of labor was shorter in waterbirths compared with vaginal delivery with epidural analgesia but the 2 nd and 3 rd stage of labor were shortest in patients having waterbirth compared with conventional vaginal delivery and vaginal delivery with epidural analgesia. Patients having waterbirth had less requirement for induction and episiotomy but had more perineal laceration. All women having waterbirths had reduced analgesia requirements and had lower scores on VAS. There was no difference in terms of NICU admission between the groups. Apgar scores were comparable in both groups. There were no neonatal deaths or neonatal infections during the study. Conclusion:The study demonstrates the advantages of labor in water in terms of reduction in 2 nd and 3 rd stage of labor, reduction in pain and obstetric intervention such as induction or amniotomy. (J Turkish-German Gynecol Assoc 2012; 13: 45-9) Key words: Water birth, analgesia, neonatal outcome Received: 15 September, 2011 Accepted: 22 November, 2011 Amaç: Suda doğum pratiğinin dökümentasyonu ve doğum travayı ve/veya doğum eylemi (doğumun birinci, ikinci ve üçüncü evresi) sırasında maternal, fetal ve yenidoğan iyilik hali üzerine etkilerini değerlendirerek, sonuçları ve güvenirlilik açısından epidural analjezi ile vajinal doğum ve konvansiyonel vajinal doğum sonuçları ile kıyas-lanması. Gereç ve Yöntemler:Suda doğum yapan ikiyüzyedi (n=207) kadın, konvansiyonel vajinal doğum yapan (n=204) ve epidural analjezi ile vajinal doğum yapan (n=191) kadınlarla kıyaslandı. Hastaların demografik verileri, doğum eyleminin 1., 2. ve 3. evresinin uzunluğu, indüksiyon ve epizyotomi ihtiyacı, perine travması, yenidoğanın apgar skorlaması, yoğun bakım ihtiyacı ve VAS skorları değerlendirildi. Bulgular:Konvansiyonel vajinal doğum ve epidural analjezi ile vajinal doğum yapanlarla kıyaslandığında suda doğuranlarda, doğumun 1. evresi kısalmakla birlikte özellikle 2. ve 3. evrelerin çok kısalmış olduğu görüldü. Suda doğum yapan hastalarda oksitosin ihtiyacı belirgin olarak daha azdı, epizyotomi oranı da daha düşüktü fakat daha fazla perineal laserasyon saptandı. Suda doğum yapan kadınların hepsinde analjezi ihtiyacı azalmıştı ve VAS skorları düşüktü. Gruplar arasında yenidoğan yoğun bakım ihtiyacı açısından fark yoktu. Apgar skorları benzerdi. Çalışma dönemi boyunca hiç yenidoğ...

Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy.

The increase in the cesarean delivery rate is leading to an increase in the rate of abnormal placentation (placenta previa and accreta), which in turn give rise to an increase in the peripartum hysterectomy rate. Cesarean section itself is also a risk factor for emergency peripartum hysterectomy. Therefore, every effort should be made to reduce the cesarean rate by performing this procedure only for valid clinical indications. The risk factors for peripartum hysterectomy should be identified antenatally. The delivery and operation should be performed in appropriate clinical settings by experienced surgeons when risk factors are identified.

The aim of the study is to assess the diagnostic accuracy, findings and feasibility of office-based diagnostic hysteroscopy in an IVF population. A total of 2500 consecutive infertile patients were enrolled prospectively prior to IVF treatment. Diagnostic hysteroscopy was performed on each subject in an office setting in the study IVF centre. A total of 1927 patients (77.1%) had a normal uterine cavity, while the remainder of the sample (n=573) demonstrated endometrial pathology on hysteroscopy (22.9%). Of the patients with endometrial pathology, 192 patients had endometrial polyps (7.68%), 96 patients had submucosal fibroids (3.84%), 31 patients had polypoid endometria (1.24%), 27 patients had intrauterine adhesions (1.08%) and 73 patients had uterine septa (2.92%). Diagnostic office-based hysteroscopy is routinely performed in the IVF clinic to assess the endometrial cavity. In such an unselected population, a significant percentage of patients had evidence of uterine pathology that may have impaired the success of IVF. Safety, ease of use, high diagnostic accuracy and high patient tolerance makes office-based hysteroscopy an ideal procedure.

The continuous suturing techniques for episiotomy closure, compared to interrupted methods, are associated with less short-term pain, are quicker and also need less suture material.

To our study, VH ensures less complication rates than AH. In experienced centers, VH can be a reliable alternative to AH. Controlled prospective studies with large patient volumes are required to compare TLH and VH according to complication rates.

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GnRHant and GnRHa provide comparable results in normoresponder patients, while GnRHant allows a greater flexibility in their treatment.