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...

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Objective To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in asymptomatic pregnant women admitted to hospital for delivery in a Turkish pandemic center. Study Design This prospective cohort study was conducted in Ankara City Hospital between April, 15, 2020 and June, 5, 2020. A total of 206 asymptomatic pregnant women (103 low-risk pregnant women without any defined risk factor and 103 high-risk pregnant women) were screened for SARS-CoV-2 positivity upon admission to hospital for delivery. Detection of SARS-CoV2 in nasopharyngeal and oropharyngeal samples was performed by Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) method targeting RdRp (RNA dependent RNA polymerase) gene. Two groups were compared in terms of demographic features, clinical characteristics and SARS-CoV-2 positivity. Results Three of the 206 pregnant women participating in the study had positive RT-PCR tests (1.4 %) and all positive cases were in the high-risk pregnancy group. Although, one case in the high-risk pregnancy group had developed symptoms highly suspicious for COVID-19, two repeated RT-PCR tests were negative. SARS-CoV-2 RT-PCR positivity rate was significantly higher in the high-risk pregnancy group (2.9 % vs 0%, p = 0.04). Conclusion Healthcare professionals should be cautious in the labor and delivery of high-risk pregnant women during the pandemic period and universal testing for COVID-19 may be considered in selected populations.

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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.

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