[Attitude of pregnant women towards labour--study of forms of preparation and preferences]. / Postawy ciezarnych wobec porodu--analiza form przygotowania i preferencji.

OBJECTIVE: The aim of this study was to assess the knowledge of alternative delivery techniques among pregnant women and their preferences concerning the course of labour. MATERIAL AND METHODS: 275 woman hospitalizated in obstetric wards in Puck and Ist Clinic in Warsaw were questionnaired in the period of July 2003 - February 2004. The mean age of women was 26 +/- 4.9. 55.7% of them were nulliparous, 44.3% multiparous. T-Student test was used for statistical analysis. RESULTS: The majority of questionnaired women knew alternative positions during delivery and possible analgetic techniques. 25.1% of women attended labour school. 81.2% wanted to give birth in the hospital, 10% at home and 8.8% in the delivery room. 51.1% preferred waterbirth and 22.5% obstetric chair--most of them came from the big cities, were better educated and attended labour school. Almost half of all women are in favour of epidural anaesthesia of delivery. Caesarean section on request was supported by 13.8%. For 67.4% the presence of intimates during labour was important. CONCLUSIONS: Labour school has a significant influence on women's knowledge and their preferences. Waterbirth and other modern delivery techniques are very popular among better educated women from big cities, while those with lower education from small cities and villages prefer "classic" labour. Therefore promotion of modern delivery methods and active participation in labour should be concentrated on these groups of women. Nowadays obstetric departments should ensure not only safety of giving birth but also complete personal comfort for pregnant women.

[Comparison of indications for cesarean section in 1985-86 and 2000-01. Analysis of changes]. / Porównanie wskazan do cicia cesarskiego w latach 1985-86 1 2000-01. Analiza zachodzacych zmian.

UNLABELLED: The aim of this research was a retrospective analysis of indications for caesarean section during last fifteen years and assessing recent trends. MATERIALS AND METHOD: 1106 pregnancies and deliveries by caesarean section at the Ist Clinic of Obstetrics and Gynaecology, Medical University of Warsaw in 1985-86 (547--I group) and 2000-01 (559--II group) were enrolled in the study. It was performed in order to estimate and evaluate such factors as age of women, mean duration of pregnancy, indications for caesarean section, complications, and general newborn condition. RESULTS: In 1985-86 and 2000-01 fetal distress was the most frequent indication for delivery via caesarean section (14.35% and 18.57% respectively, p=ns). It was followed by cephalopelvic disproportion (13.99%) and malposition (13.99%) in I group and by pregnant women diseases (14.07%) and malposition (12.45%) in II group. Analysing pathology of the placenta, we established that index of placenta praevia decreased from 2.49% to 0.57% (p < 0.01) and index of abruption of placenta from 2.25% to 0.81% (p = 0.05). Ratio of cases of cephalopelvic disproportion decreased statistically from 13.99% in the I group to 8.76% in the II group (p = 0.006). Index of prolonged labor in the I stage increased from 8.3% to 12.34% (p = 0.027). CONCLUSIONS: (1) Caesarean section is the surgical method of delivery for women with high risk pregnancy and complicated labor to protect mother and the foetus from the anticipated complications of delivery through natural passages. (2) The overall rate of caesarean section has risen because of widening of the indications. (3) Fetal distress has been the most frequent indication for caesarean section in last fifteen years. (4) Index of indications for cesarean section other than obstetric--ophthalmic, cardiological, neurological and orthopaedic, increased as a result of better health care of pregnant women. (5) Decision to perform caesarean section should be taken in consideration of present clinical situation and future consequences of abdominal delivery.