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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. [ABSTRACT FROM AUTHOR]

Many women try to become pregnant at older ages and there are even a lot of couples with unexplained infertility; for all these case we have to consider the status of their quality of embryos. This means that the lower the quality of eggs they have, the bigger the dilemma whether to use their own eggs in in vitro fertilization (IVF) technologies that they usually go in order to obtain successful pregnancies. New scientific attempts have been made nowadays in order to regenerate their ovarian tissue, and so they can have more possibilities for a successful pregnancy. PRP (plasma rich in platelets) is a natural product where a high level of platelets is concentrated, but with growth factors concentration three to five times greater than plasma. PRP contains cytokines which play an important role in cellular proliferation, chemotaxis and differentiation of mesenchymal and other cells and promote angiogenesis. We try to use the injection of the PRP to the one/two ovaries by laparoscopy in seven cases of women with unexplained infertility or poor responders to ovarian stimulation protocols. Then AMH (anti-müllerian hormone), FSH, LH and estradiol levels are measured at monthly intervals in women who do not menstruate, and during the menstrual flow in menstruating women for a period of six months. If the AMH levels rise, while the FSH, LH and estradiol levels become lower, there is an objective evidence of ovarian rejuvenation. We had one spontaneous pregnancy two months after the procedure and improved hormonal status in four cases of poor responders. These encouraging results should extend our pilot study and should also focus the injections by testing inhibin's B levels after PRP's infusion monthly, because this protein is the one that gives information about eggs' quality. It seems like the ideal candidates for ovarian regeneration with PRP are the following: menopausal or perimenopausal women under the age of 50, infertile women who are over the age of 35, having low egg reserve and low AMH, women under the age of 35 who have low egg reserve and low AMH levels, women with premature ovarian failure (POF), and women with idiopathic infertility over 35 years old. [ABSTRACT FROM AUTHOR]