ABSTRACT Aim: The objective of the study was to examine whether cardiotocography can (CTG) predict asphyxia of the embryo, manifested as hypoxic-ischemic encephalopathy (HIE), and to what extent one can rely on CTG record. Material and methods: Retrospective research was carried out at the Clinic for Gynecology and Obstetrics UKC Tuzla and medical documentation from the history of mothers and newborns was used. The study group consisted of 68 pregnancies and newborns who developed HIE. The control group consisted of 40 pregnancies, which resulted in birth of healthy newborns – without signs of asphyxia. CTG records were analyzed, Apgar score, the ways of finishing delivery. Results: Pathological CTG records (bradycardia 100, tachycardia 180, silent type of curve, late decelerations) were found in 45 (66,17%) cases of the study group in comparison to 11 (27,5%) in the control group. In the study group Apgar score in 5th minute lower than 7 had 17,46% newborns and the highest incidence of the normally finished deliveries. We conclude that cardiotocography is one of the reliable methods of fetal monitoring in pregnancy and delivery, and that pathological CTG record very likely indicates the possible presence of perinatal asphyxia. Conclusion: Achieving a low degree of correlation between pathological intrapartum cardiotocography findings and long-term outcome of children can be achieved by rapid and adequate obstetric intervention and the relatively short duration of fetal acidosis, and optimal procedures during intensive care of newborns.

Introduction: Partial molar trophoblast degeneration is a benign disease characterised by numerous complications such as an invasive mole and malignant alteration.Methods: This was a retrospective study which recruited 70 pregnant women diagnosed with hydatidiform mole or with physiological pregnancy spontaneously aborted. The pregnant women had similar demographic features and were included in two groups. 35 pregnant women with a molar pregnancy diagnosed during the first trimester were included in the study group; while 35 pregnant women with miscarriages during the fi rst trimester were included in the control group.Results: Examined trophoblast changes were: type of atypia, amount and mass of trophoblast proliferation. Specifi c β HCG serum levels were observed in all pregnant women before the treatment. Pregnantwomen in the study group had statistically signifi cant higher levels of β HCG serum in comparison with the control group (both average levels 60191.37±49662.75 and levels according to gestational age). Statisticallysignifi cant changes of villous trophoblast were observed by the pathomorphological analysis: mild trophoblast atypia (57.14%); pronounced trophoblast mass (45.71%) and mild trophoblast proliferationamount (51.43%).Conclusion: Serum β-HCG level measurements and pathomorphological analysis of chorionic villi are reliable and effective methods in a partial mole diagnostics.

The objective of this study was to compare acceptance rate of immediate postpartum contraception and other characteristics among HIV-infected and HIV-non-infected parturients. Delivery logbooks from January 1990 to June 1994 were reviewed and 776 HIV -positive females  were identified. Data of these women were abstracted together with those of 1,552 HIV-negative women whose names were immediately before and after the HIV-Infected ones(1:2 ratio). HIV infected  women were more likely to be younger, have lower number of gravida, have baby with lower birthweight and lower first-minute APGAR score, and accept immediate postpartum contraception. However, the two groups did not differ in terms of mode of delivery.Stratification of acceptance rates of postpartum contraception revealed that the rates among multigravida were not different (39% vs 33%, OR = 1.30 [0.95-1.77)). However, HlV-infected primigravidous women were more likely than the non-infected to accept contraception (17.9% vs 0.9%, OR =  22.81(lO.03-54.65)).This was probably due to the policy of the hospital in encouraging HlV infected  mothers to adopt permanent or semipermanent methods of contraception.

Introduction: Hydatidiform mole is a gestational trophoblastic disease characterized by a range of disorders of abnormal trophoblastic proliferation.Methods: This was a retrospective study of 70 singletone pregnancies until the 12th week of gestational age diagnosed with hydatidiform mole or spontaneously aborted physiological pregnancy. The pregnantwomen had almost similar demographic features and were divided into two groups. 35 pregnant women with a molar pregnancy were included in the study group; while 35 pregnant women with physiologicalpregnancy spontaneously aborted were included in the control group. Analyzed parameters included a pregnant woman’s age, blood type, parity and previous pregnancies (course and outcomes).Results: In the study group 11.43% of cases had hydatidiform mola during previous pregnancies as well as the advanced average gestational age of an ongoing pregnancy (9.63±1.83 in contrast to 8.25±2.03in the control group). The pregnant women with the hydatidiform mole were reported to have statistically significantly greater number of irregular villous borders (71.43%); slightly enlarged villi (54.29%); moderatedpresence of cisterns (65.71%) as well as mild avascularisation of villi (57.14%).Conclusion: It was concluded that a previous molar pregnancy represents the highest risk for hydtidiforme mole and the pathomorphologic analysis of vilous changes can be a reliable parameter for establishingproper diagnosis of partial hydatidiform mole.

INTRODUCTION Menopause is the last physiological menstruation and represents a crucial moment in the life of every woman. OBJECTIVE OF THE STUDY Determine the effect of parity and menarche as risk factors in the time of menopause occurrence. PATIENTS AND METHODS This study included 460 women in natural menopause. Each patient has undergone an interview based on the questionnaire, following the verbal consent of the patient who was previously explained nature of the research. Statistical analysis of data was carried out by the usual statistical methods of descriptive statistics, using regression models and "hazard ratio" for the period of life compared to the individual parameters. RESULTS The average age of menopause occurrence in women who gave birth, was somewhat higher (48.6), in comparison to women who did not give birth (47.8), but the difference was not statistically important (t=-1.07, p=0.287). In the study group there was no correlation between the age of menarche occurrence and the age of menopause occurrence. CONCLUSION There is no correlation between the age of menarche occurrence, parity and age of the menopause.

Introduction: Doppler analysis of the feto-placental and fetal circulation give dynamic information on the condition of the bloodstream during pregnancy, and early detection of fetal hypoxia. The objectives of the study were: testing whether there is influence of smoking on feto-placental circulation; determining whether there is a link to a number of smoked cigarettes during the day; assessing the benefits of Doppler ultrasonographic screening in detection of fetal hypoxia in pregnant women who smoke during pregnancy. Methods: 300 pregnancies were included in the prospective research. With regard to a number of smoked cigarettes the pregnant women were divided into three groups: I. the first group (moderate smokers) consisted of 100 pregnant women who smoked up to 15 cigarettes a day during pregnancy; II. the second group (heavy smokers) 100 pregnant women who smoked more than 15 cigarettes a day during pregnancy and III. the third group (control group) 100 pregnant women who did not smoke during pregnancy. All pregnant women underwent Doppler measurements of blood circulation (determination of resistance index – RI) in the umbilical artery, fetal aorta and middle cerebral artery. Results: The intensity of smoking has influence to circulation because RI in the umbilical artery and fetal aorta is increased and RI is decreased in the middle cerebral artery in pregnant women heavy smokers in comparison to pregnant women moderate smokers. Conclusion : Doppler sonography of the blood vessels could have an important role in detection of hypoxia and monitoring of the condition of the fetus of pregnant women who smoked during pregnancy.

Introduction: Gynaecological and obstetric surgeries are high risk operations for the development of postoperative inflammatory complications due to the proximity of the genitourinary tract. The aim of this study was to compare the frequency of inflammatory complications in emergency or elective cases of caesarean sections as well as the frequency of complications related to the method of surgical treatment used.Methods: We analyzed inflammatory complications in 450 caesarean sections, which developed in a one year period from June 1st, 2000. to June 1st 2001. Patients were grouped according to the method of the surgery, and on emergency or elective case. Misgav Ladach or Dorfler surgical methods were used.Results: The most common inflammatory complication was wound infection and the most common risk factors for inflammatory complications were premature rupture of membranes and anemia.Conclusions: Long term use of one antibiotic was the most commonly implemented form of antibiotic prophylaxis.