Introduction: Malignant ovarian germ cell tumors (MOGCTs) account for 2-5% of all ovarian cancers and among them pure embryonal cell cancer is rare condition (1, 2, 3, 4). Aim: To show successful pregnancy after unilateral salpingooopherectomy and chemotherapy in a girl with embryonal carcinoma of ovary (ECO). Case report: Patient had FIGO stage III c disease. After the surgical removal of the tumour, the patient underwent six cycles of adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP). Eight years after chemotherapy she conceived spontaneously. The patient went through regular antenatal checkups in a consultation with a gynecological oncologist. In addition to all regular examinations and controls, monthly monitoring of carbohydrate antigen (CA) 125, human epididymis protein 4 (HE 4), Roma Index is also recommended. Congenital malformation excluded at 20 weeks of gestation by level III ultrasonography. At 39th gestational week, laparotomy as well as a C-section was done and the patient was managed successfully in giving birth to a healthy female baby. Three months after delivery, the woman was recurrence free and the infant did not show any problems. At the last follow-up visit (May 5, 2018), all the tumor markers were negative, and the control MRI and ultrasound examinations did not reveal tumor recurrence or pathological lymph nodes. Conclusion Normal gonadal function and fertility are possible after fertility preservation surgery for ovarian germ cell malignancies, even with adjuvant chemotherapy.

800x600 Background: Endometrioid endometrial adenocarcinoma is the most frequent in menopause. Although we think that patients with this carcinoma has good prognosis, 25% with diagnosed FIGO stage I have 5 years survival rate since moment of diagnosis. Aim of this study was to correlate FIGO stages Ib and Ia with age, hypertension, diabetes mellitus and obesity in endometrioid endometrial adenocarcinoma, histological grad 2. Methods: In retrospective study we observed patients who were admitted for operative treatment of endometrioid endometrial adenocarcinoma, histological grad 2 in period 1995 to 2006 at Ob/Gyn Clinic Tuzla. We analyzed 30 patients in observed group (FIGO stage Ib) and 30 patients in control group (FIGO stage Ia). Results: Average age of the patients in observed group was 61,26 and in control group was 54,36. Using t-test we found statistically significant difference of average age in observed and control group (t=3.349, P=0.001). With Fisher test we found that chance for finding diabetes mellitus in observed group was 9,67 times higher (95%CI: 1.07- 450.31). Conclusion: In our study we found that FIGO stages Ib and Ia of endometrioid endometrial adenocarcinoma, pathological grad 2 are age dependent and that presence of diabetes mellitus was 9,67 times higher in FIGO stage Ib than in Ia. Considering this founding we should recommend radical treatment with adjuvant therapy in cases of patients older than 56 or if their reproductive age is higher than 38 years and if they have diabetes mellitus regardless of depth of myometrial invasion. Normal 0 21 false false false BS-LATN-BA X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif";}

Introduction   Pap smear, the main tool of cervical cancer screening is not always available, but some patients are in urgent need for proper diagnostic. Aim of this article was to investigate accuracy of colposcopy for detection of squamous intraepithelial lesions of low or high grade (LGSIL, HGSIL) and to promote colposcopy as useful tool for detection of patients in need for immediate further diagnostics.  Methods Prospective multicentric study performed in BH 95% CI = 42.024 to 5713.304).  HGSIL was confirmed in 27 (87%) cases by histology (CIN II /CIN III). There were no statistically significant differences between colposcopic finding and histology results (Yates-corrected χ2 = 0.33 P = .5637) Conclusions This study showed high level of correlation between colposcopy and PAP results    (63-64%) and to histology for HGSIL (87%). In absence of PAP test colposcopy could be used to select patients in need for biopsy.

AIM To investigate the ovarian cancer incidence for the period 1996-2010 in the Federation Bosnia and Herzegovina (FBandH) emphasizing that there is no official cancer database for that period. METHODS This retrospective study analyzed ovarian cancer incidence in the period 1996-2000 and an estimation of incidence for the period 2000-2010 based on this data, as well as on 2007 -2010 incidence according to the Federal Public Health Institute. RESULTS The incidence of ovarian cancer in the period 1996-2000 was 3.68-6.38/100.000. The estimate of incidence for the period 2000-2010 resulted with the rate of 14.6 at the end of the analyzed period. According to the Federal Public Health Institute, incidence for the period 2007-2010 was 11.4-12.4/100.000. CONCLUSION According to different sources incidence of ovarian cancer in the Federation BH varies from 11.4-12.4/100.000, which is lower than the incidence for Southern Europe and neighboring countries. Incidence published by the International Agency for Research on Cancer (2008) for BH (both entities) was 10.1/100.000. An increasing trend of incidence is evident too. However, in FBiH a cancer database does not exist, while the system of cancer registration does not function or operate without proper coordination. A further main task for health authorities is to establish a functional system of cancer registration and a database, which would enable a follow-up and work on prevention and early detection of ovarian cancer.

Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group), while 300 infants were born in time (37-42 weeks of gestation-control group).Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

Case report: In 28-year-old woman the mild gastrointestinal symptoms during second and third trimester were accompanied with severe anemia and starting pruritic erythematous eruption on the arms. Patient with mild disease required only frequent application of topic cordicosteroid. Sudden symptoms of premature labour started at 32-nd week of pregnancy. Infant died during the labor. Gastrofiberoscopy with a biopsy confirmed a diagnosis of diffuse gastric adenocarcinoma. An explorative laparotomy revealed an unresectable gastric cancer and multiple peritoneal implants. Tumoral invasion was detected in pancreas and spleen. Curative surgery was not possible. The definitive diagnosis was gastric adenocarcinoma with multiple metastases. The patient complained of dysphagia, retrosternal pain, nausea, vomiting and abdominal pain and she died 12 weeks after a surgery due to metastases. Discussion: Davis and Chen from Cedars-Sinai Medical Center reported a case of gastric carcinoma presenting as an exacerbation of ulcers during pregnancy. They stated: »Gastric cancer is unusual during pregnancy. Also, because of the physiologic changes that occur with pregnancy, it is rare to see a worsening of peptic ulcers during pregnancy«. Bruggmann et al reported recently a case of gastric carcinoma in pregnancy. They declare: »Fetal metastasis is a rare entity, therefore caesarean section and chemotherapy should not be performed until fetal maturity. If vomiting and nausea are prolonged after the sixteenth week of pregnancy a malignant disease of the stomach should be excluded.« Jasmi et a1.3 reported a 27 year old woman at 16 week's gestation who presented with a perforated malignant gastric ulcer and peritoneal carcinomatosis.

OBJECTIVE To investigate the influence of the war on perinatal and maternal mortality during the war conflict in Bosnia and Herzegovina. METHODS In a retrospective study we analysed perinatal and maternal mortality in the pre-war period (1988-1991), the war period (1992-1995) and the post-war period (1996-2003). We also analysed the number of deliveries, the perinatal and maternal mortality rates and their causes. RESULTS During the analysed period we had a range of 3337-6912 deliveries per year, with a decreased number in the war period. During the war period and immediately after the war, the perinatal mortality rate increased to 20.9-26.3% (average 24.28%). After the war the rate decreased to 8.01% in 2003 (p < 0.05). Maternal mortality before the war was 39/100,000 deliveries, during the war it increased to 65/100,000 and after the war it decreased to 12/100,000 deliveries (p < 0.05). The increase in maternal mortality during the war was because of an increased number of uterine ruptures, sepsis and bleeding due to shell injury of pregnant women. CONCLUSIONS During the war we could expect a decreased number of deliveries, and an increased rate of perinatal and maternal mortality and preterm deliveries due to: inadequate nutrition, stress factors (life in refugee's centers, bombing, deaths of relatives, uncertain future...), and break down of the perinatal care system (lack of medical staff, impossibility of collecting valid health records, particularly perinatal information, and the destruction of medical buildings).