This retrospective cohort study aimed to analyze the clinical manifestations, complications, and maternal-fetal outcomes in patients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during delivery. The cohort included 61 pregnant women positive for SARS-CoV-2 infection at the time of delivery. Patients were divided into two groups: symptomatic and asymptomatic. We found a significantly higher rate of leukocytosis (p < 0.00078) and lymphopenia (p < 0.0024) in symptomatic women compared with asymptomatic ones. Other laboratory parameters, such as CRP (p = 0.002), AST (p = 0.007), LDH (p = 0.0142), ferritin (p = 0.0036), and D-dimer (p = 0.00124), were also significantly more often increased in the group of symptomatic pregnant women. Overall, symptomatic pregnant women with SARS-CoV-2 infection at the delivery show more often altered laboratory parameters compared with asymptomatic ones; nevertheless, they have a slightly higher but non-significant rate of preterm delivery, cesarean section, as well as lower neonatal birth weight and Apgar score, compared with asymptomatic women.

Abstract Background We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method. Patients and methods Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%). Results Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy. Conclusions We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

Background: Amniocentesis (AC) is the most commonly used invasive prenatal test. The aim of this study was to determine which were the most common indications for AC, chromosomal abnormalities in relation to the age of the mother and complications as a result of AC. Methods: This is a retrospective thirteen-year cohort study including pregnant women who underwent AC in the period from 2008 to 2020. Patients were divided into two groups: below and above 35 years of age of mother at the time of AC. Results: During study period 2213 AC were performed, out of which 759 (34.29%) were in mother below, and 1454 (65.70%) above 35 years of age (p < 0.00001). The most common indication for AC in group above 35 years of age was advanced maternal age (93.9%), in group below 35 years of age was familial chromosomal diseases (29.91%). In all indications there is a statistically significant difference between the two age groups of pregnant women, all these indications are more prevalent in the group of pregnant women younger than 35 years (p < 0.00001). The most common chromosomal abnormalities in both groups was Down syndrome from numerical aberrations, and from structural inversion of chromosome 9. Short term complications were spontaneous abortion in 26 (1.17%), missed abortion in 4 (0.18%) and premature rupture of membranes in 4 (0.18%) cases. Conclusion: Advanced maternal age, demonstrated the strongest association with the uptake of AC, trisomy 21 was the most prevalent abnormal finding. Complications of AC are not significant compared to the general population of pregnant women.

Aim To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal care in Bosnia and Herzegovina. Methods This retrospective cohort study included pregnant women with twin pregnancy who delivered during the period between 1 January 2012 and 31 December 2018 at the Clinic for Gynaecology and Obstetrics, University Clinical Centre Tuzla. Results During the seven-year period 26 734 deliveries were recorded, out of which 362 (1.35 %) were twin pregnancies, 226 (62.4%) preterm and 136 (37.5%) term ones. In the preterm group 38 (16.8%) pregnancies were assisted medical reproduction, and 16 (11.7%) of those were in the term group. The average birth weight was significantly higher for the first twin in both groups (p<0.00001). Incipient intrauterine foetal asphyxia was more frequent in the preterm group (p<0.05). The most common indication for Caesarean section was abnormalities of foetal presentation and lie, 176 (68.2%) for the overall sample. Conclusion Cornerstone of twin pregnancy antenatal care is to get correct data about amnionicity and chorionicity. Since majority of prenatal data did not have this information we call all obstetricians to declare about amnionicity and chorionicity in twin pregnancies during the first trimester ultrasound examination.

Aim To investigate clinical and obstetrical characteristics, an outcome and a prognosis for pregnant women with diagnosed and treated genital or extragenital cancer and their newborns. Methods This retrospective cohort study included pregnant and childbearing women with a history of cancer diagnosed before pregnancy during the period between 1 January 2014 and 31 December 2018. Data related to the course of pregnancy and childbirth were collected from medical records (mothers' disease history and partogram). The analysis covered clinical and histopathological characteristics of cancers, type of the treatment (surgery, chemotherapy, radiotherapy), demographic data, obstetric characteristics, comorbidities of women, and outcome of the newborns. Results The study recorded 18 414 deliveries, of which 30 (0.16%) were pregnancies in women who had been diagnosed and treated earlier for genital or extragenital cancer. The average age of the women at the time of delivery was 29.43±5.97 years. There were six (20%) women with genital and 24 (80%) with extragenital cancer. The most frequent extra genital cancer was Hodgkin lymphoma, in eight (26.6%) cases; ovarian cancer was the most frequent genital cancer, in four (13.3%) cases. The average time span from the cancer diagnosis and start of the treatment to the delivery was 59.2±44.4 months (5 years) (range 12 months - 15 years). Two (6.6%) women died. Conclusion Our data demonstrate a favourable obstetric and neonatal outcome for women who have survived cancer.

Aim To investigate the prevalence and obstetrical characteristics of low birth weight infants (LBWIs) in ten Cantons of the Federation of Bosnia and Herzegovina (FBiH). Methods The prospective study included newborns of both genders, gestational age (GA) of 22 to 42 weeks and birth weight(BW) of less than 2,500 grams in the period 1 January 2009 to 31 December 2009. Results In the observed period, 22897 neonates were born, out of whom 669 (2.9%) had a BW less than 2500 grams (average BW was 1295 grams; SD ± 234.2; a coefficient of variation of 0.58). The average GA was 31.4 weeks of gestation. The average lifespan of mothers was 27.7 years (SD ± 1.2). The average Apgar scor (AS) in the first minute was 4.6 (SD ± 2.1) and in the fifth minute it was 6.6 (SD ± 1.9). The LBWIs were most commonly delivered by primiparas, 317 (47.5%). Of the 669 LBWIs, 411 (61.4%) were born per vias naturalis, with cephalic presentation. The highest number of LBWIs was born in Sarajevo Canton, 3.7%, and Central Bosnia Canton, 3.7%. The lowest prevalence was in Posavina Canton, 1.1%. The largest late fetal mortality was in Central Bosnia Canton, 7.7 ‰. Conclusion This study has determined a relatively low prevalence of LBWIs and other examined obstetrical characteristics that are in correlation with European and Global World data.

Aim The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. Case report 23 years old patient, in 28 weeks of pregnancy was admitted to the clinic due to her medical record. She did not have any subjective complaints. She had two surgeries to repair ToF. After the surgery, she had residual ventricular septal defect (VSD). She had her first surgery 20 years ago (she was 3 years old), and second 7 years ago (she was 16). She had regular check-ups since, and her heart condition was unchanged. Due to her heart surgeries and VSD, a cardiologist indicates that she should deliver by having a c-section when she is 36 weeks pregnant. The patient’s heart condition was stabilized and the patient was sent home. She was recommended to have her cardiologist check up on her as she leaves the hospital and to have a gynecological examination in 6 weeks. Conclusion It can be concluded that team work and prenatal care, in most cases, lead to delivery without complication, both for mother and fetus.

Stem cells are basic cells of the human body; it builds human body, but also participate in the regeneration of damaged tissues and organs. They are undifferentiated that can differentiate into various types of cells in an organism, which is very important in terms of therapeutic applications. They differ in embryonic and adult stem cells. Adult cells are divided into pluripotent and unipotent. Pluripotent cells are found in the blood and in the tissue of the umbilical cord. Stem cells taking process is performed immediately after birth, sampling blood and cord tissue. Today, stem cells are used to treat more than 80 different diseases. The number of possible treatments increases every day, and treatment of stem cell becomes a special branch of medicine.

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: 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.

UNLABELLED Each birth which has happened before gestation period of 37 weeks of gestation and which is not related to a degree of birth difficulty is called premature birth. Different researches pointed out that C-reactive protein (CRP) can be used as a possible marker of idiopathic preterm delivery. RESEARCH GOALS WERE To examine reliability of CRP in mothers serum as a marker of premature birth among pregnant women who had no of the known risks for premature birth. To determine critical value of CRP in pregnancies this ended up as a premature birth. To determine connection between value of CRP and low birth weight of the newborn. The research is done in a form of prospective study on 200 pregnant women. Research included pregnant women without known risks factors for premature birth with condition that those women had suitable antenatal protection. All pregnant women were divided in into two groups, experimental and control group. Experimental group is consisted of 150 pregnant women who were regularly controlled in ambulance. Control group consisted of 50 pregnant women who were hospitalized at the Department for Pathology of pregnancy due to threatening miscarriage symptoms of condition that tocolytic index were less than 4. The value of CRP in serum of all pregnant women was determined in period from 20 to 24th week of gestation. In further course of pregnancy we followed those pregnant women with more often premature birth and if premature birth occurred more often in pregnant women with increased value of CRP in relation to women who had normal values. As a critical value for CRP was taken > 2 median value. Besides descriptive statistic methods in evaluating data processing were used (see text for symbols) test, student's t-test, Fishers test and Mann-Whitney test. RESULTS Mean value of CRP in experimental group was 3.913 and in control group 14.92 (t = 4.72, p < 0.0001). Mean value of CRP was 18.17 in group of prematurely births and in women who gave birth on time 3.87 (t = 5.72, p < 0.0001). Value of CRP > 2 had 33 women who gave birth prematurely (16.5%). CONCLUSIONS CRP can be used as a reliable marker of idiopathic premature birth. CRP value which is connected with development of premature birth is 4 mg/l. There is connection between the value of CRP > 2 and low birth weight of the newborn.

Objective. To examine the reliability of human placentalalkaline phosphatase (hPlAP) in the mother’s serum as amarker of premature labour among pregnant women whohad no known risks for premature labour and to determinethe critical value of hPlAP in pregnancies which ended upas a premature labour. Patients and Methods. The researchwas conducted in the form of a prospective study of 200 pregnantwomen. All the pregnant women were divided into twogroups, the examinees and the control group. The value ofhPlAP in serum of all pregnant women determined in theperiod from week 20 to 24 of gestation. > 2 median valuewas taken as a critical value for hPlAP . Besides descriptivestatistical methods for the statistical data processing we usedthe χ² test, student t-test, Fishers test and Mann-Withneystest, logistic regression. Results. The number of prematurelabours in the examined group was 17 (11.3%), in the controlgroup 22 (44%). The probability of premature labour is6.1 times higher in the control group in relation to the examinedgroup. The mean value of hPlAP in the examinedgroup was 608.2 but in the control group 1115.6. The meanvalue of hPlAP in the pregnant women who gave birth prematurelywas 1195 but in those who gave birth on time 632.2.There was a statistical significant difference in mean values ofhPlAP. Conclusios. hPlAP can be used as a reliable markerof idiopathic premature labour. hPlAP values connected withthe development of premature labour is 990 mU/l.

All labour which occurs at a gestation period less than 37 weeks of gestation is called premature labour. Premature labour is the most common complication in the second half of pregnancy, and delivery is fol­lowed by risks for the baby. The incidence is 7 to 10% of all deliveries. It is the main cause of neonatal morbidity and mortality. The etiology of preterm labour is unknown in 40 to 70% of cases. This study shows the etiological factors of preterm labour, patophisiology, preterm newborn deliveries and treat­ment of preterm labour. Early identification of high risk pregnant women should be the best way for effective prevention.