Problem  The objective of this study was to compare serum concentrations of progesterone‐induced blocking factor (PIBF), anti‐inflammatory (IL‐10), and pro‐inflammatory (IL‐6, TNFα, and IFNγ) cytokines of women with threatened pre‐term delivery, with those of women with normal pregnancy and to evaluate the impact of PIBF on the outcome of pregnancy.

Aim. To evaluate the incidence of peritoneal adhesions as a post-operative complication after caesarean section following the Misgav Ladach method and compare it with peritoneal adhesions following traditional caesarean section methods (Pfannenstiel-Dörffler, low midline laparotomy-Dörffler). Methods. The analysis is retrospective and is based on medical documentation of the Clinic for Gynecology and Obstetrics, University Clinical Centre, Tuzla, Bosnia and Herzegovina (data from 1 January 2001 to 31 December 2005). We analysed previous caesarean section dependent on caesarean section method (200 by Misgav Ladach method, 100 by Pfannenstiel-Dörffler method and 100 caesarean section by low midline laparotomy-Dörffler). Adhesion scores were assigned using a previously validated scoring system. Results. We found statistically significant difference (p < 0.05) in incidence of peritoneal adhesions in second and third caesarean section between Misgav Ladach method and the Pfannestiel-Dörffler and low midline laparotomy-Dörffler method. Difference in incidence of peritoneal adhesions between low midline laparotomy-Dörffler and Pfannenstiel-Dörffler method was not statistically different (p > 0.05). The mean pelvic adhesion score was statistically lower in Misgav Ladach group (0.43 ± 0.79) than the mean score in the Pfannestiel-Dörffler (0.71 ± 1.27) and low midline laparotomy-Dörffler groups (0.99 ± 1.49) (p < 0.05). Conclusions. Our study showed that Misgav Ladach method of caesarean section makes possible lower incidence of peritoneal adhesions as post-operative complication of previous caesarean section.

We report genetic counseling and prenatal diagnostics in the Obstetrics and Gynecology Department of the Clinical Center Brcko District (BiH) which works for more than 4 years in prevention of giving birth to children with hereditary diseases and congenital malformations. Pregnant women from Brcko District, Tuzla Canton and wider area of BiH underwent genetic counseling. In the period from 2003 to 2007, 1234 pregnant woman underwent amniocentesis and genetic counseling. Among them 27 foetuses with chromosome disorders were discovered (2.19%). There were 9 (0.72%) cases of autosomal numerical aberrations, 9 (0.72%) of numerical anomalies of sex chromosomes and 12 (1.07%) of structural chromosome aberrations. Chordocentesis was performed in 86 pregnant women: 7 foetuses were found carrying chromosome aberrations (8.14%). Frequency of chromosomes in comparison to the Centre of Medicine Genetics in the Children Clinic in Novi Sad (Serbia) indicates that it is significantly higher (1.67% compared to 2.19%), and in both cases the populations are significantly large (12210:1234)--there is a large difference in structural chromosomal aberrations (0.39% -1.07%). This could point to harmful factors of the environment which contribute to induced genome damages. Frequency of chromosomopathies found by prenatal diagnostics is high. The causes for this have to be looked for, but the increase of structural anomalies points to environmental factors.

Aim. To determine the incidence rate and causes of perinatal mortality and make a comparison between the incidence rate and causes of perinatal mortality in the prewar (1986–1991), war (1992–1995) and postwar (1996–2005) periods in Tuzla Canton, Bosnia and Herzegovina. Methods. We retrospectively collected data from the databases of University Department for Gynecology and Obstetrics Tuzla. Data on the number of live births, stillbirths, early neonatal deaths, causes of death, gestational age and birth weights were collected. Results. There were 101712 deliveries alltogether in the above mentioned period, out of which 101638 resulted in liveborn children. Perinatal mortality gradually declines in the period of 1986–2000. The decline owns mostly to early neonatal mortality more than to fetal which also shows the trend of decrease. Statistically significant difference in perinatal mortality was found between period 2001–2005 and another analysed periods, and the most difference was found between 1991–1995 and 1996–2000 (p < 0.01). Statistically significant difference in fetal mortality was found between period 2001–2005 and 1986–1990. Statistically significant difference in early neonatal mortality was found between period 2001–2005 and 1986–1990 (p = 0.005; p < 0.005). Conclusion. Perinatal mortality in Tuzla Canton were significant higher during the war, mainly due to lower adequacy and accessibility of perinatal health care. During the peace period a significant decline of perinatal mortality is registered, due to early neonatal death.

ABSTRACT The aim of this prospective study was to investigate a value of insulin-like growth factor-binding protein-1 (IGFBP-1) in cervical secretion in women with symptoms of preterm delivery and correlate this test to the Bishop Score in prediction of a preterm delivery. The study group included 30 pregnant women with singleton pregnancy between 24 – 34 gestational weeks who were hospitalized because of a threatening preterm delivery with intact fetal membranes. A positive Actim Partus test (concentration higher than 10 μg/l) and Bishop Score higher than 4 signify a risk of the preterm delivery. The Bishop Score is a better predictor of the preterm delivery in patients with symptoms of the preterm delivery.

In about 70% of cases, ovarian carcinoma has been diagnosed at an advanced stage. Invasion and metastasis of solid tumors request protease activity resulting in basal membrane destruction and surrounding matrix. In that process, urokinase plasminogen activator (uPA) and its receptor, urokinase plasminogen activator receptor (suPAR) play a key role, that via plasmin activation lead to basal membrane and matrix degradation in surrounding of the tumor, enable to its invasion and metastasis. Determination of serum concentration of those tumor markers can be useful in preoperative as well as in postoperative period. Their serum concentrations in ovarian cancer patients may help in good monitoring of remission or progression during chemotherapy treatment. In late 1950s and ear1y 1960s, when it was found out that malignant ovarian tumors were chemosensitive, their chemotherapy treatment has begun. In the beginning it was used only mono-therapy, and by discovering new cytostatics it was replaced by poly-chemotherapy. Now days, in the therapy of advanced stages of ovarian carcinoma combination of cisplatine or carboplatine with paclitaxel is considering as standard treatment. Aim of this study was to determine serum uPA, suPAR and CEA in FIGO II and III patients with different histological type (serous, mucinous, clear cell tumor) before and after PT chemotherapy protocol during following three cycles. In this prospective study we have analyzed 17 patients with ovarian carcinoma, those have been after surgery treated by chemotherapy. Serum levels of uPA and suPAR have been determined by ELISA-test (Imubind uPA, Imubind uPAR, American Diagnostica), and CEA by OPUS Imunoassay method. Results of this study have shown that uPA, suPAR and CEA met criteria for prognostic markers for monitoring of successfulness of platina/taxol chemotherapy protocol for serous, mucinous and clear cell tumor FIGO II and III stage of ovarian carcinoma. In case of PT chemotherapy protocol suPAR was better prognostic marker for monitoring of chemotherapy successfulness (Pearson coefficient 0,9 do 1,0; p<0,00l) than uPA (Pearson coefficient between 0,86 and 0,92; p<0,02) and CEA (Pearson coefficient 0,5 do 0,89; p<0,04).

Many earlier papers have been reported Rh incompatibility as a reason of hydrops fetalis in 80 percent of all cases but with the decreasing frequency of Rh isoimmunization (the introduction of Rh D immune globulin prophylaxis), nonimmune hydrops fetalis becomes a relatively more frequent kind of hydrops. Nonimmune hydrops fetalis has been reported with an incidence of 1 in 2 500 to 1 in 4 000 deliveries.1-4

Spontaneous and habitual abortions are one of most painful experiences for couples expecting a child. It is an extraction or expulsion from its mother of a fetus weighing 500 g or less or pregnancy termination before 24 completed weeks of gestation. The incidence of spontaneous abortion is 15%-25% of all recognized pregnancies. 1%-2% of all women abort habitually. Beside many recognized causes of spontaneous and habitual abortion, 10%-50% are still unknown etiology. The larger numbers of unexplained abortions have immunological reason. By pre-embryonic reorganization of maternal immune system starts subsequent immunoprotective mechanism. There the key role has PIBF (Progesterone induced blocking factor) whose production depends of sufficient circulating progesterone concentration. PIBF supports Th-2 cytokines, inhibits nuclear killer cells (NK cells), induces an increased production of asymmetric, non-cytotoxic blocking antibodies. The production of pro-inflammatory, cytotoxic cytokines interferon-y (IFN-y), tumor necrosis factor-alpha, (TNF-alpha), interleukin-2 (IL-2) is reduced. There is the controversy about treatment of spontaneous and habitual abortion: from "do nothing" to routine pharmacological "support of every the pregnancy".

Vulvovaginitis is the most common gynecologic condition in childhood. The susceptibility of young girls to infection is high because of thin vaginal mucosa and poor hygiene of genital area, recurrent respiratory and urinary infection. The cause of recurrent vulvovaginitis could be the presence of foreign bodies in vagina. We present the case of 5-yaer-old girl who suffered from a vaginal discharge for a long time. All the time she had been under supervision by gynecologists and pediatrician. An episode of vaginal bleeding was the reason for the hospitalization at the Department of pediatrics. After complete evaluation vulvovaginitis was diagnosed, the treatment was continuated by gynecologist. The vaginal examination and vaginoscopy was performed under anesthesia and foreign body was found in vagina. The removal of the foreign body was the definitive treatment and did not require additional measures.