SUMMARY. Objective. The aim of this study is to appreciate the mode of delivery in the pregnant women with placenta praevia. Methods. Retrospective study. We analized 9010 deliveries (two years period, 2001 and 2002) performed at the University Clinical Center, Tuzla, Ob/Gyn Clinic. Control group were 16 pregnant women without placenta praevia. In statistical analysis t-test was used. Results. The incidence of placenta praevia was 0.17% (16 out of 9010 deliveries). Placenta praevia partialis was established in 8 (50%), placenta praevia centralis in 4 (25%) and placenta praevia marginalis in 4 (25%) pregnant women. All pregnant women with placenta praevia were secundiparas and multiparas. The caesarean section was previously performed in 8 (50%) pregnant women. In actual pregnancy in 14 (87.5%) of pregnant women with placenta praevia the mode of delivery was by caesarean section, in the control group in 3 (18.75%), the t-test is 5.72, p<0.05. Apgar score 8–10 was in 12 and 4–7 in 4 (25%) neonates; in the control group Apgar score 4–7 was only in one case (6.25%); the statistical difference is not significant. The gestational age at delivery in 8 cases was ≤37 weeks, in the control grup in 2; the difference is statistically significant (t=2.51, p<0.05). Conclusion. Placenta praevia is a serious complication of pregnancy. The method of choise in the delivery for pregnant women with placenta praevia is caesarean section.

Cortikosteroids, a hormons of adrenal glands have a influence to almost all organic sistems because of their antiinflamatory and immunosupressive effects. They are used in perinatology to accelerate lungs maturation in expected premature labour. The most frequent used corticosteroids are bethamethason and dexamethason, with useful effects: acceleration of growth of fetal lungs by ripening pneumocites type II and supression of creating secundary septs; by protection of brain from intraventricular haemorrhage and periventricular leucomalation; decreasing rate of rethinopathy and enterocolitis and ductus artheriosus persistens. By this way the mortality rate ofpreterm newborns is decreased in 60% of cases. Expected harmful effects of antenatal using of corticosteroids are: high blood pressure of newborns in first 24 hours after delivery, the possible oedema of lungs, in simultaneous using of corticosteroids and bethamimetic treatment. It is not recommended to repeat treatment by corticosteroids in same pregnancy because of hormonal influence to fetal growth and neurological development, till clear benefit is not proved.

INTRODUCTION Preterm labour is most common complication of second half of pregnancy, incidence is 7 to 10% of all delivers. One of most important causes of increased mortality and morbidity of neonates is respiratory distress syndrome. Numerous studies prove that corticosteroids given antenatal to mother decrease the incidence of preterm delivered neonates. AIM OF THIS STUDY IS: To determined influence of dexamethasone given prepartal on maturation of neonatal lungs in correlation with gestational age. METHOD This study include 150 pregnant women which delivered before 37 week of gestation. They are divide in three groups: two experimental and one control group. Group E1 consists of the pregnant women which received dexamethasone for five days in a single dose of 12 mg. Group E2 consists of the pregnant women which received dexamethasone less then five days, in a single dose of 12 mg. In the control group consists of the pregnant women which did not received dexamethasone. In this work we used gestational age in the moment of delivery. State of neonate is determined on the base of presence of clinical signs of respiratory distress syndrome after birth. Statistical method used in this work was test of proportion. RESULTS In this work we find that there is a less number of neonates who has respiratory distress syndrome in group consists of the pregnant women which received dexamethasone for five days, 5 (10%). In group consists of the pregnant women which received dexamethasone less then five days, number of neonates with respiratory distress syndrome was 12 (24%). The number of neonates with respiratory distress syndrome in control group was 21 (42%). The value of test of proportion: K/E1 (the pregnant women received dexamethasone for five days)-z = 1.95, p < 0.05; K/E2 (pregnant women received dexamethasone less than five days)-z = 3.92, p < 0.05. In all three groups largest number of neonates with respiratory distress syndrome was between 31-34 week of gestation. Highest mortality of neonate with respiratory distress syndrome was in control group, 7 (14%), than in group consists of the pregnant women received dexamethasone lass then five days, 4 (8%). In group consist pregnant women received dexamethasone for five days, there were not cases of mortality caused by respiratory distress syndrome. The value of test of proportion was z = 2.85 (p < 0.05), between control group and group consists of the pregnant women received dexamethasone for five days. CONCLUSION Dexamethasone accelerates maturation of fetal lungs, decrease number of neonates with respiratory distress syndrome and improves survival in preterm delivered neonates. Optimal gestational age for use of dexamethasone therapy is 31 to 34 weeks of gestation.

Precancerous and early cancerous lesions of the cervix uteri (ASCUS, AGUS, LSIL and HSIL) are precursors of invasive cancer of the cervix uteri. By Papanicolaou test they are graded as Pap III and Pap IV. Different factors may increase a risk for those lesions as well as converting low stage lesion into higher one. Oral contraceptive use is one of the most potential risk factor for those lesions. The goal of this study was to examine a relationship between oral contraceptive use and precancerous and early cancerous lesion of the cervix lesion of the cervix uteri by using Papanicolaou test. After adjustment for other potential risk factors our results have shown: 1) there is high significant positive relationship between oral contraceptives use and precancerous and early cancerous lesions of the cervix uteri; 2) the users of oral contraceptives have shown Pap III and Pap IV smear grade five to ten years earlier than non-users; 3) long-term users have shown Pap III and Pap IV five years earlier than short-term users for middle age group (35-44 years); 4) the border between Pap III and Pap IV is shifted for five years toward earlier age.