Objective To assess the role of maternal demographic characteristics, uterine artery Doppler velocimetry, maternal serum pregnancy-associated plasma protein-A (PAPP-A (OR, 2.0; 95% CI, and low 0.43; 95% CI,. Increased uterine artery PI was the only independent factor in the prediction of placental abruption (OR, 8.49; 95% CI,

II-1.

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Histological abnormalities were observed more frequently in the diabetic placentas compared to the controls. These findings support the hypothesis that impaired placental function is one of the main reasons for the increased frequency of fetal complications in diabetic pregnancies.

Obstetric hysterectomy is a necessary life-saving procedure. Abnormal placentation is the leading cause of emergency hysterectomy when obstetric practice is characterized by a high cesarean section rate. Therefore, every attempt should be made to reduce the cesarean section rate by performing this procedure only for valid clinical indications.

Aims: To determine appropriate cone dimensions for predicting margin status after large loop excision of transformation zone (LLETZ) treatment. Methods: An observational study performed at the Colposcopy Unit of a university hospital setting involving patients who underwent LLETZ conisation within a 1-year period. Data concerning the characteristics, cone dimensions, lesion grade and excision margins of the patients were recorded. Results: The median age of the women (n = 61) was 38 years (18-53). LLETZ cone specimens had 36.1% of cervical intraepithelial neoplasia (CIN)2/3 lesion and 13.1% positive margins. Mean cone depth and volume were 10.9 mm and 2.3 cm³, respectively. Multiple logistic regression for main predictors and after adjustment for age, parity and CIN severity showed that cone volume and length, cone base surface and proportion of excised volume had a significant effect on margin positivity. ROC analysis showed that optimal cut-off for cone volume was 2.1 cm³ (87.5% sensitivity - 54.7% specificity) or 8.6% of initial cervical volume (75% sensitivity - 75.5% specificity), and for cone length it was 10 mm (100% sensitivity - 52.8% specificity). Optimal cut-off for cone base surface as percentage of ectocervical surface was 32.7% (75% sensitivity - 69.8% specificity). Conclusions: These findings should be taken into consideration when planning the outer boundaries of excision and cervical tissue to be removed so as to achieve oncologically safe limits.

In triplet pregnancies, embryo reduction to twins significantly reduces the risk of severe preterm delivery and very low birth weight by about one-third, at the expense of a significant increase in total fetal loss, by about one-quarter. The procedure is likely to reduce the risk of having a severely handicapped child due to extreme prematurity.

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