Objective: To assess the current problem of alloimmunization in a tertiary referral center in Croatia. The results obtained were compared to data published worldwide. Methods: Retrospective case analysis included women with Rhesus (Rh) alloimmunization treated in our department from January 1997 to January 2003. Data of interest included the incidence, prevention, diagnosis and treatment, with the final point being perinatal mortality and morbidity. Results: 23 pregnant women with alloimmunization were identified. The incidence was 0.138% of deliveries in the same time period. The median gestational age at diagnosis/referral was 22 (range 9–37) weeks. Anti-D antigen, alone or in combination with the other antigens, was responsible for more than 90% of the alloimmunization cases included. A defined protocol for prevention of Rh D immunization after previous delivery was not followed properly in 9/19 cases. A particular problem was prophylaxis after previous pregnancy termination (TOP), whereby only 1/14 woman received adequate prophylaxis and only after 2 of 5 TOPs. Regarding fetal treatment, 9/23 women had a total of 24 intrauterine intravascular blood transfusions. Overall, perinatal mortality was 13%, and the median gestational age at delivery was 34 (range 31–40) weeks. In all there were 31 fetal exchange transfusions after delivery performed in 14/20 newborns. Conclusion: Despite precise diagnostic criteria and modern therapeutic options, alloimmunization remains a problem in Croatia. It is still related with a high perinatal mortality and morbidity. The main problem is inadequate prevention.

We describe a case of dizygotic twin pregnancy which was referred to our centre because of a discordant anomaly of one of the twins. The ultrasound examination revealed a large extra-abdominal mass (liver and bowel) with micromelia, severe kyphoscoliosis and a short umbilical cord of the second dizygotic discordant twin. These ultrasound findings were diagnosed as body stalk anomaly. Body stalk anomaly in twins is extremely rare. This is, to our knowledge, one of the few documented cases reported on dizygotic twins discordant for this anomaly. This finding, in association with a decrease of amniotic fluid volume, may be attributed to early amniotic membrane rupture as the primary event in the pathogenesis of body stalk anomaly.

Recent reports have confirmed that ectopic pregnancy is still a life-threatening condition responsible for up to 26% of all maternal deaths.' Proper and successful management of this condition can be instituted only after an early and accurate diagnosis is made. In the majority of cases this is difficult to achieve because of the nonspecificity of clinical signs and symptoms.The recent introduction of high-resolution real-time ultrasonic scanners and a sensitive radioimmunoassay of the p subunit of human chorionic gonadotropin (6-hCG) into clinical practice have enhanced the ability to diagnose ectopic pregnancy. As ultrasonic findings are rarely specific in these cases, ultrasound is most helpful in demonstrating the presence or absence of an intrauterine pregnancy in those patients suspected of having an ectopic pregnancy.2 Although demonstration of a normal intrauterine pregnancy eliminates clinical suspicion of an ectopic pregnancy in most cases, one should keep in mind that there is always the possibility of coexistent intrauterine and extrauterine pregnancies.We have recently examined a patient with combined intrauterine and extrauterine pregnancies that were easily identified on real-time ultrasound. CASE REPORTA 26-year-old gravida 2, para 1, ab 0 patient experienced a sudden onset of lower abdominal pain 20 days after an expected last menstrual period. Physical examination revealed diffuse lower abdominal pain and peritoneal irritation. Pelvic examination revealed severe bilateral adnexal pain. The uterus was slightly enlarged,

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The introduction of a polypropylene mesh strip in the suspension threads in cases using the trasvaginal suspension technique has good, long-term results for the treatment of patients with stress incontinence.