Paraovarian cysts originate from the mesothelium and are presumed to be remnants of Müllerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (≤20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.

Uterine sarcomas make up only 5% of all malignancies in gynecology. Their classification is complicated due to low incidence and large histological differences. Uterine sarcoma is usually diagnosed in postmenopausal women, and this is most often done accidentally at the postoperative stage. The existence of uterine sarcoma should be suspected in cases of rapid uterine growth in postmenopausal state. Postmenopausal abnormal bleeding is the most common reason for a medical examination. In this paper, a 48-year-old patient is presented in whose case during a regular gynecological examination; the existence of tumour change in the uterine part of uterus has been noticed. The patient did not have gynecological problems until then. The patient was then subjected to a diagnostic exploratory curettage. The pathohistological finding was negative. Given that the onset change is present after the control check, it is decided to proceed with an operative procedure. A pathohistological finding (uterus and adnexa) indicates that it is a uterine sarcoma. After that, the patient was re-treated with two more operations and then had chemotherapy and radiation therapy. After completing the whole treatment, for the period of six years, the patient now feels well and performs her usual work tasks.

Kratak sadržajUvod. Dugo vremena je u akušerstvu važio čuveni diktum Edwarda Cragina iz 1916. godine: "Jednom carski rez, uvijek carski rez". Vremenom, rukovodeći se postupcima iz prošlosti i porastom broja patoloških trudnoća sa jedne strane, kao i uticajem medija i zahtjevima pacijenata sa druge strane, procenat porođaja završenih ovom operativnom metodom je u stalnom porastu. Cilj rada je da se utvrdi učestalost carskog reza i uspješnost vaginalnog porođaja nakon prethodnog porođaja carskim rezom i uporedi perinatalni ishod novorođenčadi rođene carskim rezom i vaginalnim porođajem nakon prethodnog porođaja carskim rezom.Metode. Opservaciona studija urađena je na Porođajnom odjeljenju Univerzitetske bolnice Foča u periodu od 1. 7. 2005. do 31. 6. 2011. godine. Ispitivanje je obuhvatilo 206 ispitanica koje su podijeljenje u dvije grupe. Grupa A -pacijentkinje u probnom vaginalnom porođaju nakon carskog reza (n = 65) podijeljene su u dvije podgrupe, A1 -pacijentkinje kod kojih je probni vaginalni porođaj uspješno završen, A2 -pacijentkinje kod kojih je u probnom vaginalnom porođaju usljed nastanka komplikacija urađen carski rez. Grupa B -porodilje kod kojih je urađen elektivni, iterativni carski rez (n = 141).Rezultati. Učestalost carskog reza u ukupnom broju od 2028 porođaja u našoj ustanovi u posmatranom periodu je 17,11%. U odnosu na ukupan broj porođaja nakon porođaja carskim rezom (vaginalni porođaji + iterativni carski) procenat vaginalnih porođaja nakon porođaja carskim rezom iznosio je 22,33%. Povećanjem broja ovog načina porođaja smanjivao se broj ukupnih carskih rezova. Nije postojala statistička značajnost u fetalnom morbiditetu i mortalitetu (u istraživanju nije bilo mrtvorođene djece) koja bi opravdavala ponovni carski rez u aktuelnom porođaju nakon porođaja carskim rezom.Zaključak. Vaginalni porođaj nakon prethodnog porođaja carskim rezom sigurna je alternativa rutinskom ponovnom carskom rezu sa aspekta smanjenja procentualne stope ukupnog broja carskih rezova. Ne postoji statistička značajnost u perinatalnom ishodu novorođenčadi koja bi opravdavala ponovni carski rez u aktuelnom porođaju.