The results of our study show a higher incidence of perinatal fetal morbidity (hypoglycemia, jaundice, respiratory distress syndrome) in the patients with type 1, type 2 and gestation diabetes than in the healthy controls. Also, we found a higher incidence of cesarean section in the patients with type 1 diabetes than in those with type 2, gestation diabetes and healthy controls. Although delivery in the patients with type 1, type 2 and gestational diabetes was completed approximately one to two weeks earlier compared to the healthy controls there was no statistically significant difference in the incidence of preterm delivery (≤ 36th week of gestation) between the women with diabetes and healthy controls. Preterm delivery associated with poorer glycaemic control reflected through higher values of HbA1c in third trimester. Risks from adverse pregnancy outcomes may be reduced to minimum by adequate preconception counseling of diabetic patients and early diagnosis of diabetes in pregnancy, in order to achieve glycemic control during organogenesis and within pregnancy and through the teamwork of endocrinologists, gynecologists and pediatricians.

Protective mechanisms common both for placenta and uterus are as follows: expressions of Fas ligand prevention of infiltration of activated immune cells, regulation of immunosuppression which prevents proliferation of immune cells and high natural immunity (Na cells and macrophages) of the decidua.

Introduction. Rupture of an unscarred uterus is extremely rare and associated with severe maternal and fetal morbidity. Risk factors are second-stage dystocia, grand multiparity, high parity, labor induction or augmentation with oxytocin or prostaglandins, delivery after the 42nd week of gestation, neglected labor, fetal malpresentation, breech extraction, and instrumental delivery. Case Report. A 44-year-old multipara (gravid3 para3) underwent induction of labour at 40 + 3 weeks of gestation. The patient?s medical history showed no uterine surgeries, but her first delivery was instrumental, with vacuum extractor. The induction of labour was initiated by oxytocin infusion of 6 mIU/min. Continuous fetal heart rate monitoring was performed and there were no signs of fetal distress. Fetal descent in the second stage of labor lasted an hour, which is slightly over than average duration for multiparas. A live female infant weighing 3380 g was born and the pediatrician started resuscitation of the baby. Apgar score was 1/3/3. Ten days following the delivery, the patient was admitted to Emergency Gynaecology Department of the Clinic of Gynecology and Obstetrics due to abdominal pain, left sided retrouterine hematoma, and foulsmelling vaginal discharge. Laparotomy was indicated due to suspected uterine rupture. The intraoperative findings showed subinvolution of the uterus with signs of panmetritis and on the left side below the round ligament there was a 2 cm long rupture, passing through and invading the lateral and posterior walls of the uterus. A total abdominal hysterectomy with bilateral salpingo-oophorectomy on the left side was performed. Conclusion. Although a reliable prediction and prevention do not exist, the obstetricians? awareness of this rare event in unscarred uterus may decrease maternal and neonatal morbidity. This case report is an example of a serious and difficult outcome after a seemingly low-risk situation.