Twin to twin transfusion syndrome (TTTTS) accounts for approximately 10% of monochorionic twin pregnancies and, if left untreated, is associated with high morbidity and mortality rate. A net transfusion of blood flow from one fetus (donor twin) to the other (recipient twin) via placental vascular anastomoses has been supposed as the major etiology of TTTTS. The donor twin becomes hypovolemic and oliguria, oligohydramnios, and a variable degree of growth restriction develop, whereas the recipient twin manifests polyuria, polyhydramnios, and hydrops in response to hypervolemia. TTTTS can be treated by either serial amniocentesis or selective fetoscopic laser coagulation of the communicating vessels. The rationale for removal of large volumes of amniotic fluid is to prevent preterm delivery secondary to polyhydramnios and to improve fetal circulation by reducing pressure on the chorionic plate. On the other hand, the goal of laser therapy is to occlude vascular anastomoses, thereby interrupting intertwin blood exchange. Although laser treatment is associated with increased survival rate and reduced neurologic complications, compared with amnioreduction, it requires highly specialized centers, whereas serial amniocentesis has the advantage of being performed worldwide. Therefore, the optimal treatment for pregnancies complicated with TTTTS is still controversial.

Preterm premature rupture of membranes (PPROM) is in obstetrics with incidence of 0,4% of , with risk for chorioamnionitis 35%, risk for premature deli very 19%, and sepsis risk of 1%. Primary risk for fetus is pulmonal hypoplasia due to oligohydramnios in 29%, RDS in 66 % of such pregnancies, sepsis in 19%, and contrac ture of extremities in 3%. Fetal death is more than 30% of cases. Patient came to regular pregnancy check up in 22th week of gestation. US exami nation revealed decreased fluid volume AFI 50, with regular morphology and fetal dynamic. She was admitted to hospital. She was given cortico-steroids and antibiotics. In further course of pregnancy amniocentesis was performed in 32th week of preg nancy to rule out the infection and to check pulmonal maturity. In absence of infection and lung maturity pregnancy was continued until 36th week of gestation when Cesarean Section was. Baby went well and is now healthy child in the age of three. Some studies suggested that delivery can be significantly prolonged. In our case we menaged to gain 14 weeks,from 22th to 36th gestational week. Firstly gynaecologyst nightmare to ask the woman is she accept therapy. The aim is to deliver a healthy child without neurological and other consequen ces and mother with preserved reproductive function. Controversy still exists when is the appropriate time to finish pregnancy with prolonged PPROM.

Cervix cancer is the second most frequently found cancer in women, after breast cancer and represent one of the biggest problems of modern medicine. The aim of treatment is to determine the frequency of certain premalignant and malignant changes in cervix and the method of its operative treatment. By a retrospective method, 360 women have been operated due to the changes in cervix from 1999-2008 at Obstetrics &Gynecology Clinic of Clinical Center of Montenegro. Out of this number the total of 297 women with premalignant lesions of cervix was found and 63 women at an operable stage of cancer. With premalignant cervix changes the most frequent indication for operation was CIN III - 24.57% of patients. Cervix conization -80.13% is most frequently used as an operable intervention with premalignant changes in cervix. The groups of 40-49 years of age and 50-59 years of age are the ages of patients with most frequently conization done. The most frequent indication to operate malignant cervix was Ca I b. Wertheim-Meigs radical hysterectomy was performed with all patients with operable malignant changes. With an early identification, an adequate evaluation, the treatment, constant and cautious monitoring, almost any cervical intraepithelial neoplasia can be cured. Without the treatment, 30-50% of cervical dysplasia can advance into and invasive cervix cancer.