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The aim of this study is to determine the impact of individual obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery, and its impact on quality of life.  We designed the study as a cross-sectional, and developed the research at the University Clinic for Obstetrics and Gynecology, University of "Ss. Cyril and Methodius" in Skopje, Macedonia, over a period of one year. In this study, we engaged patients in their reproductive age, who had undergone at least one vaginal delivery (spontaneous or assisted vaginal delivery). The degree of incontinence was determined using St. Mark's Anal Incontinence Score (SMIS). We used a specific questionnaire related to anal incontinence to assess quality of life Fecal Incontinence Quality of Life Scale (FIQLS) Four hundred and seventy (470) patients were included in the study, 30% of which (141 patients) had St. Mark’s scores ?8. The following factors were found to influence the St. Mark’s score: number of vaginal deliveries, delivery mode, fetal macrosomia, use of episiotomy and the existence of perineal lacerations Results of this study show consistency with data published so far on the influence of obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery. Changes in anal continence are expressed in increased St. Mark’s score. Our study showed that the following factors had statistically significant impact on the score value: multi-parity, delivery mode, use of episiotomy, fetal macrosomia and perineal injury (grades 3 and 4).

Preterm delivery is one of the most serious challenges of contemporary perinatology. Considering the multi factorial etiology of this issue, contemporary scientific approach addresses this topic as a Preterm Delivery Syndrome. If we exclude the congenital anomalies of the female reproductive system and iatrogenic causes, we can pinpoint infections, as one of the most important etiological factor for preterm delivery. The aim of the study is to determine the frequency of the histopathological changes of the placenta in patients with preterm delivery, to determine their stage and grade, according to the classification proposed by the Amniotic Fluid Infection Nosology Committee of the Perinatal Section of the Society of Pediatric Pathology (AFINCPSPP). Finally, to define the correlation between those changes and the gestational age, as well as the correlation between the degree of the histopathological changes and the time passed from the preterm premature rupture of the fetal membrane and the delivery. This cohort prospective study includes 30 patients delivered at the University clinic for Ob/Gyn in Skopje. We’ve selected the patients according to the previously determined inclusion and exclusion criteria: gestational age between 24+0-34+0 weeks of gestation (w.g), premature preterm rupture of the fetal membranes (pPROM), presence of uterine contractions, cervical dilatation of ? 2 cm determined by vaginal examination or shortening of the cervical length by > 50% determined by vaginal ultrasound.For the evaluation of the histopathological changes of the placenta, 6 samples were provided from four (4) zones of the placentas of the delivered women: chorionic plate, umbilical cord, border between amnion and chorion, and fetal membranes. Statistical analysis was performed on IBM SPSS Statistics software package, version 23.0. Probability of p?0.05 was considered statistically significant. Differences between descriptive variables were determined using Chi square and