The River Sava as a Resource in Spatial Planning

Promatrana s aspekta prostornog planiranja, rijeka Sava je prostor sučeljavanja određenih prostornih, prirodnih i gospodarskih odrednica. Pravilno i svrsishodno planiranje ima neprocjenjivo značenje upravo zato što se jedino na takav način prostor rijeke može urediti za racionalno korištenje. Valja istaknuti da racionalno korištenje podrazumijeva i zaštitu ukupnih vrijednosti ovoga prostora. Posebnu pozornost potrebno je posvetiti definiranju prostornog obuhvata plana takvoga specifičnog prostora. Naime, postojeći prostorni planovi koncipirani su na način da im je rijeka Sava granica, a ne okosnica. Takav pristup, potaknut transgraničnom problematikom susjednih država, poglavito Hrvatske i BiH, onemogućuje racionalno korištenje, razvoj i zaštitu prostora. Preduvjeti pravilnog procesa planiranja područja rijeke Save su vrjednovanje i određivanje zajedničkih kriterija i elemenata korištenja ovoga prostora. To posljednje odnosi se na političke okolnosti jer se radi o rijeci koja protječe kroz nekoliko susjednih država. Dakle, radi se o prostornom planiranju koje, u slučaju rijeke Save, ima nadnacionalnu važnost jer svaki pogrješan korak dovodi u opasnost uravnoteženi i održivi razvoj širega prostora. Uzimajući u obzir svu složenost navedene problematike, svrha je ovoga rada dati doprinos razumijevanju procesa prostornog planiranja na način da ono rezultira održivim upravljanjem i razvojem savskog prostora.From the spatial planning aspect the river Sava is the meeting area of numerous spatial, natural and economic determinants. Appropriate and purposeful planning has an inestimable importance due to the fact that it is the only way for the rational utilization of the river basin. It should be emphasized that rational utilization also includes the overall protection of mentioned area. Special attention should be dedicated to the problem of defining spatial plan borders, because of the specific characteristics of the area. Namely,current spatial plans of the river Sava basin are outlined in a way that Sava river is their border instead of their skeleton. That approach, induced by cross-border issues between the neighbouring countries, especially Croatia and Bosnia and Herzegovina, disables the rational utilization, development and protection of the area. The preconditions of purposefully planning process of the Sava river are evaluation and determination of the common utilization of criteria and elements of the area. The latter refers to political circumstances since the river Sava flowsthroughseveral neighbouring countries. Consequently, it is a question of a spatial planning which, in case of the Sava river, has above-national importance because every faulty step jeopardizes balanced and sustainable development of a wide area. Taking into consideration the whole complexity of above mentioned, the main aim of this paper is to give contribution to the understanding of the spatial planning process in the way that planning, by itself, results in the sustainable management and development of the Sava river area

Utjecaj demogeografskih procesa na transformaciju đakovačkog kraja

U posljednjem stoljeću došlo je do velikih demogeografskih i gospodarskih promjena koje su snažno utjecale na transformaciju kulturnog pejsaža Đakovštine. Demogeografske promjene su jasno vidljive i odnose se na smanjenje ukupnog broja stanovnika, gustoće te na daljnje pogoršanje razmještaja, prirodnog kretanja i migracije, kao i negativne promjene u strukturnim obilježjima stanovništva. Depopulacija je dominantan proces, a sadašnje društveno-gospodarsko stanje ne pruža mogućnosti skore i brze demografske te ukupne društveno-gospodarske revitalizacije ovog dijela Hrvatske

Mehanizam u žarištu potresa od 25. studenog 1986. pokraj Knina

y analyzing the P-wave first motion polarities we have obtained the fault plane solution for the Knin earthquake of 25 November 1986. The fault plane/auxiliary plane ambiguity was resolved by comparing the solutions to the known geological features of the area. We were able to obtain practically the same result by modeling the first 10 s of the P-wave as recorded on the broad-band instrument at GRF, thus confirming the relatively poorly constrained classical solution parameters. The earthquake has probably occurred on the northern section of the NW-SE striking right lateral reverse Knin fault. The pressure axis corresponding to the fault plane solution does not lie in the direction of the regional compressional stress filed as reported by others, thus indicating strong deformation of the local stresses that is probably the result of interaction of numerous block structures present in that area

Dynamische demografische Determinanten der Stadt-Land- Polarisierung in der Gespanschaft Osijek-Baranja (1971–2001)

U ovome su radu prikazane i analizirane osnovne odrednice dinamike urbanoga i neurbanoga stanovništva Osječko-baranjske županije u međupopisnom razdoblju od 1971. do 2001. godine. Prostorno-populacijska polarizacija urbanih (gradskih) i neurbanih (ruralnih ili seoskih i urbaniziranih, odnosno prijelaznih ili mješovitih) naselja promatrana je sa stajališta demografskoga stanja i procesa. Osnovna smjernica istraživanja jest u utvrđivanju stupnja polarizacije između urbanih i neurbanih naselja, ali i u povezivanju dobivenih razlika s prostornom strukturom Osječko-baranjske županije. Demografska stvarnost Osječko- baranjske županije, ali i Hrvatske u cjelini, obilježena je sve izraženijim procesima ukupne i prirodne depopulacije, kao i emigracije. Negativnost navedenih procesa posebno se vidi u poremećaju dinamičkih značajki razvoja stanovništva. Proces demografskoga starenja zahvatio je gotovo sva ruralna naselja županije, a i u gradskim naseljima sve je izraženija degradacija bioreprodukcijskoga potencijala. Uzimajući u obzir različite demografske razvojne tendencije urbanih i ruralnih naselja, ali i sve izrazitije prostorne razlike populacijski propulzivnijih i zaostalijih područja u okviru županije, svrha istraživanja jest utvrditi u kojoj su mjeri negativni populacijski procesi zahvatili određene skupine naselja s aspekta urbanizacije, ali i prostornog razmještaja.The article shows and analyses basic determinants of the dynamics of the urban and non-urban (mainly rural) population of Osijek-Baranja County, Croatia, in the period from 1971 – 2001. The demographic situation and processes related with the spatial and population polarization of urban and non-urban settlements is investigated. The basic aim of the research is to determine the degree of polarization between urban and non-urban settlements in the mentioned county. It is also important to compare the results of the research with the spatial structure of Osijek-Baranja County. The demographic situation of the researched county, as well as of Croatia in general, is marked by increasing processes of depopulation and emigration. The negativity of the mentioned processes is particularly notable in the disorder of the population dynamics. The process of demographic ageing is present in almost all settlements and due to it, the bio-reproductive potential of the entire county is reduced. The article aims to determine to what extent the negative demographic processes have affected certain groups of settlements from the aspect of urbanization and spatial distribution. It is important that various tendencies of population development for both urban and non-urban settlements are considered in the research.In dieser Studie werden die Grundrichtungen in den Bewegungen der städtischen sowie nicht-städtischen Bevölkerung auf dem Raum der Gespanschaft Osijek- Baranja zwischen 1971 und 2001 (den Volkszählungsjahren) dargestellt und analysiert. Die räumliche Polarisierung zwischen urbanen (städtischen) und nicht-urbanen (dörflichen und gemischten, d.h. urbanisierten) Lebensräumen wurde unter dem Aspekt demografischer Zustände und Wandel untersucht. Das Hauptanliegen der Verfasser ist dabei, den Grad der Polarisierung zwischen urbanen und nicht-urbanen Lebensräumen zu ermitteln, ferner sollen die gewonnenen Daten in Bezug zur Raumstruktur der Gespanschaft Osijek- Baranja gesetzt werden. Die demografische Realität der genannten Gespanschaft, aber auch ganz Kroatiens, ist durch immer ausgeprägtere Prozesse einer umfassenden und natürlichen Entvölkerung sowie Abwanderung gekennzeichnet. Die negative Auswirkung dieser Prozesse ist besonders daran zu sehen, dass die dynamischen Merkmale in der Bevölkerungsentwicklung der Gespanschaft aus dem Gleichgewicht geraten sind. Der demografische Alterungsprozess hat nahezu alle ländlichen Wohngebiete der Gespanschaft erfasst, aber auch in den Städten ist die Schwächung des bioreproduktiven Potenzials immer stärker spürbar. Ausgehend von den genannten unterschiedlichen demografischen Entwicklungstendenzen, die in städtischen wie ländlichen Gegenden zu beobachten sind, aber auch von den immer krasseren Unterschieden zwischen populationspropulsiven Lebensräumen einerseits und rückständigen Gebieten innerhalb der genannten Gespanschaft andererseits, wollten die Verfasser ermitteln, in welchem Maße bestimmte Lebensräume hinsichtlich Urbanisierungsgrad und Bevölkerungsdichte von den angeführten negativen Populationsprozessen erfasst worden sind

Dynamics of Osijek Population from 1857 to 2001

U ovome su radu prikazane i analizirane osnovne determinante dinamike razvoja stanovništva grada Osijeka u 144-godišnjem razdoblju, između 1857. i 2001. godine. Dinamika stanovništva promatrana je kroz relevantne analitičke i sintetičke demografske pokazatelje. Ukupno i prirodno kretanje stanovništva i migracijska bilanca poslužili su za dobivanje uvida u prevladavajuće demografske procese u gradu Osijeku. Ustanovljeni su procesi postupne demografske regresije u vidu smanjenja prirodnog priraštaja kombiniranim utjecajem pada nataliteta, demografskog starenja i emigracije stanovništva. Negativni demografski procesi posebno do izražaja dolaze u drugoj polovici 20. stoljeća da bi njihova kulminacija nastupila u vrijeme ratnih zbivanja ranih 1990-ih godina. Utjecaji rata, bili oni izravni ili neizravni, zadali su snažan udarac već ionako uzdrmanoj demografskoj dinamici stanovništva Osijeka. Proces populacijske decentralizacije također je bitno obilježje razvoja stanovništva grada, a izražen je kroz postupno povećavanje udjela stanovništva prigradskih naselja u ukupnom stanovništvu grada. Grad Osijek, kao jezgra populacijskog i društveno-gospodarskog razvoja Slavonije i Baranje, generirao je proces postupne suburbanizacije, naročito u drugoj polovici 20. stoljeća kada se ukupan broj stanovnika Osijeka više nego udvostručio, a stanovništvo njegovog suburbanog područja utrostručilo. Nepovoljna obilježja demografske dinamike potvrđuju prisutnost snažne biološke, a naročito emigracijske depopulacije grada Osijeka, koje će, unatoč relativno povoljnijem stanju u pojedinim naseljima, u budućnosti biti snažna prepreka normalnom društveno-gospodarskom razvoju.The paper presents and analyses basic development dynamics determinants of population of Osijek for the period of 144 years from 1867 to 2001. Population dynamics has been observed through relevant analytic and synthetic demographic indicators. General and natural movement of population and migration balance sheet have been used to get an insight into prevailing demographic processes in the city of Osijek. The processes of gradual demographic regression have been established in form of decline of natural growth by combined infl uence of demographic senescence and population emigration. Negative demographic processes manifested in the second half of the 20th century and reached the culmination in the time of Homeland war in the early 1990s. War impact, both direct and indirect, delivered a sharp blow to the already shaken demographic dynamics of the population of Osijek. The process of population decentralisation is another important feature of city population development and is expressed through gradual increase of share of suburbian population in city population total. The city of Osijek, as a core of population and social-economic development of Slavonia and Baranja generated the process of gradual suburbanisation, in particular in the second half of the 20th century when the total number of inhabitants of Osijek more than doubled while population of its suburban area tripled. Unfavourable features of demographic dynamics confi rm the presence of strong biological and especially emigrational depopulisation of the city of Osijek, which in spite of the relatively favourable position in some settlements will in future be a large obstacle to normal socialeconomic development

Polarization between Urban and Non-urban Settlements in Karlovac County based on the Population Dynamics in Period (1971.—2001.)

U radu su prikazane i analizirane osnovne značajke ruralno-urbane polarizacije Karlovačke županije temeljene na dinamici stanovništva, u razdoblju od 1971. do 2001. godine. Prostorno-populacijska polarizacija između urbanih (gradskih) i urbaniziranih (prijelaznih) naselja s 1000 i više stanovnika s jedne strane i neurbanih (ruralnih ili seoskih) naselja s druge strane promatrana je sa stajališta demografske dinamike. Osnovna smjernica analize jest utvrđivanje stupnja polarizacije između urbanih (s uključenim urbaniziranim naseljima) i neurbanih naselja, ali i povezivanju dobivenih razlika s prostornom strukturom Karlovačke županije. Urbanizirana (prijelazna) naselja razmotrena su objedinjeno s urbanim naseljima. Promatrani prostor ima izrazito nepovoljna populacijsko-naseljska obilježja što se posebno očituje u negativnim i opadajućim značajkama dinamike stanovništva. U prevladavajućim, izrazito nepovoljnim, obilježjima populacijske dinamike nije moguće ostvariti ravnomjeran razvoj Županije. Uzimajući u obzir različite demografske razvojne tendencije urbanih i ruralnih naselja, ali i sve izrazitije prostorne razlike populacijski propulzivnijih i zaostalijih područja u Županiji, svrha analize jest utvrditi u kojoj su mjeri negativni populacijski procesi zahvatili određene skupine naselja s aspekta urbanizacije, ali i prostornog razmještaja.The article shows and analyses basic determinants of the polarization between urban and urbanized settlements (with population in the year 2001 of 1000 and more) at one side and non-urban settlements on the other side based on population dynamics in the period (1971-2001). Spatial and population polarization of urban (together with urbanized settlements) and nonurban settlements is investigated from the aspect of demographic dynamics. The basic aim of the research is to determine a degree of the polarization between the group of urban and urbanized settlements and the group of nonurban settlements in the mentioned county. It is also important to compare the results of the research with the spatial structure of Karlovac County. Urbanized settlements are shown within the group of urban settlements. Investigated area has a very negative determinants in the aspect of the population and settlements which are especially expressed in a negative and declining characteristics of the population dynamics. In a predominating and overcoming, expressively negative, features of the population dynamics it is almost impossible to achieve well-balanced development of Karlovac County. The article aims to determine to what degree have the negative demographic processes affected certain groups of settlements from the aspect of urbanization and spatial distribution. It is important that in the research various tendencies of population development for both urban (with included urbanized settlements) and non-urban settlements are considered

Dynamische demografische Determinanten der Stadt-Land- Polarisierung in der Gespanschaft Osijek-Baranja (1971–2001)

U ovome su radu prikazane i analizirane osnovne odrednice dinamike urbanoga i neurbanoga stanovništva Osječko-baranjske županije u međupopisnom razdoblju od 1971. do 2001. godine. Prostorno-populacijska polarizacija urbanih (gradskih) i neurbanih (ruralnih ili seoskih i urbaniziranih, odnosno prijelaznih ili mješovitih) naselja promatrana je sa stajališta demografskoga stanja i procesa. Osnovna smjernica istraživanja jest u utvrđivanju stupnja polarizacije između urbanih i neurbanih naselja, ali i u povezivanju dobivenih razlika s prostornom strukturom Osječko-baranjske županije. Demografska stvarnost Osječko- baranjske županije, ali i Hrvatske u cjelini, obilježena je sve izraženijim procesima ukupne i prirodne depopulacije, kao i emigracije. Negativnost navedenih procesa posebno se vidi u poremećaju dinamičkih značajki razvoja stanovništva. Proces demografskoga starenja zahvatio je gotovo sva ruralna naselja županije, a i u gradskim naseljima sve je izraženija degradacija bioreprodukcijskoga potencijala. Uzimajući u obzir različite demografske razvojne tendencije urbanih i ruralnih naselja, ali i sve izrazitije prostorne razlike populacijski propulzivnijih i zaostalijih područja u okviru županije, svrha istraživanja jest utvrditi u kojoj su mjeri negativni populacijski procesi zahvatili određene skupine naselja s aspekta urbanizacije, ali i prostornog razmještaja.The article shows and analyses basic determinants of the dynamics of the urban and non-urban (mainly rural) population of Osijek-Baranja County, Croatia, in the period from 1971 – 2001. The demographic situation and processes related with the spatial and population polarization of urban and non-urban settlements is investigated. The basic aim of the research is to determine the degree of polarization between urban and non-urban settlements in the mentioned county. It is also important to compare the results of the research with the spatial structure of Osijek-Baranja County. The demographic situation of the researched county, as well as of Croatia in general, is marked by increasing processes of depopulation and emigration. The negativity of the mentioned processes is particularly notable in the disorder of the population dynamics. The process of demographic ageing is present in almost all settlements and due to it, the bio-reproductive potential of the entire county is reduced. The article aims to determine to what extent the negative demographic processes have affected certain groups of settlements from the aspect of urbanization and spatial distribution. It is important that various tendencies of population development for both urban and non-urban settlements are considered in the research.In dieser Studie werden die Grundrichtungen in den Bewegungen der städtischen sowie nicht-städtischen Bevölkerung auf dem Raum der Gespanschaft Osijek- Baranja zwischen 1971 und 2001 (den Volkszählungsjahren) dargestellt und analysiert. Die räumliche Polarisierung zwischen urbanen (städtischen) und nicht-urbanen (dörflichen und gemischten, d.h. urbanisierten) Lebensräumen wurde unter dem Aspekt demografischer Zustände und Wandel untersucht. Das Hauptanliegen der Verfasser ist dabei, den Grad der Polarisierung zwischen urbanen und nicht-urbanen Lebensräumen zu ermitteln, ferner sollen die gewonnenen Daten in Bezug zur Raumstruktur der Gespanschaft Osijek- Baranja gesetzt werden. Die demografische Realität der genannten Gespanschaft, aber auch ganz Kroatiens, ist durch immer ausgeprägtere Prozesse einer umfassenden und natürlichen Entvölkerung sowie Abwanderung gekennzeichnet. Die negative Auswirkung dieser Prozesse ist besonders daran zu sehen, dass die dynamischen Merkmale in der Bevölkerungsentwicklung der Gespanschaft aus dem Gleichgewicht geraten sind. Der demografische Alterungsprozess hat nahezu alle ländlichen Wohngebiete der Gespanschaft erfasst, aber auch in den Städten ist die Schwächung des bioreproduktiven Potenzials immer stärker spürbar. Ausgehend von den genannten unterschiedlichen demografischen Entwicklungstendenzen, die in städtischen wie ländlichen Gegenden zu beobachten sind, aber auch von den immer krasseren Unterschieden zwischen populationspropulsiven Lebensräumen einerseits und rückständigen Gebieten innerhalb der genannten Gespanschaft andererseits, wollten die Verfasser ermitteln, in welchem Maße bestimmte Lebensräume hinsichtlich Urbanisierungsgrad und Bevölkerungsdichte von den angeführten negativen Populationsprozessen erfasst worden sind

Veränderungen in der Bildungsstruktur der Bevölkerung der Gespanschaft Karlovac (1981–2001)

Od 1981. do 2001. godine dogodile su se osjetne promjene u obrazovnoj strukturi Karlovačke županije. Vidi se postupno poboljšanje obrazovnih strukturnih značajki stanovništva. Promjene u obrazovnoj strukturi valja promatrati u svjetlu njihove interakcije s ostalim demografskim procesima, posebno procesima depopulacije te demografskoga starenja. Žarište istraživanja ovoga rada usmjereno je na objašnjavanje i razumijevanje promjena obrazovne strukture te utvrđivanje stupnja povezanosti negativnih demografskih procesa i razine obrazovanosti stanovništva. Obrazovanost stanovništva ove županije nalazi se ispod hrvatskoga prosjeka. Promjene u obrazovnoj strukturi valja promatrati s aspekta ukupne gospodarske situacije u Karlovačkoj županiji, jer snažna povezanost demografskih i društveno-gospodarskih procesa posebno dolazi do izražaja u slučaju njezina razmatranja. Dakako, intenzivan utjecaj na demografske i društveno- -gospodarske procese imala su ratna zbivanja na prostoru Karlovačke županije tijekom 1990-ih. Dugotrajno iseljavanje stanovništva poprimilo je još veće razmjere tijekom velikosrpske agresije na promatrani prostor, što je negativno utjecalo na obrazovnu strukturu promatranoga prostora.In the period between 1981 and 2001 significant changes in the educational structure of the population of Karlovac County occurred. The improvement in the educational structure of the population is noticeable. The changes in the educational structure of the population should be seen in the interaction with other demographic processes (especially depopulation and population ageing). The focus of this paper is based on the explanation and understanding of changes in the educational structure of the population and its correlation with negative demographic processes. There is a strong correlation between the economic situation and demographic trends which affects the educational structure of the population. The Croatian Homeland War had an intense influence on the demographic and socio-economic situation during the 1990s. The long-lasting process of emigration was intensified during Serbian aggression on the researched county, which had negative consequences on the educational structure of the population.In der Zeit von 1981 bis 2001 ist es zu spürbaren Veränderungen in der Bildungsstruktur innerhalb der Gespanschaft Karlovac gekommen, und zwar im Sinne einer allmählich voranschreitenden Verbesserung. Diese Wandel sind im Rahmen des Wechselverhältnisses mit anderen demografischen Vorgängen zu betrachten, insbesondere mit Prozessen der Entvölkerung und der demografischen Alterung. Die vorliegende Arbeit fokussiert sich auf das Verständnis und die Erläuterung der gewandelten Bildungsstruktur sowie auf die Beantwortung der Frage, inwiefern negative demografische Prozesse mit dem Bildungsniveau der Bevölkerung verbunden sind. Der Bildungsgrad der Menschen in der Gespanschaft Karlovac liegt unterhalb dem kroatischen Durchschnitt. Die jüngsten Wandel müssen unter dem Aspekt der gesamtwirtschaftlichen Lage in dieser Gespanschaft betrachtet werden, da die Interaktion zwischen demografischen und gesellschaftlichwirtschaftlichen Prozessen gerade hier besonders deutlich spürbar ist. Einen besonders großen Ausschlag gab natürlich das Kriegsgeschehen der 90er-Jahre des 20. Jahrhunderts. Die Entvölkerung, die lange vor dem Krieg in dieser Gespanschaft eingesetzt hatte, nahm im Laufe des großserbischen Aggressionskriegs noch größere Ausmaße an und wirkte sich negativ auf die Bildungsstruktur der Bevölkerung aus

Population Ageing as the Limitation Factor of the Demographic Development of Žumberak Region, Croatia

Suvremeni demografski razvoj Žumberka reflektira duboko ukorijenjene utjecaje dosadašnjeg vrlo specifičnog demografskog, društvenog i gospodarskog razvoja. Reljefna raščlanjenost prostora s dominantnim brdsko-planinskim morfostrukturnim obilježjima, granični položaj, nedovoljna prometna povezanost i gospodarska nerazvijenost kroz prošlost sve do danas znatno su otežavali društveno-gospodarski i s njim neraskidivo povezani demografski razvoj Žumberka. Dugotrajni proces ukupne depopulacije u obliku kontinuirane emigracije stanovništva u bioreproduktivnoj dobi te s tim povezani negativni biodinamički populacijski procesi utjecali su izrazito negativno na strukturna obilježja stanovništva Žumberka. Smanjeni priljev stanovništva u fertilnu dob postupno je doveo do smanjenja nataliteta, a sve veći udio staroga stanovništva podizao razinu mortaliteta. Stoga je Žumberak u pogledu demografske biodinamike postao prostor snažne biološke depopulacije stanovništva. Starenje stanovništva Žumberka kao dominantan demografski proces inducira daljnje negativne dinamičke i strukturne populacijske procese. Zbog dominantnog utjecaja na formiranje fertilnog i radnog kontingenta stanovništva demografsko je starenje značajna prepreka budućim demografskim i društveno-gospodarskim zbivanjima. Sve nepovoljniji odnos mladog i starog stanovništva Žumberka implicira povećanu potrebu za mirovinskim, socijalnim i zdravstvenim izdvajanjima što dodatno opterećuje gospodarstvo toga slabo razvijenoga prostora. Nedostatak temeljne infrastrukture, nedovoljna ponuda radnih mjesta te nedostatak radno aktivnog stanovništva ne pružaju mogućnosti za revitalizaciju i razvoj promatranog prostora.Contemporary demographic development of Žumberak reflects the deeply rooted influences of very specific historical and socio-economic development. The relief dynamics with the predominant mountainous morphostructural characteristics, together with the peripheral border location and bad traffic infrastructure have had a key role in the forming of existing negative demographic situation. The long lasting processes of total depopulation, emigration of the reproductive age population, as well as decrease of natality, have very negatively affected the forming of the structures of the population. The reduced influx of the population into fertile age, caused by emigration and reduced natality contributed the further drop of natality. The increase of the percentage of old population resulted in increased mortality. Therefore, Žumberak became the area of strong biological depopulation. The population ageing, as the main demographic process induces the further negative processes in the population dynamics and structures. The population ageing is the major obstacle in the forming of future working and fertile population contingent, which has negative effect to the entire socio-economic development. Due to the population ageing more funds are needed for the social and health care which additionally burdens the weak economy of Žumberak an Croatia in general. The lack of basic infrastructure, insufficient employment potentials, and old population are bad starting point for revitalisation and development of the researched region

Multidisciplinary approach in the management of pregnancy with placenta accreta spectrum disorder - Case report

From the histopathologic perspective Placenta accreta spectrum (PAS) shows the absence of the normal intervening decidua and invasion of the placenta into the myometrium. There is placenta accreta with the chorionic villi attach directly to the surface of the myometrium in the absence of the decidual layer and placenta increta when the chorionic villi penetrate deeply into the myometrium reaching the external layer. There is also placenta percreta where the invasive chorionic villi reach and penetrate through the myometrium to uterine serosa and it is nowadays the most common reason for peripartum hysterectomy (1). Drawing the line between these subtypes is not always easy, especially in the clinical situations when the invasiveness of the placenta is not known before the delivery (2). The maternal and fetal outcomes are improved upon appropriate antepartum diagnosis and care by multidisciplinary experts with experience in PAS treatment (3). Here we present a pregnancy and multidisciplinary delivery management of a 40-year-old female, gravida V, para IV, with history of the three cesarean sections, in 36+2 weeks of gestation in a tertiary academic teaching hospital. We confirmed suspected PAS antenatally based on ultrasound and magnetic resonance imaging (MRI). Preoperative preparation included the ensuring of blood products availability, the use of arterial occlusion balloons to reduce hemorrhage, and the use of double JJ stent to prevent ureteral injuries. We performed a cesarean section with immediate uterine amputation due to severe bleeding, after which the patient fully recovered. If PAS timely suspected and confirmed intraoperatively, the best maternal and neonatal outcome is achieved by the multidisciplinary approach that enables adequate elective procedure