Objectives: The goal of this study is to explore methods for minimizing mortality and morbidity in the context of a morbidly adherent placenta. Study Design: A descriptive observational case series. Place and Duration: This is two-year study was held in the Obstetrics and Gynecology department of Khyber Teaching Hospital Peshawar from January 2018 to January 2020. Methods: There are 36 females included in this study who have morbidly adherent placenta. The surgical procedure, antenatal diagnosis, quantity of blood loss, organ damage, blood transfusion, hospitalization, ICU and postnatal problems are all evaluated in these patients. SPSS version 21 was used to analyze and evaluate the data. Results: Ultrasound and colour Doppler were used to diagnose 30 patients antenatally. Six of them were revealed during surgery, nine of them had a severe hemorrhage, and five to ten units of blood were transfused. Three of the undiagnosed patients suffered a bladder injury, ten were admitted to the hospital, and two required ventilator support. In 26 patients, hysterectomy was performed, while four patients had conservative surgery. There were no cases of maternal or newborn death. Conclusion: Mortality and Morbidity may be reduced by increasing the index of suspicion, performing prenatal diagnostics, anticipating large volume blood transfusions, and performing planned hysterectomy with a fundal classical incision without disturbing the placenta. It is important to be aware of the possibility of a morbidly adherent placenta, just as it is important to be aware of other obstetric crises. Keywords: previous C-section Scar, morbidity, mortality, hysterectomy, morbidly adherent placenta

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Objective: Aim of current study is to determine the prevalence maternal iron deficiency anemia with lower ferritin level of new born among pregnant women. Study Design:Cross-sectional study Place and Duration:The study was conducted at Gynae and Obs department of Mufti Mehmood Teaching Hospital, D I Khan for duration of six months from January 2021 to June 2021. Methods: There were one hundred and thirty pregnant women were included in this study. Women were aged between 18-45 years. Data on enrolled patients' ages, BMIs, and educational attainment levels were collected after informed written consent was obtained. At birth, the umbilical cord and the mother's blood were taken for a Complete Blood Count (CBC) to measure haemoglobin and serum ferritin levels in both the mother's and her baby's bloodstream.SPSS 23.0 used to analyze complete data. Results: The mean age of the females were 29.14±5.87 years with mean BMI 25.4±7.44 kg/m2. Most of the females were not educated 80 (61.5%). Mean hemoglobin level of mothers were 116.9±34.66 g/L and with mean serum ferritin level 19.6±8.52 ng/mL. Frequency of iron deficiency anemia (Hb< 110 g/L ) was found among 70 (53.8%) cases with low serum ferritin < 15 ng/mL). Among 70 cases, 40 (57.1%) cases had mild anemia, moderate anemia found in 18 (25.7%) patients and severe anemia found in 12 (17.1%) cases. Among anemia patients mean ferritin level was 13.9±16.6 ng/mL with mean hemoglobin 87.5±12.34 g/L. Mean gestational age of new born were 36.8±12.43 weeks. Mean weight of the infants were 2534.23±5.2 grams. Conclusion: We concluded in this study that strongly association of iron deficiency anemia with low ferritin level. Maternal anemia is a serious health problem in which life of pregnant women and her child are endangered. Keywords: Anemia, Pregnant Women, Serum Ferritin, Hemoglobin, New born

Treatment of severe pelvic bleeding remains a major challenge in obstetrics and Gynecology. In this situation, an attempt was made with variable success at bilateral internal iliac artery ligation (BIAL). Aim: The purpose of this study was to evaluate the effectiveness of this procedure in females with intractable pelvic hemorrhage. Methods: This observational study was conducted at the Department of Obstetrics and Gynecology of Mufti Mehmood Teaching Hospital D I Khan for one year duration from January 2021 to December 2021. During the study period, a total of 35 emergency internal iliac arteries ligation and, if necessary, gradual uterine de-vascularization or cesarean hysterectomy were performed as a life-saving procedure. Results: Haemotasis was successfully achieved in 33 patients. Of the 35 patients who required a cesarean hysterectomy, two patients died of multiple organ dysfunction following the hysterectomy. However, no complications related to BIAL were observed in any of the other patients. The mortality rate was 5.7% in this study. Conclusions: In our study, BIAL was recognized as a safe and effective treatment procedure for life-threatening obstetric haemorrhage. But for unknown reasons, the procedure is much less practiced than other radical options. Keywords: ligation of internal iliac artery, emergency, pelvic bleeding