Adenomyosis is an estrogen dependent benign gynecological disease affecting women of reproductive age causing them to have an adverse effect. Symptoms in these patients include pelvic pain, menorrhagia, abnormal uterine bleeding and infertility. It has a negative impact on a woman’s reproductive ability. The gold standard treatment for adenomyosis is hysterectomy for whom fertility is not an issue and for whom future pregnancy has no concerns, however females who wish to retain uterus for child bearing purposes the treatment seems to be very challenging. In this literature we will focus on how adenomyosis affects the reproductive outcome in women and what is its impact on the pregnancy rate also we will enlighten the pregnancy outcomes and pregnancy rate in patient with adenomyosis after various treatment Including the medical, surgical and in-vitro fertilization.

Postpartum hemorrhage is a potentially lethal, hazardous whilst preventable condition making it the significant cause of maternal mortality. It is defined as loss of blood greater than 500ml in a normal delivery and more than 1000ml in C-section in the first 24 hours. One third and one fourth of the death that occurs is due to postpartum hemorrhage, Among the various causes of Postpartum hemorrhage (PPH), uterine atony is the most common cause involved in 80% of the cases. Hypovolemic shock, DIC, hepatorenal syndrome and acute distress syndrome are some of the complications in women who encounter massive postpartum hemorrhage. Death occurs in women in whom timely adequate emergency measures were not taken. Life can be saved when immediate measures are taken. When uterine atony is observed administration of utero tonic drugs such as oxytocin and prostaglandin, uterine massage, uterine compression technique and intrauterine balloon tamponade is used. When hemostasis is not achieved by conservative method then, TAE or surgical management including (vessel ligation, bilateral ligation of the uterine or internal iliac arteries), uterine compression suture, and hysterectomy is implemented in refractive cases without any further delay.