Background: Ovarian tumors are common form of neoplasm in women and account for 30% of female genital tract cancers. Ovarian cancer is the sixth most common cancer in women and the leading cause of death in women with gynaecological malignancy. Due to inefficient diagnosis/prognosis strategies mainly due to the lack of specific symptoms at the initial stage of the disease about 70% cases diagnose at advanced stage when the metastatic tumor has acquired drug resistant phenotype.Methods: Prospective study of two years duration with sample of 108 cases of simple oophorectomy and hysterectomy with unilateral or bilateral salpingo oophorectomy specimens are included in this study.Results: Maximum cases were in the age group of 21 to 45 years. Mean age of presentation was 42.84 years (benign tumors), 46.66years (Borderline tumors) and 32.6 years (malignant tumors). Epithelial ovarian tumors are the commonest and constituted 78.7% of all ovarian tumors. In present study 40.74% were benign, 2.78% were borderline and 56.48% were malignant ovarian tumors.Conclusions: Most of the ovarian neoplasms presented in the reproductive age group but ovarian malignancy can occur at all age group and abdominal symptoms are the only clue for the diagnosis of the disease. There is no definite universal screening protocol yet, for malignant ovarian tumors however abdominal symptoms supported by tumor markers like serum CA-125 and ultrasound of abdomen and pelvis with Doppler may be yardstick for early diagnosis of malignant ovarian tumor.

Background: Incidence of elderly primigravida has increased now days, due to rising education level, effective means of birth control and high carrier goals. The women who conceived in advanced age more than 35 years for first time is defined as elderly primigravida. Indian standard is fixed at more than 30 years by Dutta 2013. These women are high risk for maternal and foetal complication and outcome. The study was done to assess pregnancy outcome in elderly primigravida.Methods: This is a prospective hospital-based study done from October 2016 to November 2018. Women of reproductive age group with first pregnancy admitted to department of obstetrics and gynaecology, Veer Surendra Sai Institute of Medical Science and Research, Burla were taken after exclusion criteria.Results: The incidence of elderly primigravida was 2.51%. But majority (84.76%) though married early, conceived late. Most of them are belongs to high socioeconomic group (62.86%). Anaemia was commonest complication (28.57%), fibroid in 5.71% cases. Pre-eclampsia (18.09%), eclampsia (3.81%), IUGR (12.38%) and twin pregnancies (5.72%) were seen more frequently than young primigravida. 55.24% were developed complications during labour like foetal distress (33.33%), PPH (3.81%) and retained placenta (2.86%). Gestational diabetes mellitus in (0.95%), caesarean section rate 29.52%, normal delivery 51.42%, and congenital anomaly 8.15%.Conclusions: Elderly primigravida are high-risk for several complications like spontaneous abortion, preterm labour, prolonged labour, foetal distress, high caesarean rate, PPH, congenital anomaly and increased incidence of perinatal mortality. Majority of this patients properly supervised are capable of safe and successful pregnancies ending in healthy mother and healthy baby.

BACKGROUND Maternal near miss is an event where pregnant women come close to death but escape narrowly from missing, i.e. "near miss". Review of near miss cases has the potential to highlight the deficiency as well as the positive elements in the provision of obstetrics services in any health system. This study has been done to evaluate the frequency and to find out the determinants of maternal morbidity and mortality. METHODS Near miss cases were prospectively identified among all pregnant and recently delivered women with pregnancy related complications, who were admitted to the hospital and analysed in terms of MNM incidence ratio and maternal near miss to mortality ratio. Higher ratio indicates better care MNM:1MD. RESULTS Out of 16560 deliveries, 14272 were live births, 210 were suspected of near miss, 180 were confirmed hypertensive disorders (N=93,51.6%) haemorrhage (N=46,25.5%), sepsis (N=25 13.3%) and dystocia (N=12, 6.6%). 80.5% belonged to BPL category. 16.6% had 3 or more ANC while 83.3 had less than 3 ANC. After delivery 42.7% were in shock, 18.8% in PPH, 12.7% in sepsis/MODS, 3.3% in pulmonary oedema, 3.8% in HELLP/DIC. 92.7% cases had a duration of hospital stay of >7 days as compared to 7.3% with <7 days. The total maternal near miss ratio was 12.6 per 1000 live births. CONCLUSIONS The delay in referrals is a major cause of morbidity and mortality. Establishment of a tertiary care center in each district is essential. Delayed diagnosis, inappropriate transfer, and inadequate utilization of resources might have been the cause for maternal morbidities and mortalities in our study.