Background: The study was conducted to determine the frequency, demographic characteristics, indication and fetomaternal outcome associated with emergency obstetric hysterectomy in a tertiary care center. Methods: Thirty cases of emergency obstetric hysterectomy performed during the five-year period from April 2011 to April 2016 were analyzed in the dept. of Gynae and obs. in Shri Guru Ram Rai Institute of Medical Sciences in Dehradun. Results: During the study period there were 30 cases of obstetric hysterectomy out of 8084 deliveries giving an incidence of 0.37%. Majority of the patients (60%) were unbooked and were in the age group of 26-30 (43.3%). Common parity group were 3, 4 and 5. Morbid adherent placenta was the most common indication contributing to 40% of the cases. There were four maternal deaths in the study. All were unbooked and three of them died of hypovolemic shock with cardiopulmonary arrest and one died of septicemia. Whereas there were 60% perinatal mortality and 26.66% NICU admissions. Conclusions: Emergency obstetric hysterectomy is a potentially lifesaving procedure which often puts obstetrician in dilemma at the time of decision making.

Background: Caesarean section is one of the commonest surgical procedures worldwide. Its upward trend and its indications in low resource setting makes regular appraisal of the practice necessary. Methods: A retrospective study. Labour ward logbook and case records were looked into, and all information extracted. Results: The prevalence of caesarean section in the study population was 32.18%. The most common indication of caesarean section was previous caesarean section (33%) followed by fetal distress (26.2%). Conclusions: Risk appraisal and all efforts must be geared towards reducing caesarean section rate. Certain measures have been recommended.

Background: Medical termination of pregnancy was legalized in India under the MTP act of 1971 which states that all the women can legally have an abortion up to 20 weeks of gestation if indicated. This study is a retrospective analysis of incidence, indication, the age group availing the facility, socio-demographic and obstetric profile of MTP seekers and the method of contraception followed after MTP.Methods: A retrospective 3-year data was analyzed by MTP register of the hospital as a reference.Results: The incidence rate of MTP is 96/1000 live births in the institute. The main reason for MTP is failure of contraception which highlights the unmet need of contraception and counselling. Majority of the age group availing MTP belonged to 16-20 years. Most of the women were   from urban slums, were illiterate and belonged to class IV and V according to Prasad’s classification. Mostly MTP seekers were parous, having ≥2 living children, and maximum no. of them went to private hospitals for their previous MTP. Medical method was the most favoured method of the care giver as well as of the patient. OCP was the choice of contraception after MTP. Religious difference is still very evident in availing   MTP services which can be minimized by tactful counselling. Conclusion: MTP act of 1971 opened new horizons for the unwanted pregnancies. Young population opting for MTP indicates the unmet need of contraception and counselling suggesting that implementation and integration of MTP services should be at the root level.

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Background: IOTA (International ovarian tumor analysis) study is considered one of the largest studies on ultrasound diagnosis of ovarian pathology conducted in literature till date. It was started in 1999 and included nine European countries. It is a standardized technique for preoperative classification of ovarian pathology defined by IOTA group.Methods: A retrospective study was analyzed from a period of January 2016 to December 2017 (2-year period). The records of all the patients operated for benign and malignant ovarian pathology in the gynae department of hospital were retrieved from medical record sections. USG findings were redefined as per IOTA simple rules by sonologist and its histopathological correlation was done using kappa statistical method.Results: In the present study, out of 61 patients IOTA was applicable to 57 patients. The sensitivity where IOTA simple rules were applicable was 92.8% and the specificity was 93%. The accuracy turned out to be 92.9%. If inconclusive results were taken as malignant then sensitivity increased to 94% and specificity decreased to 87%. Good level of agreement was found between sonological and histopathological findings with Kappa statistics application (K = 0.59).Conclusions: The IOTA simple rules can be considered as an important diagnostic modality in differentiation of benign and malignant ovarian tumors, it has an added advantage of abolishing the subjectivity of routine ultrasound. However inconclusive results demand further expertise in the field and need to be taken care of before interpretation of ovarian pathologies.