OBJECTIVEStudy is to determine the incidence, indications of obstetric hysterectomy, maternal morbidity and maternal mortality associated with emergency obstetric hysterectomy at a tertiary hospital, Karad. This will help to highlight the lack of availability and inadequate utilisation of antenatal services. This will help to identify avoidable factors and stress factors; those need to organise health care services so as to improve maternal and foetal outcome. MATERIAL AND METHODSA retrospective analysis of 30 cases of emergency hysterectomies done for obstetric indications from JULY 2010 to JUNE 2015 was done. Indications for hysterectomy and causes of maternal morbidity and mortality were studied. RESULTSThere were 30 cases of emergency hysterectomies amongst 19,635 deliveries during the period of study giving an incidence 0.15%, i.e. 1 in 654 deliveries. CONCLUSIONThe presence of risk factors like placenta previa, accreta, previous LSCS should facilitate referral or transfer of patients to a tertiary care hospital. When conservative measures like haemostatic sutures, internal iliac artery ligation, embolization is not feasible or has failed obstetric hysterectomy is performed without delay, in which delay would contribute to the maternal morbidity and in unfortunate cases mortality. Special provisions of blood components, dialysis facility and ventilator support associated with availability of experienced obstetrician, anaesthetist, neonatologist, physician and surgical services are necessary round the clock. Training of obstetrician in obstetric hysterectomy is very much necessary to reduce morbidity and mortality.

BACKGROUNDEctopic pregnancy is a significant cause of morbidity and mortality in the first trimester of pregnancy. Treatment with Methotrexate (MTX), an antimetabolite chemotherapeutic agent that binds to the enzyme dihydrofolate reductase, which is involved in the synthesis of purine nucleotides. This interferes with DNA synthesis and disrupts cell multiplications, achieves results comparable to surgery for treatment of appropriately selected ectopic pregnancies. Surgery is specifically indicated in ruptured ectopic and when MTX is contraindicated. Aim-To evaluate the medical management of Ectopic pregnancy in tertiary care hospital.