Background:-Nutritional anemia is one of major contributory factor in high maternal mortality and morbidity in third world countries. Iron deficiency is the principle cause for nutritional anemia. The aim of the study was to compare the efficacy of oral iron therapy with intravenous iron therapy in the treatment of iron deficiency anemia during postpartum period Material and Methods:-A clinical observational study was undertaken at tertiary care teaching hospital over a period of 15 months in one hundred recently delivered women. The baseline hemoglobin and serum ferritin levels were recorded prior to treatment. After completion of the treatment the women were followed up for changes in hemoglobin and serum ferritin levels on day 5, 14 and 40. Results :-.On day 5 of the intravenous iron group , there was statistically significant increase in serum ferritin level from 11.47 +1.655 µg/l to 41.44 +6.500 µg/l (p value <0.01), and the ferritin level remained elevated on day 14 and day 40. There was significant increase in mean Hb level from 7.76+0.7137 g/dl to 10.78+0.7679 g/dl on day 40 (p value < 0.01) in oral iron group. There was increase in mean Hb level from 7.47+0.7678 g/dl to 11.41+0.7908 g/dl on day 40 in injectable iron group, which was statistically significant. (p value < 0.01) Intravenous iron sucrose did not result in any serious adverse reactions. Conclusion:-Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin levels more rapidly ,without any serious adverse effect in comparison with oral ferrous sulphate in women with iron deficiency anemia in the postnatal period .

Introduction:-Maternal near-miss refers to situations, where women experience severe lifethreatening obstetric complications during pregnancy, delivery or post pregnancy, which they survive either by chance or because they receive good care at health facility. Cases of near-miss occur in larger numbers than maternal deaths. It has been estimated that up to 9 million women survive obstetric complications every year, and the consequences of these may be permanent and widereaching. Excessive hemorrhage during pregnancy or childbirth and severe hypertensive disorders contribute to large number of cases that result in to serious maternal morbidity. Case Report:-We present a case of a young primipara, who reported to hospital in a condition of hemorrhagic shock with history of cardiac arrest before admission. She had intractable atonic postpartum hemorrhage, following full term vaginal delivery in private nursing home. She was resuscitated and operated for emergency obstetric hysterectomy with bilateral internal iliac ligation. She developed disseminated intravascular coagulation, which was treated by aggressive blood and component therapy. She went home in a hemodynamic ally stable condition. Conclusion:-Every obstetrician should intelligently anticipate and keep oneself prepared to tackle the problem of intractable postpartum hemorrhage. Prompt and aggressive management of post partum hemorrhage will save many young lives. A saying ' Delay means death ' holds true for such emergency situation.

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