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To find the frequency of gestational diabetes in pregnant women using 50 grams glucose challenge test. Study design: a descriptive study.

Objectives: To find the frequency of gestational diabetes in pregnant womenusing 50 grams glucose challenge test. Study design: a descriptive study. Place and duration:Department of Obstetrics and Gynecology, Lady Atchison Hospital, Lahore from August 2012to August 2013. Methodology: Through non-probability convenient sampling, 200 pregnantwomen between 24-28 weeks of gestation were studied. All known diabetic patients wereexcluded from the study. Pulse, BP, weight and height were recorded and Body Mass Index wascalculated. Physical and antenatal examination were done. Patients were given 50 gm glucosedissolved in 200 ml of water without any dietary preparation. Glucose levels were measuredin venous plasma after one hour according to American Diabetic Association protocol. Bloodglucose level more than 140mg/dl was diagnosed as screened positive and less than 140mg/dl screened negative. The data analysis was analysed by SPSS 20. Results: Out of total 200women studied, 28 (14%) had abnormal screening test while 172 (86%) had normal test. Historyof obstetric complications was noted in 10 (5%) women. PIH was noted in 19 (19.5%) andpast history of GDM was present in 14 (8.13%). Mean age of patients screened positive was25.03 ± 2.9 years. Gestational age of positive group ranged between 19 to 32 weeks. Meangestational age was 26.17+3.37 weeks. Among screened positive women, 7 (25%) womenwere primigravida while 21 (75%) women were multigravida. Conclusion: Significant riskfactor associated with GDM include family history of DM, maternal obesity, previous history ofobstetric complications. Failure to recognize and treat the GDM results in maternal and fetalmorbidity and mortality.

… Background: All over the world the rate of caesarean section is increasing day by day due to multiple factors and Pakistan is no exception to it. According to World Health Organization (WHO) the rate of caesarean section varies from 5% to 15%. This rate of C-section is acceptable to WHO and is considered as justifiable which differs from country to country due to diverse socio economic conditions, literacy rate, medico legal issues as well as availabilities of health care facilities to patients and especially antenatal facilities. Objectives: To analyze the rate and indications of caesarean section in primigravida. Study Design: Descriptive study. Setting: Government Sardar Begum Hospital Sialkot. Period: 1 st January 2017 to 31 st December 2017. Materials and Methods: Inclusion and exclusion criteria were made and all patients which underwent caesarean section were included in the study and all patients delivered vaginally were excluded from the study. A proforma was designed specially to record the different parameters/ information of patients and indications of c-section. Data was analyzed using SPSS version 22. Results: Total caesarean section rate was 40 %, out of which 30.87% were Primigravida and 69.13% were multigravida. Failure to progress was the most common indication and only in 0.47% patients, obstructed labour was an indication of C-section. Conclusion: In primigravida women the prevalence of Caesarean Section is increased which also lead to enhance repeat caesarean section chances and it is not free of risk. It is risk factor for placenta pervia, further, repeat caesarean section adherent morbidly placenta which increased the chances of huge PPH and acute maternal morbidity and mortality.Article Citation: Naeem A, Anwer A, Sajjad S. Caesarean section; indications and rate of caesarean section in primigravida. Professional Med J 2018; 25(9):1338-1341.