Background: Caesarean delivery is one of the most commonly performed operations today. Caesarean births have become safer. Primary caesarean section in a multipara means first caesarean section done in the patients who had delivered vaginally once or more. Mainly the baby and the placenta are responsible for caesarean section in multipara. Methods: It was a prospective randomized hospital based study of primary caesarean sections performed in multiparous patients at Dhiraj General Hospital at the Department of Obstetrics and Gynecology. In this study analysis of the cases in relation to different factors have been done. Results: Amongst the various indications for caesarean section in multipara, fetal distress (25.58%) and antepartum hemorrhage (22.09%) were with the highest incidence. Conclusion: Previous vaginal delivery gives the patient as well as her relatives a false sense of security. There are many cases where a caesarean becomes mandatory for her. The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic-criteria for spontaneous delivery of the pregnancy at hand. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 320-324

Background: Gestational diabetes (GDM) represents carbohydrate intolerance first discovered in pregnancy, occurs in 3.8-21% of pregnancies. Postpartum glucose intolerance returns to normal in majority. However, there is high risk of developing impaired glucose tolerance or overt diabetes mellitus later in life. Balanced diet at proper time can help achieving glycemic control. It also helps women with GDM to avoid need for insulin reducing costs of treatment.Methods: Study was done in Dhiraj Hospital in Obstetrics and Gynecology department. Study duration was 1.5 years. It was a prospective study comprising of patients who came with raised blood glucose levels on their 1st visit.Results: Prevalence of GDM (2.87%) is observed to be comparable to various other centres. Highest number of GDM cases was observed in age group of 26-30 years (62.96%). Control of glycemia with diet could be achieved in majority of women (53.85%) at 3 months post-partum as reflected by FBS levels. Incidence of Macrosomia (29.63%) and LSCS (77.78%) could not be lessened by glycemic control with diet in women with GDM.Conclusions: Prevalence of GDM was comparable to that of other studies. Rate of caesarean section was very high and main indications being foetal distress and cephalopelvic disproportion. Maternal and perinatal morbidity increases as duration of GDM increases. Control of glycemia with dietary treatment can help reduce occurrence of complications in mother and baby. It requires proper compliance, absence of which calls for need of insulin in most of patients with uncontrolled glycemia since first.

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Granulosa cell tumor is a sex cord-stromal tumor of the ovary derived from non-germ elements. These lesions occur most frequently in menopausal or postmenopausal women and its association with endometrial carcinoma is seen only in less than 5% of these cases. We herein report a rare case of adult type granulosa cell tumor of the ovary with coexistent endometrial adenocarcinoma in a 35 year old, married Indian female