Gestational Diabetes (GDM) is becoming more common everywhere around the globe. Objective: To sonographically assess the complications of gestational diabetes in fetuses associated with gestational diabetes during 3rd trimester of pregnancy Methods: A cross-sectional investigation has been carried out in Mother Care Hospital, Gujranwala. All subjects signed an informed consent form in written prior to ultrasound examination. 700 participants were enrolled in this study, among them 60(8.1%) pregnant women during 3rd trimester and at term diagnosed with GDM by glucose tolerance tests as diabetics. Patients were 29.5 years old on average, and the average Gestational age was 30.4 weeks. Estimated fetal weight was derived from ultrasound measures using the Hadlock2 equation. Patients were assessed for eligibility in inclusion criteria. Results: Out of a total of 700 women, 60(8.1%) were diagnosed as GDM and studied. Their minimum age was 21 years and maximum age was 40 years, the mean age was 32±4.04 years. Other studies have found that increasing maternal age is connected with an increase in the prevalence of GDM. Among the studied cases, most frequent complication was macrosomia 27(45%) and 12(20%) have no fetal complication by GDM. LGA 7(11.7%), polyhydramnios 5(8.3%), SGA and placental changes 3(5%), SGA 2(3.3%) and placental changes 2(3.3%) was evaluate. Conclusion: 8.1 percent of pregnant women were diagnosed with GDM. The majority of the ladies were beyond the age of 25 and had many children. Macrosomia and Polyhydramnios were the most prevalent fetal complications, hence caesarean surgery was a typical technique of birth.

The frequency of caesarean sections has been gradually increasing in the past several decades. The usage of transperineal ultrasound (TPU) has been increasing. Many studies have demonstrated that TPU can provide valuable information for the clinician. Objective: To assess the role of transperineal ultrasound in fetal head engagement as indication of caesarean section taking mode of delivery as gold standard. Methods: A cross-sectional study was carried out in Radiology Department of Nawaz Medicare and DHQ hospital, Faisalabad. Written consent was taken from all patients before the ultrasound examination. Patients were assessed for eligibility in inclusion criteria. Confirmation of intrauterine living pregnancy, placenta site, fetal presentation, liquor amount and gestational age was done with routine obstetric ultrasound. Enrolled pregnant patients at term were assessed for the fetal head-perineal distance and cervical length by TPU  examination. Results: One hundred and twenty-four (124) women participated in the investigation. Maternal age and gestational age were not determinants of outcomes of labor. Fetal head-perineal distance measured by TPU had a test sensitivity of 88.31 %, specificity of 78.72 %, the positive predictive value is 87.18%, the negative predictive value is 80.43% and diagnostic accuracy is 84.68%. Conclusions: The findings of this study shows that head perineal distance measured by TPU have higher sensitivity and is a non-invasive method which provides valuable objective measurements for fetal head engagement in primigravida at term and can be easily accepted and tolerated by women. Also, unnecessary caesarean section rate can be reduced by timely decision.