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Objective: To assess the control of gestational diabetes with metformin and to study maternal and fetal outcome in patients using metformin. Study Design: Cross Sectional study. Setting: Department of Obs & Gynae, Independent University Hospital. Period: September 2019 to July 2021. Material & Methods: Eighty six patient diagnosed as having gestational diabetes mellitus by oral glucose tolerance test included in study and Metformin used as first line therapy along with diet for control of blood sugar levels. While patients with insulin dependent diabetes and type 2 DM were excluded from study. Results: It was observed in study, that with metformin use glycemic control was excellent in 70 (81.3%) of patients. Maternal outcome like risk of maternal weight gain>10kg, preeclampsia, and premature births were low in patient usung metformin in pregnancy and as well as neonatal risk of macrosomia, prematurity, neonatal hypoglycemia and need for hospital admission were low with the use of metformin in patients suffering from gestational diabetes. Conclusion: GDM associated adverse outcome for mother like maternal weight gain, pregnancy induced hypertension operative delivery and neonate like macrosomia, birth trauma, neonatal hypoglycemia are well controlled by the use of life style modification and metformin use in almost >80 % of cases only in few cases there is additional need of insulin therapy. Maternal and fetal outcome found to be satisfactory with the use of metformin. Further studies are required to build a more confidence.

Post term pregnancy is used to describe pregnancy that continues for 294 days or more following the first day of last menstrual period. Post term pregnancy has been considered to occur in 10-20 % of all pregnancies. PGE2 have been used vaginally for induction of labour for the last two decades. Routine induction of labour after 41 weeks gestation appears to reduce perinatal mortality. Objectives: The study was done to: 1) To calculate the induction -delivery time with prostaglandins E2 in prolonged pregnancy. 2) To find frequency of normal vaginal delivery versus caesarean section after induction with prostaglandins E2. Study design: It was descriptive study. Setting: It was study of fifty patients carried out in Gynae unit 1 Allied Hospital Faisalabad. Period: 03 March 2005 to 02 March 2006. Subjects: Inclusion Criteria: 1) All patients with prolonged pregnancy of more than forty two weeks were included. 2-Only singleton pregnancies were included. Exclusion criteria: 1-Patients who had previous caesarean section were excluded from the study. 2) Patients who had associated obstetric condition that modify the mode of delivery were excluded. Data collection procedure: Detailed history and examination was carried out with availability of dating ultrasound to ascertain dates. Bishop score assessed. Tests of foetal well being carried out. After informed consent induction of labour carried out with prostin E2, and effect studied on induction -onset and delivery intervals and mode of delivery.

Introduction: Placenta praevia is a major cause of maternal & fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. Objectives: I). To Find out major risk factors and maternal complications in major degree placenta praevia. II). Know perinatal outcome in major degree placenta praevia. Study Design & Techniques: It is a descriptive study. Patients were selected by simple random sampling techniques. Settings: The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Subjects & Method: Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. Results: In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Conclusions: Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born.