Background: GDM is associated with increased risk of complications for both mother and fetus both during pregnancy as well as in the postpartum period. Screening for GDM is important to improve short and long term maternal and fetal outcomes. The main purpose of this review is to provide an update on screening for GDM. As per DIPSI criteria women can be diagnosed to have GDM in the first trimester, if the 2hour 75gms OGTT IS 140-199 mg/dL. A prospective observational study with 300 cases was conducted for a period of 1year and 11months (December 2012-2014) in VIMSAR Burla, Sambalpur.Methods: Universal screening was applied by means of DIPSI. Analysis was done by means of t-test, Odd’s ratio, chi squire test. P<.05 was taken as significant.Results: In the present study, 25 cases were diagnosed as GDM with an incidence of 8.33%. Hypertensive disorders of pregnancy (HDP) was found significantly associated with GDM cases (p value 0.02). The mean birth weight in women with GDM (3.05±0.47Kg) was higher than in women with non-GDM (2.65±0.43 Kg). Overall the macrosomia (≥4Kg) rate was 0.67% with 8% in case of GDM mothers. Not a single case of congenital fetal anomaly was detected in the GDM group under our study 20% of the GDM group had their babies admitted to NICU as compared to 17.65% of the non-GDM group (p value 0.76).Conclusions: Women with GDM are at an increased risk for adverse obstetrics and perinatal outcomes. Due to high prevalence of GDM in India early universal screening is essential. Screening for glucose intolerance during the early weeks of pregnancy is beneficial as this policy would help in identifying undiagnosed diabetes prior to conception and to render appropriate care. Screening and diagnosis of GDM with a single test procedure of 75g 2hr PGBS in a non-fasting woman i.e. following DIPSI guidelines is found to be effective, simple, economical and feasible.

BACKGROUNDHysterectomy is the most common surgery done in the gynaecological world. With the introduction of vaginal route for hysterectomy for non-descent uteri, gynaecologist have found a way of hysterectomy without any scar on abdomen, hence it is also called scarless hysterectomy. Aim-Assessment of characteristics of patient and the uterus as well as recognising the most common and uncommon indications for hysterectomy via vaginal route in non-descent uteri. MATERIALS AND METHODSTotal number of vaginal hysterectomies for non-prolapsed uteri for benign causes, done at tertiary hospital, in a period of 21 months from September 2012 to May 2014 were prospectively studied for their indication, accessibility and safety for the procedure. RESULTSAmongst 127 women who underwent vaginal hysterectomy for non-descent uteri, 46 (36.2%) were operated for dysfunctional uterine bleeding followed by adenomyosis in 32 (25.2%) followed by fibroid in 30 patients (23.6%) and endometriosis in 3 (2.3%) cases. 5 (3.9%) cases were having uterine size larger than 16 weeks. 13 (10.2%) of cases had previous caesarean section and 64 (50.4%) had bilateral tubal ligation. 3 (2.3%) women were nulliparous. Oophorectomy was done as an associated surgery in 14 (11.02%) cases. Vaginal route was changed to laparotomy in 1 (0.7%) case for intraoperative haemorrhage and pelvic adhesion. Rectovaginal fistula occurred in 1 (0.7%) case. No deaths were recorded within the study period. Mean duration of surgery was 45 min. + 23 min. Mean hospital stay was 72 hours + 24 hours. CONCLUSIONNon-descent scarless vaginal hysterectomy is safe with wide range of indications avoiding the need for open method or assisted laparoscopic method. More and more skill development programs in non-descent vaginal hysterectomy are required to increase the indications of non-descent vaginal hysterectomy in gynaecological world.