Background: Bullying and peer victimization among adolescents are growing public health concerns that affect victims' emotional well-being, and their social and academic functioning. Despite concerns about this public health epidemic in low-and middleincome countries, most prevalence, policy and intervention studies have been conducted in developed countries and economies.
Background: Cesarean section (CS) has become a frequent practice in the recent years while this increase has been seen in developing as well as developed countries. The aim of current study was to determine the frequency of lower segment cesarean section (LSCS) along with indications of LSCS in multiparous women with previous normal deliveries. Methods: This was a cross sectional study, done at the Department of Gynaecology & Obstetrics, Nishtar Hospital, Multan, from 20th July 2018 to 20th January 2019. A total of 222 pregnant women with live singleton pregnancy at term with gestational age between 37 to 41weeks and multipara with no previous LSCS were included in the study. The decision to undertake LSCS if indicated was made in every case after complete assessment. Data was collected for frequency of LSCS and its indications in shape of fetal distress, antepartum hemorrhage and malpresentation. Results: Mean age was 32.720±1.96 years, mean height 1.551±0.11 meters and mean BMI was 27.855±3.14 Kg/m2. Most women were 31-35 years (90.5%) of age and 2-4 parity (89.2%). Primary caesearen section was seen in 43 patients (19.4%). Indications for primary caesarean section were malpresentation 27.9%, fetal distress 41.9% and antepartum hemorrhage 30.2%. Conclusion: The frequency of LSCS in multiparous women with previous normal deliveries was noted to be 19.4%. Fetal distress turned out to be commonest indication for primary caesarean followed by antepartum hemorrhage and malpresentation.
Objective: To determine the frequency of perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) in pregnant diabetic women with low and high plasma glucose levels between 36-40 weeks. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynaecology, DHQ Hospital, Lodhran. Period: 2017 to 2019. Material & Methods: Total 285 diabetic women of age 25-40 years with singleton pregnancy of gestational age 36-40 weeks were selected. Patients with multiple pregnancies, GDM, renal disease and hypertension were excluded. Plasma glucose levels (fasting & 2 hour post-prandial) measured and mean values (fasting + postprandial/2) calculated. The mean values falling between 100-139 mg/dl were taken as low plasma glucose level where as ≥140 mg/dl noted as high plasma glucose level. The perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) were assessed at the time of delivery. Results: Mean age was 29.44 ± 6.01 years. Mean plasma glucose levels were 109.77 ± 6.81 mg/dl. Perinatal outcome i.e. macrosomia, large for gestational age infants and birth asphyxia was found in 7.72%, 27.37% and 22.81% respectively. In this study that pregnant women with mean plasma glucose of 100-139 mg/dl showed frequency of macrosomia by 3.59%, large for gestational age 16.17% and birth asphyxia 14.35% while women with mean plasma glucose of ≥140 mg/dl showed frequency of macrosomia by 13.56%, large for gestational Age 43.22% and birth asphyxia 34.75%. Conclusion: Pregnant diabetic women with high plasma glucose levels have significantly high percentage of large for gestational age, birth asphyxia and macrosomia as compared to diabetic mothers with low plasma blood glucose levels. Consider diabetic mothers at risk and implement efficacious treatment in order to reduce the perinatal complications.
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