Placental Migration And Its Role In Prediction Of Route Of Delivery

Introduction: The presence of a lowlying in the second trimester of pregnancy can be converted to an upper uterine segment placenta by the end of the third trimester. This phenomenon is important when a complete or marginal placenta previa is encountered in the second trimester of gestation because of the need to predict possible antepar-tum complications and mode of delivery. Aim:To examine the migration of placenta and the placental marginal sinus to predict the eventual route of delivery in low-lying placenta. Methodology:Women with a low-lying placenta with 30 weeks of gestation were included for study. The distance between the internal os and leading edge of the placen-ta was measured fortnightly using transvaginal ultrasonography until 36 weeks gestation. The relationship between the rate of placental migration, the presence of a placental marginal sinus and the eventual mode of delivery was investigated. Results:In the present study cesarean section rate was 60 % (39/65) in the slow migration group (0 –2.0 mm/week) group, six patients (6/35) in the fast (more than 2.0 mm/week) migration group underwent a cesare-an section (p < 0.01) because of other problems. The cesarean section rate was 75.9 % (22/29) in patients with a pla-cental marginal sinus, significantly greater than the rate of 11.3 % (8/71) in patients without a marginal sinus (p < 0.01). Conclusion:A decreased rate of placental migration until 36 weeks’ gestation and the presence of a placental marginal sinus were associated with subsequent cesarean delivery because of antepartum vaginal hemorrhage. These parameters may be useful for predicting the route of delivery in women with a lowlying placenta.

Evaluation Of Renal Stones By Computed Tomography And Its Correlation With Urine Ph And Biochemical Analysis

Introduction: The aim of the study is to assess the composition of renal stones by non chemical analysis that is by use of computed tomography (CT) values in Hounsfield Units (HU) and to compare the results of biochemical stone analysis collected post surgically done in biochemistry lab. Methodology: This is a prospective study, included pa-tients in age group of 25 –60yrs. Patients who were referred to radiology department from Urology and also pa-tients referred from surgery with complaints of loin pain, groin pain, hematuria, crystalluria were recruited for the study. About 100 patients were screened with first line modality of ultrasound evaluation for identifying the pres-ence of stone in kidney, later on positive confirmation from ultrasound evaluation they were further subjected to CT scan evaluation. “Urine was collected from all the patients with renal stones and urine pH was measured. Stones collected post surgically were used for the biochemical analysis to know the chemical composition of the stonesRESULTS: The stone removed from the patients of this group contain high calcium content. Most of the stones re-moved from bladder comprises two categories 1.uric acid (mainly) 2.large stones more than 20 mm size were proved to be calcium stones possibly related to greater sunlight exposure, resulting in increase in insensible fluid losses and increase in vitamin D production. We obtained a reference from hounsfield units value from stones collected post surgically from the urological department. The stones are categorized into three types -Pure highly reflective crystal-line white stones, Stones which appears most mostly black, Complex mild yellow stones. Conclusion: CT may enable accurate in vivo characterization of kidney stone composition.