Ovarian and uterine ultrasonography in healthy girls between birth to 18 years.

The aim of our study was to determine the pattern of female reproductive organ growth in Indian girls from birth to 18 years of age and to correlate the uterine length, mean ovarian volume (MOV) and Fundo Cervical Ratio (FCR) with chronological age, bone age and pubertal breast staging. A cross sectional study was performed on 218 girls from birth to 18 years of age. Height, weight, stage of puberty, X-ray for bone age and transabdominal ultrasounds were performed on all girls. Higher chronological age, bone age and increase in breast stage significantly predicted higher MOV (P < 0.001) and higher uterine length (P < 0.001). The MOV, uterine length and FCR are positively correlated with chronological age, bone age, height, weight and breast staging. Data from present study may be useful in screening cases of precocious puberty and other disorders that may need further evaluation.

The many faces of cysticercosis.

Cysticercosis in humans results from infestation with the larval stage of the parasite Cysticercus cellulosae of the tapeworm Taenia solium. Man normally acts as a definitive host. However, man can occasionally be the intermediate host, when cysticercosis becomes clinically manifest. Larvae lodge in the target organs, the brain, eyes, spine and skeletal muscles, where their appearances are highly suggestive or specific. We present a spectrum of such images, as encountered in Western India.

Low midpregnancy placental volume in rural Indian women: A cause for low birth weight?

OBJECTIVE: We sought to study midpregnancy placental volume in rural Indian women, its maternal determinants, and its relationship to neonatal size. STUDY DESIGN: We performed a prospective community-based study of maternal nutrition and fetal growth in 6 villages near the city of Pune. Measurements included midpregnancy placental volume determined by means of ultrasonography at 15 to 18 weeks' gestation, maternal anthropometric measurements before and during pregnancy, and maternal blood pressure and biochemical parameters during pregnancy. Neonatal size and placental weight were measured at birth. RESULTS: The mothers were short and underweight (mean height, 1.52 m; weight, 42 kg; body mass index, 18 kg/m(2)) and produced small babies (mean birth weight, 2648 g). Midpregnancy placental volume (median, 144 mL) was related to the mother's prepregnancy weight (r = 0.15; P <.001) but not to weight gain during pregnancy, blood pressure, or circulating hemoglobin, ferritin, red blood cell folate, or glucose concentrations. Midpregnancy placental volume was related to placental weight at birth (r = 0.29; P <.001) and birth weight (r = 0.25; P <.001) independent of maternal size. CONCLUSION: In Indian mothers midpregnancy placental volume is significantly associated with prepregnant maternal weight and is an independent predictor of birth weight. Our findings may provide clues to the high prevalence of low-birth-weight infants in India.

Prenatal diagnosis with ultrasound of anomalous course of the umbilical vein and its relationship to fetal outcome.

Diagnosis of three types of anomalous course of the umbilical vein (UV) was made in 10 cases using antenatal ultrasound (US). Pulsed wave (PW) Doppler ultrasound was used to evaluate the UV in all cases. In one case, the UV was directly joining the superior vena cava (SVC) without forming subcutaneous collaterals, an abnormal course of UV not yet reported previously. Of these ten fetuses, six had various associated anomalies, including three fetuses with central nervous system (CNS) abnormalities.

Ultrasonography of the brain in preterm infants and its correlation with neurodevelopmental outcome.

Two hundred and eighteen preterm neonates had ultrasonography (USG) brain done on third, and/or seventh and fourteenth day of life. Fifty eight (26.3%) had intraventricular/ periventricular hemorrhage, 3 had parenchymal lesions. 46 had Grade I hemorrhage, 9 had Grade II, 2 had Grade III and 1 had Grade IV hemorrhage. Grade III and IV hemorrhages occurred in neonates below 34 weeks gestation. There was an inverse relationship between gestation age and hemorrhage (p = 0.0001). A comparison of incidence of hemorrhage between preterms who were appropriate for gestational age was not significant. Out of the 63 neonates who had serial USGs on the third and seventh day of life, 15 of the 16 bleeds (94%) were detected on the third day itself, indicating it to be a opportune time for doing an USG. USG at term (40 weeks postconceptual age) was done in 99 infants to see if it could correctly predict the neurodevelopmental outcome using the Bayley Scales of Infant Development. Out of these 99 infants, 72 came for the developmental assessment at one year. One neonate who had periventricular leucomalacia with cystic changes on USG at term, was grossly abnormal with cerebral palsy and mental retardation. Six infants showed delayed development with a mean mental development quotient of 79.1 +/- 1.72 at 2 years. The specificity of USG at term for predicting outcome was 89.2% and negative predictive outcome was 90%, indicating that a normal USG at term predicted a good neurodevelopmental outcome.

Evaluating bilharzial ureteropathy for surgery.

In a study of 115 ureters showing chronic bilharzial changes, 4 main patterns of ureteropathy are defined. Type A is benign, shows mild fusiform dilatation localised to the distal ureteric segment and requires no surgery. Type B presents with distal ureteric stricture, without extensive fibrosis, is rare, and shows good results following resection and ureterovesical reimplantation. Type C shows extensive bilharzial changes without stricture and is difficult to evaluate unless fluoroscopy is added to standard urographic investigation. If peristaltic dysfunction is severe, these ureters will require placement with an ileal segment. Type D ureteropathy presents with fixed tortuosity, mainly in the upper ureteric segment, and conservative surgery, involving freeing and straightening the entire ureter, has shown good results. Staging the presenting ureteropathy has proved valuable in evaluation and follow-up.